Pathology of Spindle Cell Hemangioma (Haemangioendothelioma)
hemangioma (hemangioendothelioma) is a distinct vascular lesion which was
initially considered to be a low grade angiosarcoma when
first described in 1986.
In recent years it has been suggested that spindle cell hemangioma is probably a vascular malformation or the lesion results from abnormalities of local blood flow.
Spindle cell hemangioma may be associated with anomalies such as Mafucci's syndrome, Klippel-Trenaunay syndrome, lymphedema and early onset varicose vein.
Treatment consists of
wide local excision without adjuvant chemotherapy or radiotherapy.
These lesions usually present as a single or multiple, often
painful, small circumscribed
reddish blue nodules.
Microscopic Images of Spindle Cell Hemangioma
Microscopically this poorly circumscribed lesion consists of three main components:
- Vascular component displaying gaping thin-walled vessels containing organizing thrombi (features resemble Cavernous hemangioma).
- Solid area of spindle cells together with slit like vascular spaces (features resemble Kaposi's Sarcoma).
- Plump endothelial cells. Some of these cells contain vacuoles or intracytoplasmic lumina.
The spindle cells are immunonegative for endothelial marker CD34 . Most of these spindle cells stain positively for Vimentin and some cells are positive for actin and desmin.
Unlike Spindle cell hemangioendothelioma the spindle cells in Kaposi's sarcoma stain positively for CD34.
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