Page 266 - Concise Pathology for Exam Preparation ( PDFDrive )

10 Blood Vessels 251

Q. Classify vascular tumours.

Ans. Classification
1. Benign neoplasms, developmental and acquired conditions
(a) Haemangioma
(i) Capillary haemangioma
(ii) Cavernous haemangioma
(iii) Pyogenic granuloma
(b) Lymphangioma
(i) Simple (capillary lymphangioma)
(ii) Cavernous lymphangioma (cystic lymphangioma)
(c) Glomus tumour
(d) Vascular ectasias
(i) Nevus flammeus
(ii) Spider telangiectasia (arterial spider)
(iii) Hereditary haemorrhagic telangiectasia (Osler–Weber–Rendu disease)
(e) Reactive vascular proliferations
Bacillary angiomatosis
2. Intermediate grade neoplasms
(a) Kaposi sarcoma
(b) Hemangioendothelioma
3. Malignant neoplasms
(a) Angiosarcoma
(b) Hemangiopericytoma

Q. Describe the clinicopathological features of haemangiomas.

Ans. Haemangiomas are common benign tumours of infancy and childhood. These are
difficult to differentiate from malformations or hamartomas.
May be Localized (angiomas)
Diffuse (angiomatosis; involve large segments of the body, eg,
entire extremity)
May be Superficial (head and neck)
Internal or visceral (liver)

1. Capillary haemangioma
(a) Largest single type of vascular tumour believed to be a proliferation of vascular
endothelial cells. It is composed of capillary channels with RBCs.
(b) Most commonly found in the skin, subcutaneous tissue and mucous membranes
of the oral cavities and lips; presents as a red to reddish-purple raised lesion. May
also be seen in the liver, spleen and kidneys.
(c) ‘Strawberry type’ of capillary haemangioma is very common and tends to regress
by seven years of age in 75–90% cases.
(d) Capillary haemangioma may cause cosmetic disturbance or manifest with bleeding
due to traumatic ulceration.
2. Pyogenic granuloma (lobular capillary haemangioma or polypoid capillary
haemangioma)
(a) Typically presents as a red/pink to purple nodule, smooth or lobulated, which may
follow trauma.
(b) Shows a striking resemblance to exuberant granulation tissue with oedema and
acute and chronic inflammation.
(c) ‘Granuloma gravidarum’ is a pyogenic granuloma occurring in 10% of the
pregnant women (regresses after delivery).
3. Cavernous haemangioma
(a) Usually involves deeper structures
(b) Locally destructive large lesions, which show no tendency to regress
(c) Red-blue, soft, spongy 1–2 cm in diameter
(d) Rare giant forms that affect large subcutaneous areas of face or extremities

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