Path slide set 2 Flashcards
Treatment for kawasaki
Usually self limited but give IVIG and aspirin
A vascular proliferation in response to gram negative Bartonella bacilli that occurs on skin of immunocompromised patients
Bacillary angiomatosis
Histology of PAN
- Transmural necrotizing inflammation containing neutrophils, eosinophils, lymphocytes, and macrophages
- Fibrinoid necrosis (partial)
- Sites of inflammation NOT circumferential
- NO giant cells or granulomas
Bacillary angiomatosis is visualized how?
with PCR or with a Warthin-Starry stain
morphology for kaposi sarcoma
spindle cells
where is the gender preference for angiosarcoma?
males=females
Vasculitis in which 1/3 of patients have chronic hepatitis and HBsAg-HBsAb complexes are found in involved vessels
PAN
What is the origin of a glomus tumor
Smooth muscle cells
What are the most common vessels affected by microscopic polyangiitis
Renal glomeruli and lung capillaries
Malignant endothelial tumor in older individual that may occur anywhere but is common in skin, soft tissue, breast, and liver
angiosarcoma
Associated with Asthma and allergic Rhinitis
Chung-Strauss Syndrome
How can you differentiate primary from secondary Raynaud phenomenon?
Primary is symmetric and benign course
Secondary is asymmetric and worsens over time
What type of tumor is kaposi sarcoma?
an intermediate vascular tumor
Factor V leiden increases risk of what?
thrombophlebitis
A large lymphangioma of neck or axilla of children
Cavernous lymphangioma (cystic hygroma)
Most cases associated with MPO-ANCA
Microscopic polyangiitis
What is an effective treatment of Bacillary angiomatosis
Macrolide antibiotics
Whats the classic picture of Esophageal varices?
old alcoholic guy with cirrhosis
irregular, dilated vascular channels making a lesion with an indistinct border
Cavernous hemangioma
typical epidemiology for Primary Raynaud phenomenon
young women
What Kaposi is localized to skin, usually the distal lower extremities
Classic
Small vessel necrotizing vasculitis that may resemble PAN of M. Polyangiitis but also has eosinophils and granulomas
Chung-Strauss Syndrome
Histology of microscopic polyangiitis
- segmental necrotizing inflammation with fibrinoid necrosis
- many apoptotic neutrophils usually seen
- “luekocytoclastic vasculitis
Thrombophlebitis almost always involves what?
deep veins in leg - can be completely asymptomatic
Age group classically involved in Polyarteritis nodosa (PAN)
Young adults
has neoplastic endothelial cells that are plump and cuboidal resembling epithelium. Vascular channels may be difficult to recognize
Epithelioid hemangioendothelioma (an intermediate vascular tumor)
Describe the presentation of Thromboangiitis obliterans (Berger disease)
- May lead to vascular insufficiency of extremeties
- Patients are almost always smokers and young adults
- Inflammation may extend to involve adjacent veins and nerves leading to pain
- Chronic ulcerations which may lead to gangrene
What exogenous and endogenous agents may cause myocardial vessel vasospasm or “cardiac Raynaud” and may lead to ischemia or infarct?
Endo: epinephrine
Exog: cocaine
- localized forming red papules
- microscopically a proliferation of capillaries with plump endothelial cells
Bacillary angiomatosis
Necrotizing vasculitis involving arterioles, capillaries and venues
Microscopic polyangiitis
Besides the Aortic arch and it’s branches, what other vessels may be involved in Takayasu?
Pulmonary, Coronary, Renal
what is the molecular marker for angiosarcoma?
CD31
What is a cavernous lymphangioma (cystic hygroma) associated with?
Turner Syndrome
Mucocutaneous lymph node syndrome
Kawasaki
Vessels involved in Polyarteritis nodosa in decreasing frequency
- Renal
- heart
- liver
- GI
3 types of hemangiomas
- capillary
- cavernous
- pyogenic granuloma (lobular capillary hemangioma)
- Aphthous ulcers of oral cavity
- Genital ulcers
- uveitis
Behcet disease
Thin-walled capillaries, well defined and tightly packed together
capillary hemangioma
What therapy is usually effective in PAN?
Immunosuppressive
Associated with HLA-B51
Behcet Disease
A type of capillary hemangioma that is RAPIDLY growing often in oral mucosa where they may ulcerate and often due to trauma to site and healing process
pyogenic granuloma (lobular capillary hemangioma)
Age group for Takayasu Arteritis
Younger than 50
95% associated with PR3-ANCA
Granulomatosis with polyangiitis (Wegener)
A systemic vasculitis that spares pulmonary vessels
Polyarteritis nodosa
epidemiology for Granulomatosis with polyangiitis (Wegener granulomatosis)?
usually middle age males. ave age of 40
Common benign tumor showing a localized increase in neoplastic blood vessels commonly on skin and mucous membranes of head and neck and in liver.
If congenital (juvenile or “strawberry) they often regress
hemangiomas
epidemiology for classic kaposi
older men from middle eastern, mediterranean or eastern european descent
Age group for giant cell (temporal) Arteritis
> 50
4 types of kaposi sarcoma
- AIDS-associate
- Classic
- Endemic African
- Transplant associated
What treatment is usually successsful with Wegeners?
immunosuppressive
Benign tumors arising from glomus bodies and most often appear in distal fingers and PAINFUL
Glomus tumor
Vasculitis typically in small children involving coronary arteries and presenting as erythema of conjunctiva, oral mucosa, palms and soles, rash and cervical lymph node involvement
Kawasaki
sinonasal and pharyngeal inflammation with granulomas and vasculitis and multiply necrotizing granulomas of the lower respiratory tract which may coalesce and cavitate
Granulomatosis with polyangiitis (Wegener granulomatosis)
Acute and chronic THROMBOSING vasculitis of small and medium vessels, especially Tibial and Radial
Thromboangiitis obliterans (berger disease)
Raynaud phenomenon can be secondary to what arterial diseases?
- SLE
- SCLERODERMA
- thromboangiitis obliterans
Migratory thrombophlebitis is particularly seen with what cancer?
mucin-producing adenocarcinomas lung, ovary, and pancreas
-you will probably already know the person has cancer
Vasculitis involving aortic arch and major branch vessels giving diminished pulses of upper extremity
Takayasu arteritis (pulseless disease)
What are cavernous hemangiomas more likely to do than capillary ones?
involve deep tissue and more likely to bleed
What appear very similar to capillary hemangiomas but without RBCs and are on head/neck and axillae
Simple lymphangioma
Histology for Giant cell (temporal) arteritis
- Medial Granulomatous inflammation often with multinucleated giant cells
- Fragmentation of Elastic lamina
- Sites may be patchy and focal
- Healed sites show scarring of media and intimal thickening
Which two Kaposi’s can spread to lymph nodes and viscera?
AIDS and Transplant
