Microvenular hemangioma
{{Infobox medical condition (new)
| synonyms = Microcapillary hemangioma{{cite book |author=Rapini, Ronald P. |author2=Bolognia, Jean L. |author3=Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |isbn=978-1-4160-2999-1 }}
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Microvenular hemangioma is an acquired benign vascular tumor that presents as an asymptomatic, slowly growing, 0.5- to 2.0 cm reddish lesion on the forearms or other sites of young to middle-aged adults.{{cite book|author=James, William|author2=Berger, Timothy|author3=Elston, Dirk|year=2005| title=Andrews' Diseases of the Skin: Clinical Dermatology|url=https://archive.org/details/andrewsdiseasess00mdwi_659|url-access=limited|edition=10th|page=[https://archive.org/details/andrewsdiseasess00mdwi_659/page/n606 596]|publisher=Saunders|isbn= 978-0-7216-2921-6}} The cause of microvenular hemangioma is unknown, however it has been associated with immunosuppression.
Signs and symptoms
Microvenular hemangioma appears as slow-growing, frequently numerous lesions, erythematous, violaceous, or moderately pruriginous macules, papules, or nodules without any symptoms.{{cite journal | last1=Xu | first1=Xiu-Lian | last2=Xu | first2=Cui-Rong | last3=Chen | first3=Hao | last4=Cao | first4=Yuan-Hua | last5=Zeng | first5=Xue-Si | last6=Sun | first6=Jian-Fang | last7=Guo | first7=Ying | title=Eruptive Microvenular Hemangiomas in 4 Chinese Patients: Clinicopathologic Correlation and Review of the Literature | journal=The American Journal of Dermatopathology | volume=32 | issue=8 | date=2010 | issn=0193-1091 | doi=10.1097/DAD.0b013e3181d74290 | pages=837–840| pmid=20881833 }} They usually appear on the forearm. There have also been reports of lesions on the soles of the feet, forehead, legs, and chest.{{cite journal | last1=Giacaman | first1=A. | last2=del Pozo | first2=L.J. | last3=Bauzá | first3=A. | last4=Saus | first4=C. | title=Microvenular Hemangioma: Morphological Study of 3 Cases | journal=Actas Dermo-Sifiliográficas (English Edition) | publisher=Elsevier BV | volume=109 | issue=4 | year=2018 | issn=1578-2190 | doi=10.1016/j.adengl.2017.06.022 | pages=381–384| doi-access=free }}
Causes
Although the exact cause of microvenular hemangioma is uncertain, it has been found in certain instances during pregnancy or after changes in hormonal contraception.{{cite journal | last1=Bantel | first1=E. | last2=Grosshans | first2=E. | last3=Ortonne | first3=J. P. | title=[Understanding microcapillary angioma, observations in pregnant patients and in females treated with hormonal contraceptives] | journal=Zeitschrift für Hautkrankheiten | volume=64 | issue=12 | date=1989-12-15 | issn=0301-0481 | pmid=2534452 | pages=1071–1074}} In certain circumstances, imbalanced sex hormones could potentially be the cause.{{cite journal | last1=Ai | first1=Dong Fang | last2=Li | first2=Yan | last3=Jindal | first3=Aikaj | last4=Li | first4=Ping | title=Multiple microvenular hemangioma: A case report | journal=Oncology Letters | volume=7 | issue=1 | date=2014 | issn=1792-1074 | pmid=24348863 | pmc=3861598 | doi=10.3892/ol.2013.1659 | pages=275–277}} Microvenular hemangioma has also been associated with immunosuppression.{{cite journal | last1=Tur-González | first1=Raquel | last2=González-de Arriba | first2=Ana | last3=Martín-López | first3=María Rocío | last4=Ramos-Nieto | first4=María Luz | title=Hemangioma microvenular: lesión vascular benigna de patrón infiltrante. Presentación de 3 casos y revisión de la literatura | journal=Revista Española de Patología | publisher=Elsevier BV | volume=48 | issue=4 | year=2015 | issn=1699-8855 | doi=10.1016/j.patol.2015.07.004 | pages=203–207 | language=es}}
Diagnosis
