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Geetha SD, Abdelwahed M, Edelman MC, Buyuk A, Gordon D, Arvind R. A Rare Case of Intraosseous Papillary Hemangioma of the Head and Neck. Int J Surg Pathol 2024; 32:418-421. [PMID: 37306145 DOI: 10.1177/10668969231180282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Papillary hemangioma is a novel variant of intravascular hemangioma. It is more common in adults and has a male predominance. Most tumors reported so far are solitary and cutaneous. Here we present a rare case of an intraosseous papillary hemangioma involving the frontal bone. Brain imaging in a 69-year-old man with a slowly enlarging swelling on the right frontal area following an accidental fall demonstrated a 4.5 cm × 1.7 cm × 4.2 cm mass originating from the right frontal bone, with a tiny defect on the orbital roof. A malignant process was favored, and the mass was removed. Histopathology revealed a vascular lesion showing intraosseous distribution with foci of extension into the fibrous connective tissue. There were areas of plump endothelial cells with intracytoplasmic hyaline globules arranged in papillary configuration. The lesional cells were immunoreactive with CD34. AE1/AE3, EMA, PR, D2-40, inhibin, and S100 stains were negative. Ki-67 was low. This is the first intraosseous and second noncutaneous papillary hemangioma. Clinically it differs from other cases by the presence of trauma as a preceding event. Since its prognosis is unknown such patients should be monitored for recurrence or malignant transformation.
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Affiliation(s)
- Saroja D Geetha
- Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
| | - Mohammed Abdelwahed
- Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
| | - Morris C Edelman
- Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
| | - Arzu Buyuk
- Department of Pathology, Northern Westchester and Phelps Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
| | - David Gordon
- Department of Neurosurgery, Northern Westchester and Phelps Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
| | - Rishi Arvind
- Department of Pathology and Laboratory Medicine, North Shore University Hospital and Long Island Jewish Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Greenvale, NY, USA
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2
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Wald L, Howell D. Bilateral Conjunctival Masses in a 5-Year-Old Patient. Clin Pediatr (Phila) 2024; 63:279-281. [PMID: 37050892 DOI: 10.1177/00099228231168453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- Lindsay Wald
- University of Florida College of Medicine, Gainesville, FL, USA
| | - Diane Howell
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
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3
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Abdo M, Dykstra JA, Meyer A, Dai H. Giant papillary hemangioma-A rare tumor with an exceptional size. J Cutan Pathol 2024; 51:140-145. [PMID: 37916657 DOI: 10.1111/cup.14554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/01/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
Papillary hemangioma (PH) is a recently described vascular tumor with a predilection for the skin of the head and neck. Histopathologically, it is characterized by a bland endothelial proliferation arranged in a papillary configuration, bearing resemblance to glomeruloid hemangioma seen in the context of polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes syndrome. The largest cutaneous PH reported to date measured 1.5 cm in greatest dimension. Here, we report a case of PH with an alarming size of 10 cm. We present this case to add to the limited literature on this rare tumor, highlight the histopathologic differences between PH and its mimics, and emphasize the variable nature of PH tumor size.
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Affiliation(s)
- Maryam Abdo
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jordan A Dykstra
- Division of Dermatology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Anders Meyer
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hongyan Dai
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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Gapizov A, Sidhu HK, Affaf M, Safdar S, Irfan R, Ekhator C, Saddique MN, Devi M, Silloca Cabana EO, Kamran M, Bellegarde SB, Hussain I. Unraveling Intravascular Lobular Capillary Hemangioma: A Comprehensive Scoping Review. Cureus 2023; 15:e45142. [PMID: 37711265 PMCID: PMC10498483 DOI: 10.7759/cureus.45142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 09/16/2023] Open
Abstract
This scoping review focuses on intravascular lobular capillary hemangioma (ILCH), a rare and distinct subset of lobular capillary hemangioma (LCH). This study provides a comprehensive overview of ILCH, delving into its clinical characteristics, origins, pathogenesis, diagnostic methods, treatment options, and outcomes. Despite its rarity, ILCH presents unique diagnostic and management challenges due to its intravascular origin. The review emphasizes the importance of accurate differentiation from other vascular lesions and underscores the need for histopathological confirmation. This article discusses the presentation of ILCH in the reported literature. The pathogenesis remains uncertain, with factors such as trauma, inflammation, hormonal changes, and medications being considered potential contributors. Histopathological features, imaging techniques, and diagnostic tools are discussed, highlighting the distinct histological architecture of ILCHs and the importance of immunohistochemical staining for accurate diagnosis. Surgical excision is the primary approach for managing ILCH due to its potential complications, including superior vena cava (SVC) occlusion and thrombosis. This review concludes by outlining potential directions for future research, including investigating genetic and molecular mechanisms underlying ILCH development, developing targeted therapies, building patient registries for collaborative efforts, and exploring minimally invasive surgical techniques. The importance of long-term patient outcome studies and international collaborations is emphasized to enhance our understanding of this rare vascular anomaly.
