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Cellular hemangiomas ("hemangioendotheliomas") in infants. Light microscopic, immunohistochemical, and
F Gonzalez-Crussi1, M Reyes-Mugica
1Pathology Department, Children's Memorial Hospital, Northwestern University, Chicago, IL 60614.
Insights
Cellular hemangiomas of infancy, benign tumors, show surprising cell diversity. This cellular heterogeneity, including a newly identified cell type, helps explain their growth and natural involution.
Area of Science:
- Oncology
- Pathology
- Dermatology
Background:
- Cellular hemangiomas of infancy (infantile hemangioendotheliomas) are benign tumors.
- Their dense cellularity can be mistaken for soft tissue sarcomas.
Purpose of the Study:
- To investigate the cellular heterogeneity of infantile hemangiomas.
- To identify the cell types present in these lesions and understand their implications.
Main Methods:
- Ultrastructural analysis.
- Immunohistologic study.
Main Results:
- Routine histology shows a monomorphous appearance, but ultrastructural and immunohistologic studies reveal significant cellular heterogeneity.
- Predominant cells include pericytes and endothelial cells.
- Fibroblasts, mast cells, and a newly identified interstitial cell expressing factor XIIIa and a macrophage marker are also present.
Conclusions:
- The diverse cell composition of infantile hemangiomas reflects their dynamic nature.
- This heterogeneity is key to understanding their growth, stabilization, and eventual involution.
Abstract:
Cellular hemangiomas of infancy, also known as "infantile hemangioendotheliomas," are benign tumors whose dense cellularity may lead to confusion with soft tissue sarcomas. Ultrastructural and immunohistologic study revealed considerable cellular heterogeneity in these lesions despite the monomorphous appearance revealed by routine histologic preparations. Pericytes and endothelial cells are predominant, but fibroblasts and mast cells are regularly present in these tumors. An interstitially located cell of uncertain identification, expressing factor XIIIa and a macrophage marker, not previously noted, comprises an important segment of the cell population. The cell composition reflects the dynamic potential of these lesions, whose natural tendency is to grow, then to become stable, and finally to involute.
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