Vascular Flashcards
how are varicose veins produced
prolonged increased intraluminal pressure leading to vessel dilation and venous incompetence
complications of varicose veins
stasis/ brawny induration
congestion
edema
pain
thrombosis
ulceration
poor wound healing
superimposed infection
esophageal varices
hemorrhoids
most common locations of varicose veins
superficial veins of the leg due to dependent pressure
risk factors of DVT
h/o prior emboli
stasis
malignancy
hypercoagulable states
pregnancy/ estrogen use
obesity
smoking
clinical presentation of SVC vs IVC syndrome
SVC: marked dilation od veins in the upper body with cyanosis and respiratory distress
IVC: lower extremity edema with distension of superficial collateral veins of the lower abs; proteinuria
neoplasms that could cause SVC syndrome
bronchogenic carcinoma
mediastinal lymphoma
aortic aneurysm
neoplasms that could cause IVC syndrome
hepatocellular carcinoma
renal cell carcinoma
Define ectasia
expansion of a hollow or tubular organ
define hemangioma
tumor characterized by increased numbers of normal or abnormal vessels filled with blood
define lymphangioma
benign lymphatic counterpart of a hemangioma
most common type of hemangioma
location and morphology
Capillary hemangiomas= most common
found in the skin, subQ tissues, mucosal surfaces, liver, spleen, and kidneys
Morphology: tin walled capillaries with scant stroma
most common hemangioma in newborns
Location
Juvenile/ Strawberry hemangioma
found on the kin of newborns and typically regresses by age 7
significance of cavernous hemangiomas
can compress adjacent structures, bleed, and be cosmetically troublesome
associated with VHL
Morphology: large dilated infiltrative vascular channels separated by connective tissue stroma
what kinds of hemangiomas typically occur after trauma
what do they look like
where are tey found
pyogenic granulomas
Morphology: rapidly growing capillary hemangiomas that appear as red pedunculated lesions
Location: skin, gingival and mucosal surfaces
which lymphangioma is associated with Turner syndrome
Cavernous lymphangioma/ cystic hygroma
Describe glomus tumors
Painful, but benign tumors arising from modified smooth muscle cells of the glomus bodies
Mostly located in the distal portions of the digits and under fingernails
Describe bacilliary angiomatosis
vascular proliferation caused by Bartonella infections. Bacteria induces host hypoxia-inducible factor 1 (HIF-1) which drives VEGF production
grossly appears as red papules/ nodules/ rounded subQ masses
Microscopically, cells exhibit nuclear atypia and mitosis with stroma neutrophils
Describe Kaposi Sarcoma
vascular neoplasm caused by HHV8, associated with AIDS
mostly asymptomatic with red patches confined to lower extremities; patches later spread to become raised nodular plaques
Morphology of Kaposi sarcoma
Patches: irregularly dilated endothelial lined vascular spaces with interspaced lymphocytes, plasma cells, and macrophages
Plaques: dermal accumulations of jagged vascular channels lined and surrounded by plump spindle cells; RBCs, hemosiderin-laden macrophages and mononuclear inflammatory cells scattered between vascular channels
Nodules: sheets of plump proliferating spindle cells around small vessels and slitlike spaces, with marked hemorrhage, hemosiderin pigment and mononuclear inflammation
Demographics of Kaposi Sarcoma
Classic type
Endemic African Type
Classic type: older men of Mediterranean, middle eastern and eastern European descent
Endemic African Type: HIV seronegative individuals (wearing no shoes)
Describe angiosarcoma
Malignant endothelial neoplasms appearing as small red papules/ nodules that eventually grow and blend into surrounding structures
Morphology: varying degrees of differentiation with central areas of hemorrhage and necrosis
solid spindled appearance without discernable blood vessels
Risk factors for angiosarcoma
PVC
thorotrast
arsenic
radiation
carcinogenic exposure to the liver in the setting of lymphedema in the BUE after radical mastectomy