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Affiliation(s)
- Abubakar Gapizov
- Department of General Surgery, American University of Antigua, St. John's, ATG
| | - Harmandeep K Sidhu
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, IND
- Department of Medicine and Surgery, Indira Gandhi Medical College and Hospital, Nagpur, IND
| | - Maryam Affaf
- Department of Medicine and Surgery, Women Medical and Dental College, Abbotabad, PAK
| | | | - Rabbia Irfan
- Department of Internal Medicine, Mayo Hospital, Lahore, PAK
| | - Chukwuyem Ekhator
- Department of Neuro-Oncology, New York Institute of Technology, New York, USA
| | | | - Monika Devi
- Department of Medicine, Ziauddin University, Karachi, PAK
| | | | | | - Sophia B Bellegarde
- Department of Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG
| | - Iqbal Hussain
- Department of Internal Medicine, Khyber Medical University, Peshawar, PAK
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Agrawal S, Fritchie KJ, Fernandez AP, Ko JS, Bergfeld W, Rubin BP, Billings SD. The capillary lobule variant of radiation-associated angiosarcoma in the setting of breast cancer: A diagnostic pitfall. J Cutan Pathol 2023; 50:140-146. [PMID: 36107728 PMCID: PMC10091944 DOI: 10.1111/cup.14328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/11/2022] [Indexed: 01/24/2023]
Abstract
AIM Post-radiation angiosarcoma is an iatrogenic event seen in the setting of breast cancer treatment. Histopathologically, there are morphologic variants of angiosarcoma that mimic benign entities, including the capillary lobule variant of post-radiation angiosarcoma. We present the largest case series to date of this histopathologic variant of post-radiation angiosarcoma. METHODS AND RESULTS Cases of the capillary lobule variant of post-radiation angiosarcoma from institutional/consultation archives from 2008 to June 2022 were reviewed. For inclusion, tumors had to occur in irradiated skin and exhibit a multi-lobular proliferation of tightly packed capillary-like vessels, as previously described in this variant. Prior ancillary studies were also reviewed. Eight cases met the criteria. All occurred in women treated with radiation for breast cancer (median age 75 years). All cases had similar findings, including a multi-lobular proliferation of tightly packed vessels, infiltrative cords, and atypical single endothelial cells. A conventional angiosarcoma pattern was also seen in five cases. All cases tested were positive for vascular markers (CD31, CD34, and/or ERG) and MYC. MYC amplification was shown by FISH in all cases tested. Smooth muscle actin (SMA) was positive in pericytes in the capillary lobules in all five cases tested and areas of conventional angiosarcoma in two of three cases. CONCLUSIONS The capillary lobule variant of angiosarcoma is a rare and therefore potentially under-recognized variant of post-radiation angiosarcoma. The lobular architecture and SMA positivity may mimic benign vascular proliferations. Careful attention to histopathologic features and ancillary tests may facilitate accurate diagnosis.
