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Vascular Tumors Flashcards

1
Q

** ** Vascular tumors

A

Benign neoplasia

Intermediate grade neoplasia / Borderline Vascular tumors / Low grade malignant vascular Tumors

Malignant Vascular Tumors

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2
Q

Benign neoplasia

A

Hemangioma

Lot of blood filled channels (capillar

y or larger +/- tThrombosed area) lined by epithelial cells

Lot of blood cells present

Could be developmental anomaly (Hamaltoma)

Lymphangioma

Common with hemangiomas

  • Endothelial tubes (capillary tubes)
  • Could be Hamaltomas

DIference from hemangiomas

  • No blood cells
  • Are full of lymphatic fluid (transudate)

Glomengiomas (glomus tumors)

Common with hemangiomas

Endothelial tubes (capillary tubes)

Glomus structure = specialised capilary witch is concerned with temperature regulation

Clinicaly

Most common subungual

Extremly painfull

Vascular Ectazia

Abnormal localised vascular dilatation

Usualy aquired by birth

Can be aquired

Baccilary Angiomatosis

Reactive proliferation of cappilary in infections
Patologic overproliferation due to bacilly
Usualy Pacient Immunocomprimised (another is Kaposi sarcoma)

Bacillus Bartonella Henselae

Produce cat scratch disease in healthy host
Probably produce growth factors for vascular tissue

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3
Q

Benign neoplasia - Hemangioma

A

General

Lot of blood filled channels (capillary or larger +/- Thrombosed area) lined by epithelial cells

Lot of blood cells present

Could be developmental anomaly (Hamaltoma)

Types

Capillary hemangioma

  • Loops of cappilary full of blood
  • Tighly packed
  • 1 out fo 200 births
  • Present in SKIN, SUBCUTIS less in viscera
  • Initialy grow with the baby, but disapear by age of 7 (DON’T RESECT THEM)
  • Also called STRAWBERY HEMANGIOMA

Cavernous hemangioma

“Cavernous = Large interconnecting spaces”

  • Large spaces between cappilary
  • Ddx between 1 and 2 (1 fine tubing, more common, more superficial, smaller, never localy destructive, almost always regress
  • They do not regress, larger, deeper, less well cyrcumscribed.
  • Look lyke red blue songy
  • Blood can be trombosed or dystrophic calcefication
  • CLINICAL:
    • Cosmetic
    • If superficial lead to traumatic ulceration and bleeding
    • Spontaneous bleeding
  • Are quite common found on scan Ex liver (must rule out that there is no malignancy
  • DANGEROUS WHEN PRESENT IN CNS - can cause symptoms due to pressure or can rupture VON HIPPLE LINDAU (born with multiple cavernous hemangiomas (retina, CNS brainstem, other) Kidney adenoomas

Lobular Capilary hemangioma or Pyogenic Granuloma

  • Develop after trauma (mouth)
  • loops of cappilary develop pathological in fluid with inflamatory cells
  • Rapidly growing exophytic red blue nodule
  • Bleed easy
  • There are present acute and chronic inflamatory cells (no puss)

1% pregnant female have Granuloma Gravidarum (after delivery regresses)

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4
Q

Benign neoplasia - Lymphangioma

A

Common with hemangiomas

Endothelial tubes (capillary tubes)

Could be Hamaltomas

DIference from hemangiomas

No blood cells

Are full of lymphatic fluid (transudate)

Types

Capilary

  • Endothelium packed lymph
  • 1-2cm head and neck
  • Clinicaly fluid filled blisters

Cavernous / (Cystic Hygroma)

  • Larger
  • Large filled with lymph, margins not clear
  • Base of neck/Axila
  • Associated with Turner’s Syndrome
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5
Q

Benign neoplasia - Glomengiomas

A

Common with hemangiomas

  • Endothelial tubes (capillary tubes)
  • Glomus structure = specialised capilary witch is concerned with temperature regulation

Clinicaly

  • Most common subungual
  • Extremly painfull
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6
Q

