Lymph nodes - not lymphoma
Inflammatory disorders (noninfectious)
Vascular transformation of sinuses

Author: William D. DePond, M.D. (see Authors page)

Revised: 27 June 2018, last major update June 2006

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Vascular transformation of sinuses
Cite this page: DePond, W.D. Vascular transformation of sinuses. website. Accessed July 16th, 2018.
Definition / general
  • Also called nodal angiomatosis
  • Usually found incidentally after resection of a nearby tumor
  • Benign; all ages
  • Due to obstruction of lymphatic efferent vessels or venous obstruction (Arch Pathol Lab Med 1990;114:656) or perhaps other angiogenic factors
Case reports
Microscopic (histologic) description
  • Subcapsular and medullary sinuses contain complex network of anastomosing blood vessels of variable sizes with fibrosis
  • May have irregularly branching vascular slits accompanied by pericytes with maturation towards well formed vascular channels, may have extravasated red blood cells and interstitial fibrin deposits
  • Reactive, not neoplastic
  • May also have spindle cell nodules confined to sinus (associated with retroperitoneal nodes removed for renal cell carcinoma)
  • Lymphoid parenchyma may show atrophy
  • No atypia, no PAS+ hyaline globules, no capsular involvement
Microscopic (histologic) images

Images hosted on PathOut server:

Case of the Week #405:

AFIP images:

Various images

Vascular transformation of sinuses

Intraabdominal lymph node

Nodular spindle cell vascular transformation

Differential diagnosis
  • Kaposi sarcoma: involvement throughout lymph node including capsule, not just sinuses; well formed and curved spindle cell fascicles, vascular slits are nonbranching; atypia and PAS+ hyaline globules, no fibrosis, patients are HIV+ or African children (Am J Surg Pathol 1991;15:732)