Colon
Mesenchymal tumors
Hemangioma


Topic Completed: 25 November 2021

Minor changes: 5 March 2021

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PubMed search: Hemangioma colon [TI] pathology

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Hemangioma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontumorangioma.html. Accessed April 18th, 2021.
Definition / general
  • Uncommon benign vascular proliferation of the colon
Essential features
  • Benign vascular proliferation
  • Often related to a syndrome
  • Typically a cavernous hemangioma (majority) or capillary hemangioma
Sites
  • Most common site in large intestine is rectum
  • More common in small intestine than large intestine
Clinical features
  • Causes bleeding, melena, anemia, rarely intussusception or obstruction
  • Patients are often young and may have a syndrome (blue rubber bleb nevus syndrome, Klippel-Trénaunay syndrome, etc.) (Clin Colon Rectal Surg 2011;24:193)
Case reports
Gross description
  • Well circumscribed reddish lesion
Microscopic (histologic) description
  • Cavernous hemangioma: localized or diffuse; blood filled sinus-like spaces with scant connective tissue, variable smooth muscle; may be infiltrative but no other concerning features
  • Capillary hemangioma: small, closely packed capillaries, rarely multifocal; no features suggestive of malignancy (Dtsch Med Wochenschr 2004;129:1970)
  • Other rare variants with distinctive morphology can occur, such as anastomosing hemangioma (Am J Surg Pathol 2013;37:1761)
Microscopic (histologic) images

Contributed by Ed Uthman, M.D. and Raul S. Gonzalez, M.D.

Incidental submucosal
hemangioma in
sigmoid colectomy

Colonic hemangioma Colonic hemangioma

Colonic hemangioma

Positive stains
Sample pathology report
  • Sigmoid colon, resection:
    • Segment of colon with submucosal cavernous hemangioma (1.4 cm)
    • Margins of resection unremarkable.
    • Six benign lymph nodes.
Differential diagnosis
Board review style question #1
What is the most common subtype of hemangioma encountered in the colon?

  1. Anastomosing hemangioma
  2. Capillary hemangioma
  3. Cavernous hemangioma
  4. Glomeruloid hemangioma
Board review style answer #1
C. Cavernous hemangioma

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Reference: Hemangioma
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