ABSTRACT
El hemangioma microvenular corresponde a una neoplasia infrecuente de origen vascular y estirpe benigno. Su etiología es desconocida; sin embargo, se han reportado casos asociados a la inmunosupresión y factores hormonales. Suele aparecer en adultos jóvenes con ligera predominancia en mujeres y en la mayoría de los casos se presenta como un nódulo asintomático en extremidades. Clínicamente, puede imitar lesiones vasculares benignas y malignas. Dentro de su diagnóstico diferencial debe considerarse el Sarcoma de Kaposi y otros tipos de hemangiomas. Debido a su inespecificidad clínica, el diagnóstico debe ser realizado histológicamente. Se han descrito múltiples alternativas terapéuticas además del seguimiento periódico. Algunos casos han sido tratados con una escisión completa sin recurrencias a 5 años de seguimiento y otros tratados con láser pulsado con excelente respuesta. Se presenta el caso de una mujer de 44 años con una placa eritematoviolácea asintomática de aproximadamente 8 centímetros en su antebrazo derecho de 1 mes de evolución, con biopsia compatible y control clínico a 10 meses sin cambios significativos.
Microvenular hemangioma is a rare neoplasm of vascular origin and benign lineage. Its etiology is unknown; however, there are some cases associated with immunosuppression and hormonal factors. It usually appears in young adults with a slight predominance in women and in most cases, it presents as an asymptomatic nodule on the extremities. Clinically, it can mimic benign and malignant vascular lesions. Its differential diagnosis includes Kaposi's sarcoma and other types of hemangiomas. The diagnosis must be made histologically. Multiple therapeutic alternatives have been described. Some cases have been treated with complete excision without recurrence at 5 years, and others with pulsed laser with excellent response. We present the case of a 44 year old woman with a 1 month history of an asymptomatic erythematous plaque of approximately 8 centimeters in her right forearm with compatible biopsy. The lesion had no significant changes at 10 months followup.
Subject(s)
Humans , Female , Adult , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Hemangioma/diagnosis , Hemangioma/pathologyABSTRACT
Microvenular hemangioma (MVH) is a rare acquired benign vascular neoplasm, which presents commonly as a solitary purple-to-red nodule or plaque measuring approximately 10 mm in diameter. MVH occurs primarily on the extremities or the trunk. Most lesions are solitary, and multiple lesions are rare. Histopathological features of MVH include numerous, scattered, thin and irregularly branching small vessels in the dermis and endothelial cells without atypia. Owing to similarities in clinical morphology and histopathological features, MVH may often be indistinguishable from the early patch stage of Kaposi sarcoma. Immunohistochemical (IHC) analysis helps differentiate between the 2 diseases. The results of IHC tests in patients with MVH show positive staining for CD31 and smooth muscle actin and typically, negative staining for the human herpes virus 8 antigen. We report a rare case of multiple MVH clinically mimicking the early patch stage of Kaposi sarcoma in a 63-year-old woman who presented with a 3-year history of slowly growing, compressible, soft, bluish-purple macules and plaques on the trunk and right arm.
Subject(s)
Female , Humans , Middle Aged , Actins , Arm , Dermis , Diagnosis, Differential , Endothelial Cells , Extremities , Hemangioma , Muscle, Smooth , Negative Staining , Sarcoma, Kaposi , Vascular NeoplasmsABSTRACT
Microvenular hemangioma is a relatively rare, acquired, and slow-growing benign vascular lesion that usually arises as a small, reddish papule or plaque in young to middle-aged individuals. It commonly occurs on the arms, trunk, or legs. Histologically, it consists of irregular branching capillaries and venules involving the full thickness of the reticular dermis. A 38-year-old woman presented for 3 years with a solitary reddish nodule on the scalp. Histological examination showed irregular venules throughout the dermis. We report this case of microvenular hemangioma developing on the scalp, an unusual location.
Subject(s)
Adult , Female , Humans , Arm , Capillaries , Dermis , Hemangioma , Leg , Scalp , VenulesABSTRACT
Objective To analyze the clinical and histopathologic features of eruptive microvenular hemangioma (EMVH). MethodsThe clinical and histological findings in six patients with EMVH were retrospectively reviewed.Results The patients were young or middle-aged,with a median age of onset of 34 years.The ratio of males to females was 1 ∶ 1.Clinically,all the patients experienced a sudden development of widespread,asymptomatic,brunneus,flat-topped papules and plaques measuring from 0.1 to 2.0 cm in diameter.Histopathologic examination revealed a poorly circumscribed proliferation of small,irregularly branched,thin-walled blood vessels haphazardly arranged between collagen fiber bundles in the dermis.The lumina of the blood vessels were often collapsed.There was no cellular atypia or mitosis.A variable degree of sclerosis was noted in the surrounding stroma.Immunobistochemical study revealed that the endothelial cells stained positive for CD34,CD31,and factor Ⅷ-related antigen.Conclusions The diagnosis of EMVH is proposed,and awareness of this disease may benefit its early diagnosis and avoidance of unnecessary treatment.
ABSTRACT
Microvenular hemangioma is an uncommon aquired vascular tumor, occurring in young to middle-aged adults of both genders. It usually presents as a small, solitary, purple-to-red papule, nodule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickeness of the reticular dermis. Herein, we report a case of microvenular hemangioma, clinically mimicking Kaposi's sarcoma, on the toe of the right foot in a 44-year old male.
Subject(s)
Adult , Humans , Male , Dermis , Extremities , Foot , Hemangioma , Pericytes , Sarcoma, Kaposi , Toes , VenulesABSTRACT
Microvenular hemangioma is an uncommon acquired vascular tumor of young to middle-aged adults of both genders. It usually presents as a small, solitary, purple to red papule or plaque on the extremities or trunk. Histologically, the tumor is composed of small branching venules with collapsed lumina and conspicuous pericytes infiltrating the full thickness of the reticular dermis. Because of histological similarity to a Kaposi's sarcoma, the awareness of microvenular hemangioma is important. We report a case of microvenular hemangioma in a 9-year-old girl.
Subject(s)
Adult , Child , Female , Humans , Dermis , Extremities , Hemangioma , Pericytes , Sarcoma, Kaposi , VenulesABSTRACT
A case of microvenular hemangioma in a 38-year-old female is described. The patient presented with a slowly growing, solitary reddish nodule on Lt. posterior thigh, which measured 1x1 cm. Histologically, the tumor was an infiltrative growth throughout the dermis. It consisted of thin-walled, small sized, irregularly branched vessels. The vascular lumina were narrow. The flattened endothelial cells had oval to spindle-shaped nuclei and scant cytoplasm that were immunohistochemically positive for factor VIII-related antigen and smooth muscle actin. The tumor cells lacked cellular atypia, pleomorphism, and mitotic figures. We diagnosed this case as microvenular hemangioma.
Subject(s)
Adult , Female , Humans , Actins , Cytoplasm , Dermis , Endothelial Cells , Hemangioma , Muscle, Smooth , Thigh , von Willebrand FactorABSTRACT
Microvenular hemangioma (MH) is a recently described, uncommon, acquired vascular, tumor presenting clinically as a small reddish nodule in young and middle, aged individuals of either gender. Histologically, thin and irregularly branching small venules with inconspicouous lumia and without cellular atypia are found widely throughout the dermis. The presence of histologic features of the collagen dissection and vascular tufts makes it necessary to differentiate MH with Kaposi's sarcoma and angioblastoma. As we are aware, the description of these two cases which showed the characteristic clinical and histologic features of MH, is the first report of MH in Korea.