tumors of blood vessels - ju medicine...tumors benign tumors contain vascular channels lined by...
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CVS TUMORS
Dr. Nisreen Abu Shahin
Associate Professor of Pathology
Pathology Department
University of Jordan
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Vascular tumors
Borderline
tumorsMalignant
tumors
benign tumors
contain vascular
channels
lined by normal-
appearing
endothelial cells
intermediate
between benign
and malignant
behavior
More cellular
Cytologic atypia
Proliferative
D not form well-
organized vessels
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Benign
Malignant
Borderline
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NOMENCLATURE
Hem-angi-oma
Lymph-angi-oma
Angiosarcoma
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TUMORS OF BLOOD VESSELS
1- benign (most common)
e.g. hemangioma
2- borderline (locally aggressive)
e.g. kaposi sarcoma
3- malignant (rare; metastasis)
e.g. angiosarcoma
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HEMANGIOMA
common
composed of blood-filled vessels.
m/c age: infancy & childhood
Most are present from birth
many regress spontaneously (↓ size)
m/c location: head and neck
Some in internal organs (1/3 liver)
Malignant transformation: very rare
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HISTOLOGIC AND CLINICAL VARIANTS:
1- Capillary hemangiomas :
- most common type
- skin and mucous membranes of oral cavity & lips
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2- strawberry hemangiomas of newborn
(juvenile hemangioma):
- m/c head & neck
- Usually regress with time
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3- Pyogenic granulomas:
- rapidly growing pedunculated
lesions on gingival mucosa
- 1/3 history of trauma
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4- Cavernous hemangiomas :
- large, dilated vascular channels
- deep organs (liver most common)
- do not spontaneously regress
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INTERMEDIATE-GRADE (BORDERLINE)
TUMORS
Kaposi Sarcoma (KS)
a vascular neoplasm caused by human
herpesvirus- 8 = HHV-8
Several types: classic; endemic;
Transplantation-associated; and AIDS-
associated;
AIDS-associated (epidemic) KS is an AIDS-
defining illness (used as a criterion for
diagnosis of AIDS)
the most common HIV-related malignancy
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kaposi sarcoma: Multiple red-purple skin
plaques or nodules, usually on the distal
lower extremities; progressively increase
in size and number and spread proximally
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MALIGNANT TUMORS
Angiosarcoma :
lesions can occur at any site, but most
often involve the skin, soft tissue, breast,
and liver.
Pathogenesis= ? Carcinogens; ?unknown
A latent period between exposure and
tumor development
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RISK FACTORS OF ANGIOSARCOMA
Chemical carcinogens liver
angiosarcoma
Irradiation
Lymphedema
- e.g. ipsilateral upper extremity several years
after radical mastectomy (i.e., with lymph node
resection) for breast cancer
foreign bodies long-term (years)
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CARDIAC TUMORS
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CARDIAC TUMORS
Very rare
Metastatic Neoplasms are the most common
malignancy of heart (5% of patients dying of
cancer).
most common source lung cancer
Angiosarcomas most common primary
malignant tumor of heart.
Benign tumors are also very rare but important
for their critical location
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CARDIAC MAGNETIC RESONANCE IMAGING (CMRI)
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"BALL-VALVE" OBSTRUCTION
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CLINICAL FEATURES AND SIGNIFICANCE
1- "ball-valve" obstruction
2- Embolization
3- fever and malaise tumor elaboration of
interleukin-6
Diagnosis: Echocardiography
Treatment: surgical resection in benign
tumors.