- Transmural necrotizing inflammation containing neutrophils, eosinophils, lymphocytes, and macrophages - Fibrinoid necrosis (partial) - Sites of inflammation NOT circumferential - NO giant cells or granulomas

Path slide set 2 Flashcards by Garrett Gilbert

Treatment for kawasaki

Usually self limited but give IVIG and aspirin

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A vascular proliferation in response to gram negative Bartonella bacilli that occurs on skin of immunocompromised patients

Bacillary angiomatosis

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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

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Bacillary angiomatosis is visualized how?

with PCR or with a Warthin-Starry stain

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morphology for kaposi sarcoma

spindle cells

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where is the gender preference for angiosarcoma?

males=females

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Vasculitis in which 1/3 of patients have chronic hepatitis and HBsAg-HBsAb complexes are found in involved vessels

PAN

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What is the origin of a glomus tumor

Smooth muscle cells

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What are the most common vessels affected by microscopic polyangiitis

Renal glomeruli and lung capillaries

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Malignant endothelial tumor in older individual that may occur anywhere but is common in skin, soft tissue, breast, and liver

angiosarcoma

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Associated with Asthma and allergic Rhinitis

Chung-Strauss Syndrome

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How can you differentiate primary from secondary Raynaud phenomenon?

Primary is symmetric and benign course

Secondary is asymmetric and worsens over time

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What type of tumor is kaposi sarcoma?

an intermediate vascular tumor

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Factor V leiden increases risk of what?

thrombophlebitis

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A large lymphangioma of neck or axilla of children

Cavernous lymphangioma (cystic hygroma)

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Most cases associated with MPO-ANCA

Microscopic polyangiitis

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What is an effective treatment of Bacillary angiomatosis

Macrolide antibiotics

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Whats the classic picture of Esophageal varices?

old alcoholic guy with cirrhosis

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irregular, dilated vascular channels making a lesion with an indistinct border

Cavernous hemangioma

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typical epidemiology for Primary Raynaud phenomenon

young women

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What Kaposi is localized to skin, usually the distal lower extremities

Classic

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Small vessel necrotizing vasculitis that may resemble PAN of M. Polyangiitis but also has eosinophils and granulomas

Chung-Strauss Syndrome

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Histology of microscopic polyangiitis

segmental necrotizing inflammation with fibrinoid necrosis
many apoptotic neutrophils usually seen
“luekocytoclastic vasculitis

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Thrombophlebitis almost always involves what?

deep veins in leg - can be completely asymptomatic

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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