Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: DePond WD. Vascular transformation of sinuses. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesvasculartransformationofsinuses.html. Accessed April 26th, 2024.
Definition / general
- Also called nodal angiomatosis
- Usually found incidentally after resection of a nearby tumor
- Benign; all ages
- Due to obstruction of lymphatic efferent vessels or venous obstruction (Arch Pathol Lab Med 1990;114:656) or perhaps other angiogenic factors
Case reports
- 57 year old man with gastric cancer; lymph nodes removed during surgery (Case of the Week #405)
- Man with congestive heart failure (G Ital Nefrol 2002;19:60)
Microscopic (histologic) description
- Subcapsular and medullary sinuses contain complex network of anastomosing blood vessels of variable sizes with fibrosis
- May have irregularly branching vascular slits accompanied by pericytes with maturation towards well formed vascular channels, may have extravasated red blood cells and interstitial fibrin deposits
- Reactive, not neoplastic
- May also have spindle cell nodules confined to sinus (associated with retroperitoneal nodes removed for renal cell carcinoma)
- Lymphoid parenchyma may show atrophy
- No atypia, no PAS+ hyaline globules, no capsular involvement
Microscopic (histologic) images
Case #405
AFIP images
Vascular transformation of sinuses
Intra-abdominal lymph node
Nodular spindle cell vascular transformation
Differential diagnosis
- Kaposi sarcoma: involvement throughout lymph node including capsule, not just sinuses; well formed and curved spindle cell fascicles, vascular slits are nonbranching; atypia and PAS+ hyaline globules, no fibrosis, patients are HIV+ or African children (Am J Surg Pathol 1991;15:732)
