Histopathology of vascular anomalies.

Department of Pathology, Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.
Clinics in plastic surgery (Impact Factor: 0.95). 01/2011; 38(1):31-44. DOI: 10.1016/j.cps.2010.08.007
Source: PubMed

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.

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    ABSTRACT: Venous malformations (VMs) are among the most common slow-flow vascular malformations characterized by irregular venous channels, luminal thrombi, and phleboliths. To systematically manifest the disorganized vascular structures in sporadic VMs, we initially evaluated histopathological characteristics, perivascular cell coverage, adhesion molecules expression and vascular ultrastructures. Then, the expression of Tie2 and TGF-β in VMs was detected. Meanwhile, the in vitro studies were performed for mechanism investigation. Our data showed that the perivascular α-SMA(+) cell coverage and expression of adhesion molecules in VMs were significantly decreased compared with those in the normal skin tissues. We also found that the expression and phosphorylation levels of Tie2 were upregulated, whereas TGF-β was downregulated in VMs, and they were negatively correlated. Moreover, the in vitro results also revealed a possible balancing effect between Tie2 and TGF-β, as demonstrated by the findings that Ang-1 (agonist of Tie2) treatment significantly downregulated TGF-β expression, and treatment with recombinant TGF-β could also suppress Tie2 expression and phosphorylation. This study provided strong evidence supporting the disorganized vascular structures and dysregulation of related molecules in sporadic VMs, and demonstrated a possible balancing effect between Tie2 and TGF-β, which might help to develop novel therapeutics for vascular disorganization-related disorders.
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