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Hemangioma


Roseann I. Wu, M.D., M.P.H.

Last author update: 1 September 2015
Last staff update: 11 January 2023 (update in progress)

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PubMed Search: Hemangioma [title] lung

Roseann I. Wu, M.D., M.P.H.
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Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Pathophysiology | Clinical features | Diagnosis | Radiology description | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis
Cite this page: Wu R. Hemangioma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungtumorhemangioma.html. Accessed April 2nd, 2023.
Definition / general
  • Benign vascular proliferation with numerous thin-walled capillary vessels (Am J Surg Pathol 2006;30:750)
  • Solitary, isolated lesion
  • More commonly detected in children
    • Terminology
  • Also known as "solitary capillary hemangioma" though cases of cavernous hemangioma have been reported
    • Epidemiology
  • Extremely rare in the lung and airways
  • No clear gender predilection, wide age range
    • Sites
  • Endobronchial or parenchymal with possible predilection for lower lobes
    • Pathophysiology
  • Solitary lesion, tends to be peripheral when parenchymal
  • Stable or slow-growing with indolent behavior
    • Clinical features
  • Incidental finding and asymptomatic in adults but may mimic carcinoma on imaging as a solitary nodule
  • Infants may show respiratory symptoms
    • Endobronchial hemangiomas may present with stridor, wheezing, chest retraction
    • Diagnosis
  • Difficult to diagnose clinically
  • Diagnosis established by histopathologic examination
    • Radiology description
  • Well-defined, variably dense, occasionally cystic masses on radiographs / CTs
  • May show pure or mixed ground-glass appearance on high-resolution CT
    • Case reports
  • 9 year old child with pulmonary hemangioma (Pediatr Dev Pathol 2002;5:283)
  • 53 year old woman with pulmonary capillary hemangioma showing pure ground glass opacity (Ann Thorac Cardiovasc Surg 2014;20:578)
  • 55 year old woman with solitary pulmonary capillary hemangioma (Pathol Int 2013;63:615)
    • Treatment
  • Surgical resection, if warranted, is curative
    • Gross description
  • Small, up to a few centimeters in size
  • Soft, ovoid but ill-defined, red-purple to brown lesion
    • Microscopic (histologic) description
  • Mostly "capillary" type with small vessels rather than "cavernous" type with large vessels
  • Thickened alveolar septa with proliferation of anastomosing vascular spaces replacing normal tissue
  • Thin-walled vascular spaces lined by bland, flat to cuboidal endothelial cells
  • Variable dilatation and vascular congestion
  • Lack of atypia or mitoses
    • Microscopic (histologic) images

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    Positive stains
  • CD31, CD34, factor VIII
    • Negative stains
  • GLUT1
    • Differential diagnosis
  • Arteriovenous malformation: abnormal, thick-walled, tortuous arteries and veins, associated with Rendu-Osler-Weber syndrome
  • Kaposi sarcoma: mitoses, increased Ki-67
  • Pulmonary capillary hemangiomatosis: multiple hemangiomas, often associated with veno-occlusive disease
  • Reactive vascular proliferations
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