Vascular Tumors

Question 1

Cherry hemangioma

Answer 1

Benign small red papular lesions of the elderly

Sharply circumscribed areas of congested capillaries

Frequency increases with age

Question 2

Pyogenic granuloma

Answer 2

Polypoid capillary hemangioma that can ulcerate and bleed

Associated with trauma and pregnancy

Question 3

Cystic hygroma

Answer 3

Cavernous lymphangioma of the neck

Associated with Turner syndrome and Down sydrome (present at birth)

Question 4

Glomus tumor

Answer 4

Benign, painful, red blue tumor under fingernails

Arises from modified smooth muscle cells of glomus body

Glomus body shunts blood away from the skin surface in ocld tems to prevent heat loss and to direct blood limbs to skin for body heat
Involved in thermoregulation

Question 5

Bacillary angiomatosis

Answer 5

Benign capillary skin papules found in AIDS patietns

Caused by bartonella henselae-cat scratch fever
Can be unseen and fatal but also can cause fever and lymphadenopathy

Frequently mistaken for Kaposi sarcoma

Question 6

Angiosarcoma

Answer 6

Firm violaceous nodules
rare blood vessel malignancy typically occuring in head, neck and breast areas

Usually in elderly and sun exposed areas

Associated with radiation therapy and arsenic expsore and chronic lymphedema (radical mastectomy is risk factor)

Very aggressive with poor prognosis

Infiltration of dermis with slit-like abnormal vascular spaces

Question 7

Lymphangiosarcoma

Answer 7

Endothelial malignant neoplasm

Lymphatic malignancy associated with persistent lymphedema (post radical masectomy)

Question 8

Kaposi sarcoma

Answer 8

Endothelial malignancy most commonly of the skin but also mouth, GI tract, and respiratory tract

Associated with HHV-8 and HIV

Frequently mistaken for bacillary angiomatosis

Begin on feet and spread proximally-late stage spread to lungs and GI tract

Multiple blue violet or brownish dermal plaqeus

Histology: spindle and endothelial cell proliferation, RBC extravasation, inflammation
Arises from primitive mesenchymal cells

Question 9

Cavernous hemagnioma

Answer 9

Dilated vascular spaces with thin walled endothelial cells

Soft blue compressible mass

Appear on skin, mucosa, deep tissues and viscera

In brain and viscera associated with VHL

Question 10

Spider angioma

Answer 10

Bright red central papule surrounded by several outward radiating vessels
Blanch with pressure and refill centrifugally upon release

Increased estrogen states (pregnancy, cirrhosis, oral contraceptive use, estrogen supplement use)

Question 11

Liver angiosarcoma

Answer 11

Abdominal pain

expresses CD31-PECAM1 (vascular endothelial origin)

Associated with arsenic, thorotrast, polyvinyl chloride

Question 12

Strawberry hemangioma

Answer 12

Superficial hemangioma
Benign in infancy

Grows rapidly and regresses spontaneously a 5-8 years old

Consist of unencapsulated aggregates of thin walled capillaries