Soft tissue tumors - Symplastic hemangioma

Home Chapter Home Jobs Conferences Fellowships Books

Soft tissue tumors

Benign vascular tumors

Symplastic hemangioma

Reviewer: Vijay Shankar, M.D. (see Reviewers page)
Revised: 24 February 2013, last major update November 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Definition
=========================================================================

● Hemangioma with bizarre stromal cells in fibrinous material around vessels

Epidemiology
=========================================================================

● Limited published reports

Etiology
=========================================================================

● Due to degenerative atypia of vascular smooth muscle and interstitial cells, similar to symplastic leiomyoma of uterus or ancient schwannoma

Treatment
=========================================================================

● Excision, does not recur or metastasize (Hautarzt 2000;51:327)

Micro description
=========================================================================

● Vascular lesion with thick walled and variably dilated vessels
● Degenerative atypia of vascular smooth muscle and interstitial cells within a pre-existing 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

Micro images
=========================================================================

Lower extremity

Virtual slides
=========================================================================

16 year old girl with calf lesion

Positive stains
=========================================================================

● Smooth muscle actin (pleomorphic cells)

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

End of Soft tissue tumors > Benign vascular tumors > Symplastic hemangioma

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).