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Affiliation(s)
- Shruti Agrawal
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Jennifer S Ko
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Wilma Bergfeld
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Brian P Rubin
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA
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Abstract
PURPOSE The angular vein extends between the supraorbital and supratrochlear veins superiorly and the facial vein inferiorly. Rarely, this vessel can be involved by infections, vascular malformations, or benign tumors. In this study, we report both our experience and the published literature on angular vein disorders. METHODS A retrospective study was performed on patients seen between 2008 and 2022. The medical literature was searched for reports of conditions affecting the angular vein. RESULTS During the study period, we encountered 5 patients with angular vein disorders. Information from these patients was combined with 18 published cases. Among the 23 patients, the diagnosis was confused with lacrimal drainage abnormalities in 52%, and 57% underwent imaging. "Swelling" or a palpable, moveable mass were frequent findings. Pain or tenderness was experienced by 43.5% of patients. Five patients were observed, and 2 infections were treated with antibiotics. The remaining 16 lesions were successfully treated with excision (n = 15) or cauterization (n = 1), without complications. Final diagnosis included 14 vascular malformations (isolated varix: 7, thrombosis: 6, cavernous venous malformation: 1), 7 vascular tumors (intravenous pyogenic granulomas: 6, intravascular papillary endothelial hyperplasia: 1) and thrombophlebitis (n = 2). CONCLUSIONS Disorders of the angular vein are uncommon and frequently misdiagnosed as lacrimal abnormalities. While these lesions can frequently be identified on clinical findings, imaging can be helpful in some cases. Patients with suspected thrombophlebitis require urgent antibiotic therapy. Minimally symptomatic angular vein lesions can be observed. Surgical excision is effective in treating the different vascular malformations and tumors affecting this structure.
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Affiliation(s)
- Philip L Custer
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences
| | - Tiffany C Ho
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences
| | - Fouad Boulos
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, U.S.A
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Ohashi T, Kawago M, Hirai Y, Kiyoi M, Miyasaka M, Yata Y, Kawaji M, Fusamoto A, Iguchi H, Nakanishi H, Nishimura Y. Resection of a capillary haemangioma using robotic-assisted thoracic surgery: A case report. Respirol Case Rep 2022; 10:e0899. [PMID: 35035979 PMCID: PMC8753499 DOI: 10.1002/rcr2.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/29/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
Capillary haemangioma is a rare condition that is difficult to diagnose preoperatively because of its rarity and nonspecific imaging findings. In this report, we describe a case of capillary haemangioma diagnosed by robot-assisted thoracic surgery (RATS). A 72-year-old man was incidentally found to have an anterior mediastinal tumour on chest computed tomography. The preoperative imaging findings were indicative of thymoma, and surgical treatment by RATS was selected. The intraoperative findings suggested that the tumour was a haemangioma originating from the pericardiophrenic vein. The pathological findings revealed a well-defined tumour with capillaries in a vascular-like structure and some thrombus formation. The pathological diagnosis was capillary haemangioma. The patient was discharged unaided at 7 days postoperatively and no recurrence was observed at 16 months postoperatively.
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Affiliation(s)
- Takuya Ohashi
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Mitsumasa Kawago
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Yoshimitsu Hirai
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Megumi Kiyoi
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Miwako Miyasaka
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Yumi Yata
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Mari Kawaji
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Aya Fusamoto
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Hideto Iguchi
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Hitomi Nakanishi
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
| | - Yoshiharu Nishimura
- Department of Thoracic and Cardiovascular SurgeryWakayama Medical UniversityWakayamaJapan
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Roy RR, Shimada K, Hasegawa H. A Case of Oral Glomeruloid Hemangioma Without Systemic Conditions. Cureus 2022; 14:e21705. [PMID: 35145824 PMCID: PMC8803383 DOI: 10.7759/cureus.21705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2022] [Indexed: 11/05/2022] Open
Abstract
Glomeruloid hemangioma is a rare variant of hemangioma that is accompanied by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin abnormalities (POEMS) syndrome and, rarely, by thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome. This report presents the case of a 78-year-old male who presented with a hemorrhagic nodule on the tongue without any other systemic diseases. Microscopically, the lesion was a lobular proliferation extending from the lamina propria to muscular tissue. Some intravascular nodules with irregular vascular lumens closely resembled renal glomeruli. Each nodule consisted of plump endothelial and stromal cells that partially showed vacuolated cytoplasm containing eosinophilic and periodic acid-Schiff (PAS)-positive globules. Immunohistochemically, IgG-positive deposition was noted within CD31-positive cells. Many plump stromal cells were positive for CD31, CD146, nestin, and type IV collagen but not α-smooth muscle actin (αSMA). These results reflect the proliferation of immature endothelial cells and pericytes, which might characterize this unique lesion. Microscopically, this case revealed glomeruloid hemangioma without systemic conditions related to POEMS, and composed of an intravascular proliferation of immature endothelial and pericytic stromal cells.
