Capillary, Venous, and Cavernous Hemangiomas



Capillary, Venous, and Cavernous Hemangiomas


Amitabh Srivastava, MD










Capillary hemangiomas present as small, superficial, well-circumscribed, red-purple nodules. The overlying skin is intact in this example image but may be ulcerated (especially in pyogenic granulomas).






The lobular configuration of capillary hemangiomas is apparent at low-power examination image. Multiple distinct lobules of capillaries are centered in the dermis, and the overlying skin is intact image.


TERMINOLOGY


Abbreviations



  • Pyogenic granuloma (PG)


Synonyms



  • Capillary hemangioma = lobular hemangioma


Definitions



  • Benign vascular tumors composed of blood vessels of various size lined by plump to flattened endothelial cells with no atypia


ETIOLOGY/PATHOGENESIS


Developmental Anomaly



  • Juvenile (infantile) capillary hemangiomas may be congenital


  • Venous hemangiomas may represent vascular malformations


CLINICAL ISSUES


Epidemiology



  • Age



    • Depends on subtype


  • Gender



    • Capillary and cavernous hemangiomas in adults occur more commonly in women


Site



  • Depends on subtype


Presentation



  • Painless mass


  • Red elevated papule(s)


Natural History



  • Juvenile capillary hemangiomas regress spontaneously with time


Treatment



  • Surgical approaches



    • Surgical excision is curative, but usually not necessary unless affecting vital structures


  • Drugs



    • Glucocorticoids or interferon-α therapy for large or symptomatic juvenile hemangiomas


  • Watchful waiting for juvenile hemangiomas that regress with time


Prognosis



  • Recurrences are rare; only occur in some incompletely excised lesions


MACROSCOPIC FEATURES


General Features



  • Elevated nodular red-purple lesions


  • Usually involve skin or subcutaneous tissue


  • Discoloration may not be obvious in deep-seated lesions


  • Recurrences may be sessile


Size



  • Variable size

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Capillary, Venous, and Cavernous Hemangiomas
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