[Clinicopathological features of congenital hemangioma: a study of 40 cases].

• DOI: 10.3760/cma.j.cn112151-20211026-00776
• Publication Date: 2022-03-08
• Authors: Donghua Liang; B Zhou; N Li; Lingfei Kong; Q Y Liu; K L Ding; X S Niu; He Zhu; Haohui Zhu
• Keywords: CD31; Vascular malformation; Cuboidal Cell; Lumen (anatomy)

Objective: To investigate the clinical and pathologic features, diagnosis differential of congenital hemangioma (CH). Methods: Forty cases CH were diagnosed from January 2017 to December 2020 in Henan Provincial People's Hospital. The pathological immunohistochemical data analyzed, with review literature. Results: There 24 male 16 female patients. lesions located head, neck (11 cases), limbs (14 trunk (15 cases). manifestations painless plaques or masses, larger ones protruded on skin surface, mostly dusky purple bright red, surrounding white halos. Under low magnification, tumor was lobular well demarcated, composed neo-microvascular lumen different sizes. vascular endothelial cells cuboidal hobnail appearance, forming stellar drainage vessels within lobules. Extra-medullary hematopoiesis seen one case rapidly involuting CH; there number tortuous dilated between structures, some non-involuting malformations, which devoid lobulated structures. Immunohistochemistry showed that strongly positive for CD31, CD34 ERG, while D2-40 GLUT-1 negative. Conclusions: is a benign characteristic growth abnormal blood stroma. Pathological often needs be differentiated infantile hemangioma, pyogenic granuloma, kaposiform hemangioendothelioma malformation.目的： 探讨先天性血管瘤（congenital hemangioma，CH）临床及病理学特征、诊断及鉴别诊断。 方法： 回顾性收集河南省人民医院2017年1月至2020年12月确诊CH病例40例，分析临床及病理学资料，采用免疫组织化学法检测相关指标，并复习文献。 结果： 40例CH中，男性24例，女性16例，发病部位有头面颈部（11例）、四肢（14例）、躯干（15例）。临床主要表现为出生时即发现，呈缓慢生长的无痛性斑块或肿块，较大者隆起于皮肤表面，多呈青紫色或鲜红色，周围可见白色晕环。低倍镜下见肿瘤组织界限尚清，呈分叶状结构生长，小叶内可见大小不等新生血管腔形成，血管内皮细胞呈立方样或钉突样形态，小叶内可见星状引流血管，1例快速消退型CH可见髓外造血现象；小叶之间可见多少不等迂曲扩张畸形血管腔，部分不消退型CH以畸形血管为主，分叶状结构不明显。免疫组织化学示血管内皮细胞呈CD31、CD34、ERG强阳性，D2-40和葡萄糖转运蛋白-1阴性。 结论： CH是一种良性的先天性血管肿瘤，形态学呈特征性分叶状生长，间质可见畸形血管；病理诊断常需与婴儿性血管瘤、化脓性肉芽肿、卡波西型血管内皮瘤以及脉管畸形相鉴别。.