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Vascular Tumours

Pathology of Composite Hemangioendothelioma         

Dr Sampurna Roy MD         





Composite hemangioendothelioma is the most recently described entity of the Haemangioendothelioma (HE) spectrum.

These are vascular neoplasms with a spectrum of biological potential ranging from benign to low-grade malignancy.

Composite hemangioendothelioma is one of the less commonly encountered variants exhibiting a mixture of elements of other hemangioendothelioma subtypes, such as epithelioid, retiform, and spindle cell.

Local recurrences are common but metastasis is rare.

Site: Hands and feet.

Age: Adults

Microscopic features:   Case Link 

The tumours is composed of a complex admixture of histologic components that varied from tumour to tumour.

There is variation in the proportions of each component as well as the manner in which each component is distributed throughout each lesion.

The predominant histologic components are epithelioid hemangioendothelioma and retiform hemangioendothelioma.

In some cases there are areas of spindle cell hemangioendothelioma.

Angiosarcoma-like elements are also identified. (Occasional association with a history of lymphedema, raises the question of whether this variant of hemangioendothelioma may actually be an angiosarcoma that behaves prognostically better than the conventional type. )

In some cases large granular eosinophilic macrophages have been reported within the blood vessels of the retiform hemangioendothelioma - like areas.

Further reading:

Composite hemangioendothelioma and its classification as low-grade malignancy  

Composite hemangioendothelioma arising from the kidney: case report with review of the literature.

Bone Scan, MRI, and FDG PET/CT Findings in Composite Hemangioendothelioma of the Manubrium Sterni.

A Case of Composite Hemangioendothelioma Arising from the Spleen.Japanese Journal of Clinical Oncology Volume 42, Issue 8Pp. 770

Composite cutaneous hemangioendothelioma on the back.

Composite hemangioendothelioma: report of 5 cases including one with associated Maffucci syndrome.

Composite cutaneous haemangioendothelioma: case report and review of the literature.

Congenital composite hemangioendothelioma: case report and reappraisal of the hemangioendothelioma spectrum.

Composite hemangioendothelioma: a complex, low-grade vascular lesion mimicking angiosarcoma




Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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