Vascular Lesions Flashcards
Congenital vascular lesions
Lymphangioma and hemangioma
Neoplasm vascular lesion
Angiosarcoma and kaposi sarcoma
Benign vascular lesion composed of a localized collection of dilated lymphatic channels
Lymphangioma
Presents as painless, nodular, vesicle like swellings when superficial or as submucosal masses when located deeper
Diagnosed within the first two decades of life
Lymphangioma
Location of intraoral lymphangioma
And extraoral lymphangioma
Tongue most common
Palate, buccal mucosa gingiva and lips
Skin and subcutaneous tissues
Lymphangioma of the lip may cause a ____
Macrocheilia (permanent swelling of the lip)
A diffuse soft tissue swelling that may be life threatening because it involves vital structures of the neck
Lymphangioma of the neck
Aka
Cystic hygroma, hygroma colli or cavernoius lymphangioma
Histopathological feature
Variably sized, irregular, this walled fluid - filled spaces are lined by lymphatic epithelium ad surrounded by a stroma of fibrous, smooth muscle and adipose tissue along with lymphocytes
Lymphangioma
Histopathological feature of lymphagioma
Variably sized, irregular, this walled fluid - filled spaces are lined by lymphatic epithelium ad surrounded by a stroma of fibrous, smooth muscle and adipose tissue along with lymphocytes
IHC profile of lymphangioma
D2-40 (podoplanin, transmembrane mucoprotein)
CD31, SMA on walls of lymphatic vessels
Treatment for lymphangiooma
Surgical excision
Recurrence are common die to its non-encapsulated nature
Pwede pd sclerotherapy
Etiology of kaposi sarcoma
Human herpersivrus 8
The lesion consists of an unencapsulated proliferation of anaplastic endothelial cells enclosing irregular luminal spaces
Angiosarcoma
Benign vasular lesion/ tumor
Abnormal endothelial cell proliferation
Hemangioma
Subtype of hemangioma:
Proliferation of capillaries with plump endothelial cells in a fibromyxoid stroma, arranged in lobules
Lobullar capillary hemangioma
Subtype of hemangioma
Multiple, large cystic, thin-walled, blood filled spaces lined by endothelial cells and separated by scant connective tissue stroma
Cavernous hemangioma
Essential diagnostic criteria
Polypoid, lobular circumscribed nastomosing network of capillaries
Plump endothelial cells
Fibroymxoid stroma arranged in one or more lobules
Hemangioma
Treatment for hemangioma
Excision
45% recurrence, more common in children if not completely eradicated
M,ay regress spontaneously
Two vascular malformationt that was introduced in the topi
Struge weber syndrome (encephalotrigeminal angiomatosis)
And
Rendu-osler weber syndrome (hereditary hemorrhagic telangiectasia)
Malignant neoplasm that represents the morphological and iHC features of endothelial cells and unknown origin
Angiosarcoma
Usual location or amgiosarcomas
Scalp
Occasionally in maxillary sinus and oral cavity
Unencapsulated prliferation of anaplastic endothelial cells enclosing irregular luminal spaces
Has an aggressive clinical course and a poor prognosis
Angiosarcoma
Non specific, general signs and symptoms of enlarging tumor
Invasion of vital structures and bone erosion
5th decade = male
39mm
Angiosarcoma
Less than 15mm in size __
More than 39mm in size
<15 mm hemagioma
39mm > angiosarcoma
Histologic features
Anastomosing vascular space line by atypical endothelial cells; infiltrative growth; endothelial multilayering; marked nuclear atypia; brisk mitotic activity
Angiosarcoma
IHC for angiosarcoma
ERG transcription factor - most commonly used
CD34, CD31
40% reoccur
60% overall srvival rate
Metastasis spread most commonly to the lungs, liver, spleen and bone
Angiosarcoma
Also of endothelial origin but known to be caused by the human herpesvirus 8 (HHV8)
Kaposi sarcoma
Locally agressive vascular endothelial proliferation assciated with HHV-8
Immunocompromised, AIDS related
Kaposi sarcoma
Multiple reddish to purple macules that progress into plaques or nodules, which may ulcerate
Kaposi sarcoma
Etiologic agent for kaposi sarcome
Herpesvirus
Aids
Kaposi sarcoma that is predominntly in older men living in the mediterranean basin
Classic type kaposi sarcoma
Kaposi sarcoma that apears multifocal reddish brown nodules primarily in the skin of the lower extremities , organ may also be affected
Indolent course and only a fair prognosis
Classic type kaposi sarcoma
Was identified in africa, where it is considered endemic
Seen in extremities of blacks
Most commonly affected organ is the skin
Endemic type of kaposi sarcoma
Kaposi sarcoma seen in patients with immunodeficiency status, includes with organ transplants and commonly associated with AIDS
Immunodeficiency type of kaposi sarcoma
Hypercellular foci containing bland-appearing spindle cells, ill-defined vascular channels and extravasated RBC
Kaposi sarcoma
IHC for kaposi sarcoma
CD31, CD34 and
factor VIII-related antigen will identify endothelial cell derived tumors
DD of kaposi
Hemangioma
Erythroplakia
Melanoma
Pyogenic granuloma
Treatment of kaposi
Highly active antiretroviral therapy (HAART)
Small, slit like vascular spaces with extravasated RBC
Mildly atypical cell with surrounding bland spindle cells
Lymphocytic infiltrate is present
Unencapsulated infiltrating fascicles of spondle cells with atypia and mitoses
Kaposi sarcoma
Extraoral; unilateral epixstasis
Oral: solitary, red hemorrhagic papule
Hemangioma
