Soft tissue
Benign vascular tumors
Symplastic hemangioma

Topic Completed: 1 November 2012

Revised: 27 March 2019

Copyright: 2002-2018,, Inc.

PubMed search: Symplastic hemangioma

Vijay Shankar, M.D.
Page views in 2018: 1,223
Page views in 2019 to date: 777
Cite this page: Shankar V. Symplastic hemangioma. website. Accessed August 20th, 2019.
Definition / general
  • Hemangioma with bizarre stromal cells in fibrinous material around vessels
  • Limited published reports
  • Due to degenerative atypia of vascular smooth muscle and interstitial cells, similar to symplastic leiomyoma of uterus or ancient schwannoma
Microscopic (histologic) description
  • Vascular lesion with thick walled and variably dilated vessels
  • Degenerative atypia of vascular smooth muscle and interstitial cells within a preexisting vascular lesion, with minimal endothelial cell atypia
  • Atypical cells are spindled or epithelioid with variable hyperchromasia, nuclear enlargement, pleomorphism and multinucleation (J Cutan Pathol 2006;33:735)
  • Perivascular hemorrhage, vascular thrombosis and focal papillary endothelial hyperplasia are common
  • Stroma has hemosiderin and mononuclear inflammation
  • May have fibrous tissue, stromal edema or fat cells within superficial dermis
  • May have rare atypical mitotic figures or bizarre lipoblast-like stromal cells
  • No endothelial cell multilayering
  • No mitotic figures
Microscopic (histologic) images

Images hosted on other servers:

Lower extremity

Positive stains
Differential diagnosis
  • Angiosarcoma: endothelial cells are atypical, there is frequent multilayering of cells and prominent mitotic activity
  • Pleomorphic hyalinizing angiectatic tumor: infiltrative lesion of superficial soft tissue of distal extremities; shows heavily hyalinized, fibrin containing vessels, spindled and pleomorphic stromal cells with frequent intranuclear inclusions
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