Histopathology of Vascular Anomalies
ABSTRACT Over the past decade, many changes and updates have occurred in the world of vascular anomalies, including their histopathology. An appreciation has developed that a combined team approach is optimal in arriving at a correct diagnosis. Technical advances such as immunohistochemical stains for GLUT1, an excellent marker for infantile hemangioma, and vascular immunostains such as D2-40, PROX1, and vascular endothelial growth factor receptor 3, which distinguish lymphatics from arteries and veins, have been of immense help in daily practice.
Article: [In Process Citation].Perspective infirmière: revue officielle de l'Ordre des infirmières et infirmiers du Québec 03/2011; 10(2):31, 33-6. DOI:10.1089/lrb.2011.9103
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ABSTRACT: Vascular anomalies in children and adolescents are the most common soft tissue lesions and include reactive, malformative, and neoplastic tumefactions, with a full spectrum of benign, intermediate, and malignant neoplasms. These lesions are diagnostically challenging because of morphologic complexity and recent changes in classification systems, some of which are based on clinical features and others on pathologic findings. In recent decades, there have been significant advances in clinical diagnosis, development of new therapies, and a better understanding of the genetic aspects of vascular biology and syndromes that include unusual vascular proliferations. Most vascular lesions in children and adolescents are benign, although the intermediate locally aggressive and intermediate rarely metastasizing neoplasms are important to distinguish from benign and malignant mimics. Morphologic recognition of a vasoproliferative lesion is straightforward in most instances, and conventional morphology remains the cornerstone for a specific diagnosis. However, pathologic examination is enhanced by adjunctive techniques, especially immunohistochemistry to characterize the type of vessels involved. Multifocality may cause some uncertainty regarding the assignment of "benign" or "malignant." However, increased interest in vascular anomalies, clinical expertise, and imaging technology have contributed greatly to our understanding of these disorders to the extent that in most vascular malformations and in many tumors, a diagnosis is made clinically and biopsy is not required for diagnosis. The importance of close collaboration between the clinical team and the pathologist cannot be overemphasized. For some lesions, a diagnosis is not possible from evaluation of histopathology alone, and in a subset of these, a specific diagnosis may not be possible even after all assembled data have been reviewed. In such instances, a consensus diagnosis in conjunction with clinical colleagues guides therapy. The purpose of this review is to delineate the clinicopathologic features of vascular lesions in children and adolescents with an emphasis on their unique aspects, use of diagnostic adjuncts, and differential diagnosis.Pediatric and Developmental Pathology 01/2012; 15(1 Suppl):26-61. DOI:10.2350/11-11-1119-PB.1 · 0.86 Impact Factor
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ABSTRACT: Vascular anomalies are classified into vascular tumors (infantile hemangioma) and vascular malformations. Vascular malformations are divided into slow flow and high flow subtypes. Magnetic resonance imaging helps in classification and assessing extent and distribution. Conventional angiography also known as digital subtraction angiography is pivotal in assessment of fine vascular details and treatment planning. Imaging correlates well with histopathology. We review recent development in imaging techniques of various vascular anomalies most of which are affecting the peripheral system which potentially may broaden understanding of their diagnosis, classification and treatment.The international journal of cardiovascular imaging 08/2012; 29(2). DOI:10.1007/s10554-012-0106-5 · 2.32 Impact Factor