Multiple distinct red globules are seen under a microscope, and a finely pigmented network is seen around the periphery.{{cite journal | last1=Scalvenzi | first1=Massimiliano | last2=De Natale | first2=Flora | last3=Francia | first3=Maria Grazia | last4=Balato | first4=Anna | title=Dermoscopy of Microvenular Hemangioma: Report of a Case | journal=Dermatology | publisher=S. Karger AG | volume=215 | issue=1 | year=2007 | issn=1018-8665 | doi=10.1159/000102038 | pages=69–71| pmid=17587844 }} Histologically, microvenular hemangioma is made up of venules with thin walls that branch erratically and have barely noticeable vascular lumina. The dermis's collagen bundles are thickened. Pericytes envelop the endothelial cells,{{cite journal | last1=Aloi | first1=Filippo | last2=Tomasini | first2=Carlo | last3=Pippione | first3=Mario | title=Microvenular Hemangioma | journal=The American Journal of Dermatopathology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=15 | issue=6 | year=1993 | issn=0193-1091 | doi=10.1097/00000372-199312000-00003 | pages=534–538}} which can exhibit a combination of plump and flat cells without pleomorphism or mitotic patterns.{{cite journal | last1=Fukunaga | first1=Masaharu | last2=Ushigome | first2=Shinichiro | title=Microvenular hemangioma | journal=Pathology International | publisher=Wiley | volume=48 | issue=3 | year=1998 | issn=1320-5463 | doi=10.1111/j.1440-1827.1998.tb03899.x | pages=237–239}}
Immunohistochemically, an microvenular hemangioma's endothelial cells show positive staining for CD31, CD34, and factor VIII, while its pericytes show positive staining for SMA.{{cite journal | last1=Stefanaki | first1=Christina | last2=Stefanaki | first2=Kalliopi | last3=Floros | first3=Konstantinos | last4=Rontogiani | first4=Dimitra | last5=Georgala | first5=Sofia | title=Microvenular Hemangioma: A Rare Vascular Lesion | journal=The Journal of Dermatology | publisher=Wiley | volume=32 | issue=5 | year=2005 | issn=0385-2407 | doi=10.1111/j.1346-8138.2005.tb00915.x | pages=402–404| pmid=16043906 }} However, neither cell shows positive staining for podoplanin.{{cite journal | last=Fernandez-Flores | first=Angel | title=Lack of expression of podoplanin by microvenular hemangioma | journal=Pathology - Research and Practice | publisher=Elsevier BV | volume=204 | issue=11 | year=2008 | issn=0344-0338 | doi=10.1016/j.prp.2008.06.002 | pages=817–821| pmid=18650031 }}
The differential diagnosis for microvenular hemangioma includes acquired (tufted) angioma, Kaposi sarcoma, Kaposiform hemangioendothelioma, and sclerosing hemangioma.{{cite book | last=Mocellin | first=Simone | title=Soft Tissue Tumors | chapter=Microvenular Hemangioma | publisher=Springer International Publishing | publication-place=Cham | date=2021 | isbn=978-3-030-58709-3 | doi=10.1007/978-3-030-58710-9_173 | pages=553–554}}
Treatment
See also
References
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Further reading
- {{cite journal | last1=Napekoski | first1=Karl M. | last2=Fernandez | first2=Anthony P. | last3=Billings | first3=Steven D. | title=Microvenular hemangioma: a clinicopathologic review of 13 cases | journal=Journal of Cutaneous Pathology | publisher=Wiley | volume=41 | issue=11 | date=2014-10-29 | issn=0303-6987 | doi=10.1111/cup.12386 | pages=816–822 | pmid=25263662 | ref=none}}
- {{cite journal | last1=Kim | first1=Y.-C. | last2=Park | first2=H.-J. | last3=Cinn | first3=Y.-W. | title=Microvenular Hemangioma | journal=Dermatology | volume=206 | issue=2 | date=2003 | issn=1018-8665 | doi=10.1159/000068453 | pages=161–164 | pmid=12592086 | ref=none}}
External links
- [https://www.visualdx.com/visualdx/diagnosis/microvenular+hemangioma?diagnosisId=54922&moduleId=101 VisualDx]
{{Medical resources
| ICD11 = {{ICD11|XH9UU3}}
| ICD10 = {{ICD10|D18.0}}
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{{Vascular tumors}}