Vascular Tumors & Tumor-like Lesions Quiz

Vascular Tumors & Tumor-like Lesions

• Nevus Flammeus: Most common vascular ectasia. Flat, light pink to deep purple, involves dilated vessels on the head and neck. Usually regresses spontaneously.
• Port Wine Stain: Grow during childhood, thickened skin surface, do 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 (e.g., pregnancy) or liver cirrhosis.
• Hemangiomas: Aggregates of closely packed, thin-walled capillaries. Types include strawberry and juvenile capillary hemangiomas, which often regress spontaneously. Cavernous hemangiomas can be associated with von Hippel-Lindau disease.
• Pyogenic Granuloma: Rapidly growing pedunculated lesions, commonly found on skin, gingiva, and oral mucosa, and frequently develop after trauma.

Glomus Tumor

• Painful, distal digits, under fingernails, modified smooth muscle cells of glomus bodies.
• Regulates thermoregulation.

Basillary Angiomatosis

• Gram-negative opportunistic bacillus (Bartonella) causing vascular proliferation. Seen in immunocompromised individuals and can affect skin, bone, and brain. Associated with B. henselae (domestic cat scratch disease) and B. quintana (human body lice).
• Bacillus causes VEGF production which leads to endothelial proliferation, presenting as a red papule/nodule/subcutaneous mass microscopically showing endothelial capillary proliferation, nuclear atypia, neutrophils, and nuclear waste. Purplish granular bacterial communities.

Kaposi Sarcoma

• Patch, raised plaques, or nodules, associated with malignancies or altered immunity.
• Can be asymptomatic and limited to skin and subcutaneous tissue.
• Classic KS is associated with HIV, while African endemic KS is seronegative, under 40, and can be indolent or aggressive. More lymph node involvement than classic KS.

Transplant-Associated KS

• T-cell immunosuppression involving mucosa, viscera, and lymph nodes. Often regresses with immunosuppression, but raises risk of organ rejection.
• Hemangioendothelioma. Defined vascular channels, plump tumor cells with abortive intra cytoplasmic lumina.

Angiosarcoma

• Malignant endothelial neoplasm; includes hepatic angiosarcoma associated with carcinogens (arsenic, thorotrast, PVC). Can arise in the setting of lymphedema, especially after radical mastectomy (e.g., breast cancer).

Hemangiopericytoma

• Very rare origin from pericytes. Cells resemble myofibroblasts around venules and capillaries.

Neoplastic Heart Diseases

• Primary tumors: papillary fibroelastoma, lipoma, and rhabdomyosarcoma.
• Metastatic tumors: common in breast, lung, and malignant melanoma. Leukemia and lymphomas

Myxoma

• Most frequently occurring tumor in the adults in the atria, specifically 80-90% in the left atrium.
• Single mass originating from fossa ovalis, from 1-10 centimeters in diameter (stalk or sessile) in consistency. Soft, translucent, gelatinous.
• Multipotent mesenchymal cell differentiation origin; starshape, hyperchromatic nuclei, and endothelial with multiple nuclei.
• Spontaneous regression (hamartoma?). 1 to 2 centimeters in size, ventricular, grey/white mass, large round or polygonal nuclei with spider extensions, cytoplasm with glucose-loaded vacuoles, and obstructive implications.
• Lipoma usually has no symptoms.

Causes of Pericarditis

• Infections, viruses, bacteria, fungi, and parasites.
• Immune-mediated reactions such as SLE, scleroderma, and rheumatic fever.
• Post-myocardial infarction (Dressler syndrome), drug hypersensitivity, and after cardiac surgery.
• Other causes include neoplasia, MI, uremia, trauma. and radiation.

Acute Pericarditis-

• Inflammatory response of pericardial membrane.

• Types include serous, serofibrinous, fibrinous, suppurative, and hemorrhagic.

• Causes: Non-bacterial inflammation (rheumatoid arthritis, systemic lupus), viral infections, early bacterial infections.

• Inflammatory reaction with minimal PMNL, lymphocytes, histiocytes. Fluid accumulation. Avascular permeability, high protein fluid organization rare, with healing resolution.

Healed Pericarditis

• Adhesive mediastinopericarditis, constriction pericarditis, serous, serofibrinous, fibrinous, hemorrhagic.
• Causes: non-bacterial inflammation (rheumatoid arthritis, systemic lupus, tumors), early bacterial, viral infections.

Purulent/Suppurative Pericarditis

• Invasion of pericardial sac by infection: direct extension, seeding from blood, lymphatic spread, or direct introduction during cardiac surgery.
• Thick, creamy pus, serosal surface is red, granular, yellow-green exudate or resolution potentially leading to constriction pericarditis.

Hemorrhagic Pericarditis

• Exudate composed of blood intermixed with fibrinous or suppurative effusion. Causes include tuberculosis, malignant neoplasia, cardiac surgery, or caseous pericarditis.

Test your knowledge on various vascular tumors and tumor-like lesions such as Nevus Flammeus, Port Wine Stain, and Hemangiomas. This quiz covers their characteristics, associations, and clinical implications. Boost your understanding of these conditions and their significance in medical practice.