Benign neoplasia - Venous Ectazia

A

Definition

  • Abnormal localised vascular dilatation
  • Usualy aquired by birth
  • Can be aquired

TYPES

Teleangiectasias

(dilatation of microcirculation)

  • Small focal muco-cutaneous lesions
  • Arteriole, Venules, Capillary
  • Congenital / Aquiered

Nevus Flammeus

  • Most Common
  • Called commonly Birth Mark
  • Macular lesion
  • They regress
  • PortWine** **stains
    • Grow with the child
    • Can be present anywhere
    • Most common innofensive
  • If present on Trigeminal area Maybe present on Cortex and Leptomeninges ipsilateraly and be a part of Sturg-Weber Syndrome (! RULE OUT)
    • MENTALY RETARD
    • SEISURE
    • HEMIPLEGIA
    • RADIOPAQUE OPACITIES

Spider Teleangiectasia / Arterial Spiders

  • More common in Female
  • Hyperestronism (estrogen may act GF lead to growth of vessels)
    • Pregnancy - up to 6 - if more than something wrong (ex: Chirrosis)
    • Chirossis
  • Distributed along Sup V. Cava teritory (above nipple = superior V.Cava)

“Palmar erythema anny condition that increases CO2”

Hereditary Hemoragic Teleangiectasia / OSSLER WEBER RENDU DISEASE

AD Congenitall abnormality with dilated arterioles and venules in skin & mucous membranes(GI RT UT etc)that create masses that bleed easily

CLINICAL

  • Epistaxis
  • Hemoptysis
  • Hematemesis
  • Hematuria
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7
Q

Benign neoplasia - Baccillary angimatosis

A
  • Reactive proliferation of cappilary in infections
  • Patologic overproliferation due to bacilly
  • Usualy Pacient Immunocomprimised (another is Kaposi sarcoma)
  • Probably produce growth factors for vascular tissue

Bacillus Bartonella Henselae

  • Produce cat scratch disease in healthy host
  • From CATS => vectors flee

Bartonella Quintana

  • Causes french fever
  • From fleas
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8
Q

Vascular tumors - Borderline Vascular tumors

A

Kaposi’s Sarcoma

Endothelim derived tumors

  • HHV-8 produces a peptide like Cyclin-D (Protein produced by protooncogenes) cell will increase Turnover (with increase in turnover failure of control by antioncogenes)
  • Affect p53
    • there is a Gene that encodes proof reader protein( verifies matching between alleles )
    • If mistake found P53 ACTIVATED
    • P53 product activates DNA repair gene
    • If not DNA not repaired P53 activates ProApoptotic genes
  • HHV-8 mainly found in male homosexual

In imunocompetent hosts, these cells will be wasted

CLINICAL (evolutive scale signs)

  • Patches (flat lesion)
  • Papular stage
  • Nodular stage

Sporadic lesions ( Classic / European Type / Chronic)

  • Older male / Jews
  • Peripheric -> center part of body
  • 10% lesion in viscera
  • Rx: local radiation / resection

Lymphadenopathic / African / Endemic

  • In lymphnodes
  • Endemic in Africa - present even without HIV in that region

Transplant Associated K.S.

  • Immunosupressed host
  • HHV-8 infection
  • AFFECTS: mucosa, internal organs, LESS SKIN INVOLVEMENT
  • Rx: reduce immunosupresion

A.I.D.S Associated K.S

  • After “H.A.A.R.T highly Active Anti Retroviral Therapy” 1% / instead of 30%
  • More commonly in Homosexual Man (std)

Hemangio Endothelioma

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9
Q

Malignant Vascular Tumors

A

AngioSarcomas

  • More common
  • Highly malignant
  • Endothelium cells
  • Present anywhere, but the worst are in LIVER pasthystory (ATP)
    • Arsenic
    • Thorotrast
    • PolyVinylCholoride (P.V.C - Plastic)
  • MARKERS that tell you that tumor is from endothelium ( CD31 CD34 vWF )
  • LymphAngioSarcoma
    • in chronic Lymphedema

HemangioPeriCytomas

  • Pericytes
  • Rare
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