Spindle Cell Hemangioma
Steven D. Billings, MD
Key Facts
Terminology
Formerly called spindle cell hemangioendothelioma
Clinical Issues
Subcutaneous mass
Usually acral location
Sometimes multifocal
Local recurrence in 50-60% of cases
No metastatic potential
Associated with Mafucci syndrome in some cases
Microscopic Pathology
Dilated vessels often with focal thrombi
Solid spindled cell areas
Vacuolated endothelial cells, so-called “blister cells”
Negative for HHV8 nuclear antigen
Top Differential Diagnoses
Kaposi sarcoma
Kaposiform hemangioendothelioma
Epithelioid hemangioendothelioma
 Low magnification shows a noncircumscribed lesion in the dermis and subcutis composed of an admixture of thin-walled dilated blood vessels and sheets of spindle cells. |
 High magnification of spindle cell hemangioma shows straight/curved fascicles of uniform spindle cells  with irregularly shaped vascular spaces  and small  areas of hemorrhage. |
TERMINOLOGY
Synonyms
Formerly known as spindle cell hemangioendothelioma
Definitions
Benign vascular tumor characterized by cavernous vascular spaces and spindled cell areas
ETIOLOGY/PATHOGENESIS
Unknown
Some cases associated with Mafucci syndrome, Klippel-Trenaunay syndrome, varicosities, and congenital lymphedema
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