Vascular tumours

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Micrograph showing a capillary hemangioma, a common type of vascular tumour. H&E stain.

This article covers soft tissue vascular tumours. Vascular malformations are covered in the vascular malformations article.

Normal histology

Normal blood vessel histology is dealt with in the vascular disease article.

Mimics

Distinct entities

Hemangioma

Lymphangioma

General

Treatment:

  • Surgical excision.

Microscopic

Features:[2][1]

  • Thin-walled channels lined by endothelium.
  • +/-Eosinophilic intraluminal material.
  • +/-Clusters of intraluminal lymphocytes.
  • +/-Occasional RBCs.

DDx:

Images:

IHC

Features:[3][4]

  • D2-40 +ve.

Kaposi sarcoma

Masson hemangioma

  • AKA intravascular papillary endothelial hyperplasia.[5]
  • AKA Masson tumor.[6]

Angiosarcoma

Kaposiform hemangioendothelioma

General

  • Locally aggressive.[7]
  • Childhood tumour.[8]
  • Approximately half have Kasabach–Merritt phenomenon[8] = vascular tumour --> coagulopathy.

Microscopic

Features:[9]

  • Spindle cells lesions in sheets or nodules.
  • +/-Round tumour nodules - "cannon ball" appearance.

DDx:

IHC

Features:[9]

  • Vimentin +ve.
  • C31 +ve.
  • CD34 +ve.
  • UEA-1 lectin +ve.

Epithelioid hemangioendothelioma

See also

References

  1. 1.0 1.1 1.2 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 12. ISBN 978-0781765275.
  2. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 489. ISBN 978-0781765275.
  3. Kalof, AN.; Cooper, K. (Jan 2009). "D2-40 immunohistochemistry--so far!". Adv Anat Pathol 16 (1): 62-4. doi:10.1097/PAP.0b013e3181915e94. PMID 19098468.
  4. Kahn, HJ.; Bailey, D.; Marks, A. (Apr 2002). "Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas.". Mod Pathol 15 (4): 434-40. doi:10.1038/modpathol.3880543. PMID 11950918.
  5. Korkolis DP, Papaevangelou M, Koulaxouzidis G, Zirganos N, Psichogiou H, Vassilopoulos PP (2005). "Intravascular papillary endothelial hyperplasia (Masson's hemangioma) presenting as a soft-tissue sarcoma". Anticancer Res. 25 (2B): 1409–12. PMID 15865098.
  6. URL: http://path.upmc.edu/cases/case544/dx.html. Accessed on: 25 January 2012.
  7. Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 603. ISBN 978-0781765275.
  8. 8.0 8.1 Lyons, LL.; North, PE.; Mac-Moune Lai, F.; Stoler, MH.; Folpe, AL.; Weiss, SW. (May 2004). "Kaposiform hemangioendothelioma: a study of 33 cases emphasizing its pathologic, immunophenotypic, and biologic uniqueness from juvenile hemangioma.". Am J Surg Pathol 28 (5): 559-68. PMID 15105642.
  9. 9.0 9.1 9.2 Miller, K. (Mar 1991). "Sister-chromatid exchange in human B- and T-lymphocytes exposed to bleomycin, cyclophosphamide, and ethyl methanesulfonate.". Mutat Res 247 (1): 175-82. PMID 1706068. http://www.nature.com/modpathol/journal/v14/n11/full/3880441a.html.