Vascular Tumors & Tumor-like Lesions

Vascular Tumors & Tumor-like Lesions

• Nevus Flammeus: Most common vascular ectasia. Flat, light pink to deep purple, involving dilated vessels on the head and neck. Often regresses spontaneously.
• Port Wine Stain: Grows during childhood, thickened skin surface that does not fade with time.
• Sturge-Weber Syndrome: Facial port wine nevus, ipsilateral venous angiomas in the cortical leptomeninges, mental retardation, seizures, hemiplegia, and skull radio-opacities.
• Spider Telangiectasias: Frequently associated with hyperestrogenic states (pregnancy or liver cirrhosis).
• Hemangiomas: Aggregates of closely packed, thin-walled capillaries. Types include strawberry, juvenile capillary, and cavernous hemangiomas. Strawberry and juvenile capillary types often spontaneously regress. Cavernous hemangiomas are associated with von Hippel-Lindau disease.
• Pyogenic Granuloma: Rapidly growing, pedunculated lesions on skin, gingiva, and oral mucosa. Often develops after trauma.

Glomus Tumor

• Painful, distal digits, under fingernail. Modified smooth muscle cells of glomus bodies; involved in thermoregulation.
• Basal Cell Angiomatosis: Gram-negative opportunistic bacillus (Bartonella) causing vascular proliferation in immunocompromised individuals. Skin, bone, and brain can be involved. Associated with Bartonella henselae (cat-scratch disease) and Bartonella quintana (human body lice).

Kaposi Sarcoma

• Patch/raised plaques or nodules. Associated with human herpesvirus 8 (KSHV-8). Classic Kaposi Sarcoma is often associated with malignancy or altered immunity. Not associated with HIV, and is asymptomatic localization to skin and subcutaneous tissue. Endemic (African) Kaposi Sarcoma is often seronegative, under 40 years old, can be indolent or aggressive, and involves lymph nodes more than classic KS.

Transplant-Associated Kaposi Sarcoma

• Involved in T-cell immunosuppression, often involves mucosa and viscera. May regress with immunosuppression. Risk of organ rejection. AIDS-associated Kaposi Sarcoma.
• Hemangioendothelioma: No well-defined vascular channels, tumor cell's often plump with abortive intracytoplasmic lumina.
• Angiosarcoma: Malignant endothelial neoplasm. Associated with hepatic angiosarcoma: (arsenic, thorotrast, PVC). Can arise ipsilateral upper extremity after radical mastectomy. Also includes Hemangiopericytoma (origin from pericytes - rare); pericellular, resembling myofibroblasts surrounding venules and capillaries.

Neoplastic Heart Diseases

• Primary Tumors: Papillary fibroelastoma, lipoma, angiosarcoma, rhabdomyosarcoma.
• Metastatic (more common): Lung carcinoma, breast carcinoma, malignant melanoma, leukemia, and lymphomas.

Myxoma

• Most common in adults (90% atrium, 80% left atrium). Single mass from fossa ovalis (1-10 cm diameter, stalk or sessile). Soft, translucent, gelatinous appearance. Originating from multipotent mesenchymal cells. Star-shaped, hyperchromatic nuclei, endothelial cell with multiple nuclei.
• Rhabdomyoma: Spontaneous regression (hamartoma?). 1-2 cm, ventricular mass, grey/white, with spider extensions of nuclei and large round/polygonal shaped nuclei with cytoplasm and glucose-loaded vacuoles.
• Lipoma: Typically asymptomatic, usually localized on heart valves.

Causes of Pericarditis

• Infections (viruses, bacteria, fungi; other parasites), immune-mediated reactions (SLE, scleroderma, rheumatic fever), post-cardic surgery, drug hypersensitivity reactions, MI, uremia, trauma, radiation, tuberculosis, malignant neoplasia, cardiac surgery.

Acute, Healed, and Purulent/Suppurative Pericarditis

• Acute: Adhesive, constrictive, serous, serofibrinous, fibrinous, suppurative, hemorrhagic. Causes: Non-bacterial inflammations (RF, SLE, tumor), early stage bacteria, viral infection. Inflammation reaction (scant PNL, lymphocytes, histiocytes). Fluid accumulation. Avascular permeability, protein-rich fluid; organization is rare, heals with resolution. Fibrinous & Serofibrinous pericarditis is most frequent.
• Healed: Adhesive mediastinopericarditis, constrictive pericarditis, serous, serofibrinous, fibrinous, hemorrhagic.
• Purulent/Suppurative: Invasion of pericardial sac with infective organisms (direct extension, seeding from blood, lymphatic extension, introduction through surgery, etc.). Thin, creamy pus, yellowish-green exudate, serosal surface, resolution (rare), organization, constrictive pericarditis). Hemorrhagic pericarditis with blood exudate. Causes: Tuberculosis, malignant neoplasia, cardiac surgery.

Explore the various types of vascular tumors and tumor-like lesions, including Nevus Flammeus, Port Wine Stain, and Sturge-Weber Syndrome. This quiz covers the characteristics, associations, and clinical implications of these conditions, enhancing your understanding of vascular pathology.