Vessel/Heart Tumors Flashcards
A 4-year-old girl presents with a small, raised red lesion on the right side of her shoulder that has been there since shortly after birth. Physical exam finds a small dome-shaped, crusted, red nodule on her right shoulder, which is consistent with an infantile hemangioma. What is the best treatment for this lesion?
The natural history of infantile hemangiomas involves rapid growth of a red, cutaneous plaque followed by spontaneous regression. Treatment, therefore, is often not required because the lesions are usually asymptomatic and regress spontaneously within years.
A 25-year-old woman presents with a painful lesion that is located under the nail of her second finger of her left hand. The pain is worse with exposure to cold. Histologic sections reveals a tumor that originated from modified smooth muscle cells. What is this tumor?
Glomus tumor is a painful lesion located under the nail bed that originates from modified smooth muscle cells that control thermoregulation.
Glomus body is normally involved in thermoregulation
An immunosuppressed patient with AIDS presents with several, circumscribed lesions involving his right arm. One of the lesions is biopsied and after receiving the pathology report that the lesion is consistent with bacillary angiomatosis, the patient is treated with oral erythromycin, after which the lesions disappear. What is the most common cause of this lesion?
Bartonella henselae
Bacillary angiomatosis, a disease of immunosuppressed individuals characterized by vascular lesions on the skin, is caused by infection with Bartonella henselae, which is also the cause of cat scratch disease.
A 25-year-old man who is HIV positive presents with several irregular brown lesions on his left forearm. A biopsy from one of these lesions reveals a tumor composed of spindle-shaped cells forming slit-like spaces with infiltration of lymphocytes, plasma cells, and macrophages and extravasation of erythrocytes. What is the correct diagnosis for this lesion?
Kaposi sarcoma, which is caused by human herpesvirus type 8 (HHV-8)infection of endothelial cells, often presents as multiple red, purple, or brown lesions on the lower extremities in patients with HIV infection. Kaposi sarcoma is characterized histologically by spindle-shaped endothelial cells, slit-like vascular spaces, and extravasated red blood cells.
What is the most common adult primary tumor of the heart, which is usually located in the left atrium and may produce signs of syncope or orthostatic hypotension due to obstruction of the blood flow into the left ventricle?
Myxomas are the most common primary cardiac neoplasm and most are found in the left atrium. Cardiac myxomas may interfere with the mitral valve by a ball valve effect causing signs such as intermittent syncope and possible sudden death. Parts of the tumor may break off and form a tumor embolus.
What is the most likely diagnosis for a malignant, nonmobile mass found in an adult within the interatrial septum and partially obstructs blood flow into the right ventricle?
Metastatic tumors are much more common than primary cardiac tumors and more commonly occur within the wall of the heart on the right side. Common types of malignancies that can involve the heart include malignant melanoma, breast cancer, and lung cancer.
Benign vessel tumors
Cherry angioma
Why do spider angiomas blanch w/ pressure?
Arteriole composition
Spider angiomas are acquired vascular ectasias that are associated with increased estrogen levels, such as birth control pills, pregnancy, and liver disease (cirrhosis). Physical examination would show dilated subcutaneous arterioles that radiate from a central arterial lesion (hence the name).
Spider angiomas blanch with pressure.
Glomus tumor
Malignant vessel tumors
Angiosarcoma or melanoma
What predisposes individuals to angiosarcoma?
Lymphedema - commonly associated w/ mastectomy
What are the two Ag markers of endothelial cells?
Most common origin of myxoma
Left atrium
Cardiac tumors
What tumor is benign in muscle but most common is metastic in cardiac tissue of children
Rhabdosarcoma
Histology of myxoma
Highly aggressive malignant tumors that arise from the endothelial cells of the sinusoids of the liver and are associated with vinyl chloride, arsenic, and Thorotrast
Liver angiosarcoma
What disease classically occurs after the treatment of breast cancer from either radiation exposure or chronic lymphedema and is characterized by firm, violaceous nodules on the ipsilateral extremity?
Angiosarcoma
Most common primary cardiac neoplasm and most are found in the left atrium?
Myxomas are the most common primary cardiac neoplasm and most are found in the left atrium.
