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Vascular tumor

  1. Classification:
    1. BENIGN
      1. Hemangiomas
        1. Capillary Hemangioma     
        2. Cavernous hemangioma           
        3. Pyogenic granuloma
      2. LymphangiomaQ
        1. Simple (capillary Lymphangioma      
        2. Cavernous (cystic) lymphangiomas
    2. Glomus tumor
    3. Vascular
      1. Nevus flammeus
      2. Salmon patch
      3. Port wine stain (Sturge - weber syndrome / encephalotic. Angiomatosis)
      4. Spider telangiectasia (arterial spiders)
      5. Hereditary Hemorrhagic telangiectasia (Osler - Weber Rendu disease) Q 
    4. Reactive vascular proliferation
      1. Bacillary angiomatosis
    5. Intermediate grade neoplasms:
      1. Kaposi sarcoma.
      2. Hemangioendothelioma
    6. Malignant: Q
      1. Angiosarcoma
      2. Hemangiopericytoma (benign & malignant)

Benign Tumors

  1. Capillary hemangioma
  1. Increased number of blood vessels which resemble capillaries
  2. Skin, subcutaneous tissue rarely visceral
  3. Strawberry- common Q
  4. Lobulated hemangioma, unencapsulated aggregates of closely packed capillaries lined with endothelium
  1. Cavernous Hemangioma
  1. Large dilated vascular channels filled with blood
  2. Mostly cosmetic defect rarely life threatening as in von Hippel lindau syndrome cavenous hemangiomas of brain stem (cerebellum)
  1. Pyogenic Granuloma
    Skin, oral mucosa
    Polypoid, capillary hemangioma, arises on a stalk, associated with edema & inflammatory cell Q
    1. H/O bleeding
    2. Granuloma gravidarum - pregnant women, gingival, regress after pregnancy
  1. Glomus tumor'
  1. Distal portion of digits Q
  2. Elevated, red blue. firm, painful nodule         
  3. Branching vascular channels stroma containing nests of glomus cells arranged around vessels

Borderline Tumors

  1. Kaposi's sarcoma- Q   MC VASCULAR
    Frequent occurrence with AIDS. Four forms seen
    1. Chronic or European KS- multiple red purple nodule, extremitates, different stages may be present associated with immunosuppression
    2. Lymphadenopathic endemic type - young African with generalized lymphadenopathy rarely involving skin
    3. Transplant associated - Highly aggressive, involves lymph nodes, mucosa, visceral organs.
    4. AIDS associated -1/3rd of HIV patients esp. homosexual males.
      No particular site predilection
  1. Morphology:
3 Stages –
  1. Patch Stage: Red pink macule. distal lower extremity. Dilated. irregular angulated blood vessels lined by endothelial cells & surrounded by chronic inflammatory infiltrate. Q
  2. Plaque: Dilated, jagged vascular channels lined by plump spindle cells surrounded by hemo siderophage lymphocyte and plasma cell. Q
  3. Nodular: Sheets of plump, proliferating. spindle cells Dermis: few scattered small vessels & slit like spaces. Mitotic figures, hemo siderophage abundant


  1. Angio Sarcoma
  1. Skin, soft tissue, breast. Liver Q
  2. Thorostat, PVC, arsenical, lymphadenomatous extremity (arise in dilated lymphatic vessels -   lymphangiosarcoma)
  3. Small. ill-defined, vascular swelling
  4. Plump spindle cell (endothelial) with mitotic figures Q
  1. Hemangiopericytoma:
  1. Derived from pericytes
  2. Thigh, 4-8 cm
  3. Capillaries arranged in fishhook pattern; silver stain used to diagnose this disease

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