Mesenchymal tumors


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PubMed Search: Hemangioma [title] lung

Roseann I. Wu, M.D., M.P.H.
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Cite this page: Wu R. Hemangioma. website. 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
    Negative stains
    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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