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Arteropathies, Microcirculation and Vasculitis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Intravascular papillary endothelial hyperplasia (IPEH) is an unusual form of proliferating endothelium in the setting of organizing thrombus. Although benign, this lesion is clinically important, because it presents as a mass lesion, may be confused histologically with angiosarcoma, and tends to recur if incompletely resected. Historically, IPEH has been described as occurring in numerous locations throughout the body. It can be associated with aneurysms. The wall can be markedly thickened by nodular cellular tissue containing both large and small vascular channels. More cellular areas consisted of numerous capillary-sized vascular channels resembling granulation tissue in a cellular matrix containing myxoid collagenous tissue, fresh and degenerating blood, clusters of hemosiderin-laden macrophages, and scattered mononuclear inflammatory cells. Unlike organizing thrombi, which typically regress with time, IPEH exhibits tumour-like growth and recurs when incompletely resected. Histological comparisons with organizing thrombi suggest that IPEH is a form of abnormal organization from thrombus formation. IPEH can mimic vascular neoplasms such as angiosarcoma. Unlike angiosarcoma, which virtually never occurs within the lumen of a vessel, IPEH typically arises within and remains confined to the lumen of a vessel or aneurysm. Common locations include the fingers, scalp, neck and trunk, where the lesions appear as red or blue, firm, small, superficial masses. Multiple lesions may represent examples of IPEH occurring in the setting of a systemic angiomatosis syndrome.
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
Grossly, meningiomas are well-circumscribed, firm, tan, or grayish lesions arising from the meninges. Hyperostosis of adjacent bones may be present. Microscopically benign meningiomas usually have a bland, whorled appearance, with little anaplasia or mitotic activity. Psammoma bodies may be present. Histologic variants (e.g., fibrous, transitional, angiomatous) can be identified but are of little prognostic significance. Malignant varieties are identified on the basis of clinical behavior (rapid growth or recurrence, invasiveness), pathologic features such as microscopic features of malignancy (cellular or nuclear anaplasia, mitotic figures), or specific histologic type (rhabdoid, papillary, anaplastic) (Figure 19.7).
Thermomagnetic Surgery in Cancer
Published in Leopold J. Anghileri, Jacques Robert, Hyperthermia in Cancer Treatment, 2019
Robert W. Rand, Harold D. Snow
In addition, angiomatous neoplasms are often in relatively inaccessible locations or contiguous with vital structures and therefore not amenable to total surgical resection. The presence of multiple thin-wall vessels inherent in the angiomatous nature of the tumor itself introduces serious, often prohibitive risks of surgical resection because of the uncontrolled hemorrhage, even using the modern skull-base microsurgical technique.
A rare case of recurrent isolated eyelid myxoma: Case report and review of literature
Published in Orbit, 2022
Anamika Joshi, Saumya Jakati, Mohammad Javed Ali
A definitive diagnosis of myxomas requires histopathological analysis. A myxoid change with spindle- or stellate-shaped stromal cells is characteristic. They contain small- to medium-sized thin-walled blood vessels, imparting a slightly angiomatous appearance, and hence commonly termed as superficial angiomyxomas. Mitotic figures are usually sparse with no nuclear atypia or hyperchromasia. Often, collagen delicately investigates the tumour periphery and extends into the lesion, partially dividing it into nodules. Abnormal epithelial components like epidermoid cyst with keratin and entrapped hair follicles may be seen. Frequent extension of tumour cells into subcutaneous tissue and dermis can be seen, as was present in our case. Epidermis is usually spared. Allen et al. showed two cases of cutaneous myxoid tumours associated with inflammation having ulceration of epidermis.1 Alcian blue stain demonstrates the mucin in the lesion well. The spindle cells are usually negative for S-100 protein, vimentin, smooth muscle actin, and keratin; however, they show positivity for CD34 on immunostaining.3 However, in a case report by Yuen et al. of an isolated eyelid myxoma, tumour cells showed negativity for CD 34.4
Supratentorial hemangioblastomas in von Hippel–Lindau wild-type patients – case series and literature review
Published in International Journal of Neuroscience, 2018
Luís Rocha, Carolina Noronha, Ricardo Taipa, Joaquim Reis, Mário Gomes, Ernesto Carvalho
The main differential diagnosis concerns the meningioma, hemangiopericytoma and renal cell carcinoma (RCC) metastasis. The finding of a cyst with a mural tumour nodule in the cerebral hemispheres suggests primarily a benign astrocytoma, but other tumours, such as ependymoma, neuroblastoma, choroid plexus papilloma and even meningioma, can present with similar imaging [1,17]. Angiomatous meningioma is an important differential diagnosis, due to imaging similarity with most common supratentorial location and dural attachment [20,43]. Immunohistochemical study is essential for the diagnosis [35]. Hemangioblastoma vascular component is composed of small, occasionally dilated capillary spaces, whereas the cellular component is characterized by large, vacuolated cells. In angiomatous meningioma, as characterized by the current WHO classification scheme, small and larger calibre blood vessels are present within a background of typical meningothelial cells [34,44].
Papillary Endothelial Hyperplasia of Scalp with Bone Erosion: A Case Report with Review of Literature
Published in Fetal and Pediatric Pathology, 2021
Divya Shetty, Ritika Khurana, Sudhamani S., Sneha Padmakar, Rajiv Rao
PEH may resemble sinusoidal hemangioma and pyogenic granuloma. Sinusoidal hemangioma shows elongated papillae lined by flattened endothelial cells arranged in an orderly, sieve-like pattern, unlike the disorganized papillae of PEH. Pyogenic granuloma also arises in a vein like PEH but it is composed of well-defined lobules of tightly packed capillaries rather than complex, heterogeneous papillae of PEH [9]. Unlike angiomatous tumors, the proliferation of endothelial cells is within the vascular lumen. A passive extension outside the vessel may occur following a vascular rupture or in a hematoma. Lack of necrosis, absence of cellular pleomorphism, or atypical mitoses helped to distinguish PEH from malignant vascular neoplasms such as angiosarcoma [1,7,8].