Vascular Tumors Flashcards
Lymphangioma
“frog spawn”
D2-40 positive
Angiokeratoma
“Bloody SK”
May have clot inside, acanthosis, hyperkeratosis, thin walled vessels
Nevus flammeus
Dilated capillary sized vessels
Angioma serpiginosum
Clinically looks like small dots on legs of female, bleed freely when traumatized
Histologically you see dilated tortuous capillaries in upper dermis
Venous lake
(usually collapses after biopsy)
Glomus tumor
“string of black pearls”
commonly tender
Glomangioma
One to two layers of glomus cells around prominent vessels
More vessels than cells
Pyogenic granuloma
lobular capillary hemangioma
Bacillary angiomatosis
usually not distinctly lobular
Bartonella infection causes blood vessels to grow out of control and form tumor like masses
Look for amorphous clusters of organisms (+warthin starry) and +++neutrophils
Cherry angioma
Capillaries with pink hyalinization in walls
Infantile hemangioma
Tightly packed endothelial cells
RICH and NICH are glut 1 negative
Angiolymphoid hyperplasia with eos
Centrally you see thick walled vessels w/hobnail endothelium
Peripheral proliferation of smaller vessels and lymphoid nodular aggregates
Nodular aggregates of eos
What is angiolymphoid hyperplasia with eosinophilia aka?
Epithelioid Hemangioma
Kimura disease
Many deep lymphoid nodules
Many eosinophils with eosinophilic microabscesses
Presents as painless subQ swelling
Increased IgE
Intravascular papillary endothelial hyperplasia of Masson
*re-canalizing thrombus within a vascular space
papillary projections with hyalinized cores
Tx is cut it out (it can mimic malignancy)
AV malformation
Thin and thick walled vessels together
*compared to an angioma, there is no hyaline in walls
Glomeruloid hemangioma
a/w Castleman dz and POEMS
polyneuropathy
organomegaly
endocrinopathy
M protein
skin findings
Hobnail hemangioma
aka targetoid hemosiderotic hemangioma
*hemosiderin
Superficially you will see dilated vascular spaces, down deeper and on periphery more slit like with hemosiderin (mimicker of melanocytic lesion)
Eccrine angiomatous hamartoma
Capillaries, mature eccrine glands, and ducts
DEEP hamartoma which is tender typically
Microvenular hemangioma
small very flat vessels w/surrounding pericytes
bland and monomorphic appearing, spreads down deep
Tufted angioma aka angioblastoma
“cannonball tufts” of capillaries in dermis
slowly growing plaque in child
Myopericytoma
dermal nodule
whirled onion skin layers surrounding vascular channels
Myofibroma is mimicker
PEComa
Perivascular endothelioid cell tumor
Very pale or clear cells around delicate vessels
+HMB45 (MelanA) but S100 is negative which helps to differentiate from Melanoma
Kaposiform hemangioendothelioma
Soft tissue mass in infants almost always
many pts get kasabach merritt syndrome
Microscopically it looks limilar to tufted angioma or kaposi with slit like vessels but lobules are typically less well circumscribed, more infiltrative into surrounding tissue
PHAT
Pleomorphic hyalinizing angiectatic tumor
Pleo - spindled cells (can mimic schwannoma) *PHAT is s100 negative, CD34 positive - helps to differentiate
hyalinized or fibriboid vessel walls
Hemangiopericytoma
Diffuse pericytes, staghorn vessels
Spindle cell hemangioma
“Hemorrhagic lung” with alveolar spaces
Spindled cells
Pheloliths
Atypical vascular lesion
Angiosarcoma
Atypical infiltrating connected vascular channels dissecting between collagen
Hyperchromiatic atypical multilayered endothelial cells
looking for c-MYC amplification via FISH can be helpful
Can be epitheliod appearing as well
Epithelioid hemangioendothelioma
Dilated vascular channels with solid epithelioid and spindle cell areas
Intracytoplasmic lumens
Variable pleomorphism and mitotic activity
“Blister cells” are the small round vascular spaces noted here (its trying to make vascular spaces)
Retiform hemangioendothelioma
Arborizing blood vessels reminiscent of rete testes
considered a low grade angiosarcoma
Kaposi sarcoma, tumor stage
Fairly circumscribed dermal nodule of spindled cells which form irregular slit like vascular spaces containing red blood cells
“sieve-like” appearance with no true endothelial lining
Cytologic atypia
+HHV8, +CD34, CD31, ERG
Kaposi sarcoma, patch stage
Subtle dermal proliferation of angulated thin walled slit like vessels
promontory sign: vessel wrapping around native structure
Extravasation of RBCs, hemosiderin deposition
+HHV8, +CD34, +CD31