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Xing X, Liu J, Xu S, Deng Y, Yang J. Research advances in Dieulafoy's disease of the bronchus (Review). Exp Ther Med 2022; 23:100. [PMID: 34976142 PMCID: PMC8674951 DOI: 10.3892/etm.2021.11023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Dieulafoy's disease is characterized by abnormal submucosal arteries and results in acute luminal hemorrhage. Dieulafoy's lesions can also be found in the submucosa of the bronchus. Due to its low incidence rate and non-specific clinical symptoms, Dieulafoy's disease is easy to overlook, but can lead to massive bleeding and high rates of mortality. Therefore, improvements in the understanding of the disease are necessary. The awareness of the disease and associated diagnostic and treatment techniques have continued to improve, and thus, an increasing number of cases of Dieulafoy's disease of the bronchus have been reported. In the present review, 74 cases of Dieulafoy's disease are summarized. New technologies such as endobronchial ultrasound, narrow-band imaging, angiography and argon plasma treatment have been found to be increasingly applied to diagnose and treat Dieulafoy's disease of the bronchus. Therefore, the primary focus of this systematic review is to highlight advances in the diagnosis and treatment of bronchial Dieulafoy's disease.
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Affiliation(s)
- Xiqian Xing
- Department of Respiratory Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650021, P.R. China
| | - Jie Liu
- Department of Respiratory Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650021, P.R. China
| | - Shuanglan Xu
- Department of Respiratory Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650021, P.R. China
| | - Yishu Deng
- Department of Respiratory Medicine, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, Yunnan 650021, P.R. China
| | - Jiao Yang
- First Department of Respiratory Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
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Kaiser B, Chijioke O, Bruder E, Takes M, Haug M, Mende K. Infraorbital Subcutaneous Intravascular Lobular Capillary Hemangioma After Rhinoplasty. Ann Plast Surg 2021; 87:239-241. [PMID: 34270467 DOI: 10.1097/sap.0000000000002954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lobular capillary hemangioma (LCH; also referred to as pyogenic granuloma) is a common benign vascular tumor that is characterized by proliferation of capillaries with a lobular architecture. Lobular capillary hemangioma can involve superficial cutaneous, mucosal, or subcutaneous structures; the subcutaneous and intravascular variant is very rare. METHODS A 26-year-old female patient presented with a small infraorbital mass that was slowly growing within the last 6 months. She reported no pain but an uncomfortable feeling of pressure in this area. Six months before symptom onset, the patient had undergone a closed rhinoplasty with osteotomies without any reported complication. RESULTS An excisional biopsy was performed via a transconjunctival approach, and the histopathological findings were characteristic for a subcutaneous intravascular LCH. At the 3-month follow-up, the patient was asymptomatic with no evidence of a recurrent lesion. CONCLUSION To our knowledge, this is the first report of a subcutaneous intravascular LCH after rhinoplasty. We would like to draw the attention of stakeholders to this rare condition and raise awareness among clinicians to what seems to be a late finding after rhinosurgery.
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Affiliation(s)
- Benedict Kaiser
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery
| | | | | | - Martin Takes
- Department of Interventional Radiology, Basel University Hospital, Basel, Switzerland
| | - Martin Haug
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery
| | - Konrad Mende
- From the Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery
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Jing W, Wen X, Zhang M, Zhou C, Huang J, He Y. Ultrasonographic features of an intravascular lobular capillary hemangioma originating in the basilic vein: Case report and literature review. JOURNAL OF CLINICAL ULTRASOUND 2021; 49:741-745. [PMID: 33978977 DOI: 10.1002/jcu.23017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/05/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023]
Abstract
Intravascular lobular capillary hemangioma (ILCH) is a rare variant of pyogenic granuloma, which develops within the lumen of a blood vessel. Here, we report the case of a 38-year-old male presenting with a mobile, incompressible, nonpulsatile nodule in the superficial fascia of the forearm. A first ultrasonographic examination diagnosed the mass as intravascular thrombosis with partial recanalization. Three months later, a second ultrasonographic examination concluded to the existence of an intravascular tumor, which finally turned out at pathological examination to be ILCH. Here, we report the ultrasonographic features of ILCH and the differential diagnosis between ILCH and other intravascular masses like thrombus.
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Affiliation(s)
- Wenli Jing
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaorong Wen
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mei Zhang
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chenyun Zhou
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Huang
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Ying He
- Department of Ultrasound Medicine, West China Hospital, Sichuan University, Chengdu, China
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