ABSTRACT
Intravascular papillary endothelial hyperplasia (IPEH) is an unusual reactive lesion of vascular origin, which rarely occurs in the oral cavity. Pathogenetically, is it divided into true, mixed and extra‑vascular types. We report a case of extra‑vascular IPEH of the lower lip in 54‑year‑old female patient. Patient gives history of trauma 4 months back with lesion developing at the site to trauma. The lesion was 3 cm × 4 cm in size with soft to firm in consistency. Histologically, it is characterized by an exuberant papillary endothelial cell proliferation toward the lumen of an enlarged blood vessel from the area of an organizing thrombus. The lesion was surgically excised under local anesthesia. The patient was followed for 1‑year with no evidence of recurrence. This paper discusses the various aspects of IPEH of the oral cavity such as pathogenesis, clinical features, histopathology treatment, and prognosis.
Subject(s)
Adult , Endothelium, Vascular/pathology , Female , Hemangioendothelioma/diagnosis , Hemangioendothelioma/etiology , Humans , Hyperplasia/etiology , Lip , Vascular Neoplasms/diagnosis , Vascular Neoplasms/etiologyABSTRACT
AIM OF THE STUDY: To study the clinical profile of extrahepatic portal venous obstruction (EHPVO) in a tertiary referral centre in Mumbai. METHODOLOGY: Retrospective analysis of records of 113 patients with EHPVO, treated between January 1984 and May 1996. RESULTS: Thirty eight of 54 (70.4%) patients in whom information was available were delivered at home. Eleven of the 50 (22%) had umbilical sepsis after birth. Median disease duration was 5 years (range 4 months-31 years), with age at initial presentation 13 (range 0.5-45) years; 24 (20%) patients presented after age 20 years. Eleven presenting initially with splenomegaly bled after 3 (1-14) years. Number of bleeding episodes per patient was 2.5 (1-12). 13 of 44 (29.6%) patients bled (first bleed or recurrence) after age 20 years. Twenty five (22.3%) had ascites at some time, 17/102 (16.7%) had hypersplenism, and hypoalbuminaemia was present in 20/103 (19.2%). Endoscopic sclerotherapy obliterated varices in 47/52 (90.4%) in 10.5 (3-40) sessions over 7 (1-100) months. Twenty three patients underwent surgery: devascularisation in 20 (with splenectomy in seven), distal lieno-renal shunt in two, and meso-caval shunt in one patient. Follow-up was available in 68 (60.2%) patients. Rebleeding after sclerotherapy occurred in 27/64 (42.2%), with median one (1-5) per patient; recurrence of varices was noted in 15/35 (42.9%) patients over 12 (3-39) months. Varices were present in 12 patients 163 (33-305) months after surgery. CONCLUSIONS: Home delivery and umbilical sepsis may be risk factors in the development of EHPVO. A significant number of patients present or continue to bleed from varices after age 20. Variceal sclerotherapy is effective for eradication of oesophageal varices.
Subject(s)
Adolescent , Adult , Causality , Child , Child, Preschool , Developing Countries , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Hemangioma, Cavernous/etiology , Home Childbirth , Humans , Hypertension, Portal/etiology , India , Infant , Infant, Newborn , Male , Portal Vein , Pregnancy , Risk Factors , Thrombosis/etiology , Vascular Neoplasms/etiologyABSTRACT
O angiohistiocitoma com células multinucleadas é dermatose vascular benigna, caracterizada pela presença de múltiplas pápulas eritêmato-violáceas, agrupadas, acometendo preferencialmente alguma extremidade. Sua histologia evidencia hiperplasia vascular com proliferação de células do tecido conjuntivo, associada à presença de células gigantes multinucleadas. Acomete principalmente mulheres após a quarta década de vida. Relata-se o primeiro caso dessa entidade na América Latina e discute-se os principais aspectos clínicos, histopatológicos e imuno-histoquimicos