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Published on: June 15, 2020
[Clinicopathological features of congenital hemangioma: a study of 40 cases]
1Department of Breast Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Insights
Congenital hemangioma (CH) is a benign vascular tumor presenting as plaques or masses. Pathological diagnosis requires differentiation from similar vascular lesions.
Area of Science:
- Pathology
- Dermatology
- Pediatrics
Background:
- Congenital hemangioma (CH) is a rare vascular tumor present at birth.
- Understanding its clinical and pathological features is crucial for accurate diagnosis.
Purpose of the Study:
- To investigate the clinical and pathological characteristics of congenital hemangioma.
- To analyze diagnostic and differential diagnostic criteria for CH.
Main Methods:
- Retrospective analysis of 40 congenital hemangioma cases.
- Review of clinical, pathological, and immunohistochemical data.
- Literature review for comparative analysis.
Main Results:
- CH presents as painless congenital plaques or masses, often with characteristic color and surrounding halos.
- Histopathology reveals lobulated growth with neo-microvascular lumens and specific endothelial cell morphology.
- Immunohistochemistry shows strong positivity for CD31, CD34, and ERG, with negative D2-40 and GLUT-1.
Conclusions:
- Congenital hemangioma is a benign vascular tumor with distinct pathological features.
- Differential diagnosis is essential, distinguishing CH from infantile hemangioma, pyogenic granuloma, kaposiform hemangioendothelioma, and vascular malformations.
Abstract:
Objective: To investigate the clinical and pathologic features, diagnosis and differential diagnosis of congenital hemangioma (CH). Methods: Forty cases of CH were diagnosed from January 2017 to December 2020 in Henan Provincial People's Hospital. The clinical and pathological and immunohistochemical data were analyzed, with review of literature. Results: There were 24 male and 16 female patients. The lesions were located in the head, neck (11 cases), limbs (14 cases), and trunk (15 cases). The clinical manifestations were congenital painless plaques or masses, the larger ones protruded on the skin surface, mostly dusky purple or bright red, with surrounding white halos. Under low magnification, the tumor was lobular and well demarcated, composed of neo-microvascular lumen of different sizes. The vascular endothelial cells were cuboidal or hobnail in appearance, forming stellar drainage vessels within the lobules. Extra-medullary hematopoiesis was seen in one case of rapidly involuting CH; there were different number of tortuous and dilated vascular lumen between the lobular structures, and some non-involuting CH cases were vascular malformations, which were devoid of lobulated structures. Immunohistochemistry showed that endothelial cells were strongly positive for CD31, CD34 and ERG, while D2-40 and GLUT-1 were negative. Conclusions: CH is a benign congenital vascular tumor with characteristic lobulated growth and abnormal blood vessels in the stroma. Pathological diagnosis often needs to be differentiated from infantile hemangioma, pyogenic granuloma, kaposiform hemangioendothelioma and vascular malformation.
