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Anastomosing hemangioma with fatty changes of the genitourinary tract: a lesion mimicking angiomyolipoma.

Tran TA, Pernicone P - Cent European J Urol (2012)

Bottom Line: Anastomosing hemangioma of the genitourinary tract is a recently described vascular lesion of the kidneys and testes.We described a case of an anastomosing hemangioma associated with fatty changes of the stromal component in a 59-year-old female patient.This unusual morphologic finding not only represents a novel curiosity in this rare type of vascular lesion, but also could potentially pose significant diagnostic challenges as it is commonly mistaken as an angiomyolipoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Florida Hospital Orlando, FL, USA.

ABSTRACT
Anastomosing hemangioma of the genitourinary tract is a recently described vascular lesion of the kidneys and testes. Although these lesions can occur in the renal hilum with infiltration of the hilar adipose tissue, the presence of adipocytes in this type of vascular tumor has not been reported. We described a case of an anastomosing hemangioma associated with fatty changes of the stromal component in a 59-year-old female patient. This unusual morphologic finding not only represents a novel curiosity in this rare type of vascular lesion, but also could potentially pose significant diagnostic challenges as it is commonly mistaken as an angiomyolipoma.

No MeSH data available.


Related in: MedlinePlus

Encapsulated tumor, well demarcated from surrounding adipose tissue of the renal hilum (2A, x 20) with clusters of fat cells (arrow) between the vascular channels (2B, x 40) (H & E stain).
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Figure 0002: Encapsulated tumor, well demarcated from surrounding adipose tissue of the renal hilum (2A, x 20) with clusters of fat cells (arrow) between the vascular channels (2B, x 40) (H & E stain).

Mentions: Under low power examination, the lesion was well circumscribed and appeared encapsulated (Fig. 2a). The wall-like capsule was composed predominantly of smooth muscle as highlighted by immunohistochemistry for smooth muscle actin. However, the capsule was devoid of elastic fibers and internal elastic lamina based on evaluation of Verhoeff's elastic stain. The tumor was composed of dilated sinusoidal capillary-like vessels that were lined by hobnail endothelial cells with a mild degree of nuclear atypia (Fig. 3B). Rare medium-sized vessels with thick muscular walls were present at the periphery of the tumor. Fibrin thrombi and extramedullary hematopoiesis were easily identified in the lumen of the small vessels (Fig. 3a and 3b). In several areas, the architecture of the capillary-like vessels was reminiscent of splenic parenchyma (Fig. 3a). A small focus of intravascular extension was observed at the periphery of the tumor (Fig. 4). The central portion of the tumor appeared sclerotic and edematous. Of interest was the presence of several clusters of fat cells distributed throughout the lesion (Fig. 2b). Immunohistochemical studies for CD31 and Factor VIII highlighted the extensive endothelial cell-lined vascular network. The tumor demonstrated no immunoreactivity for Melan-A, HMB-45, and EMA. Although the tumor was negative for S-100 protein, the fat cells were strongly positive for this antibody. The overall histologic and immunohistochemical findings of the tumor were consistent with those of an anastomosing hemangioma of the genitourinary tract with fatty changes.


Anastomosing hemangioma with fatty changes of the genitourinary tract: a lesion mimicking angiomyolipoma.

Tran TA, Pernicone P - Cent European J Urol (2012)

Encapsulated tumor, well demarcated from surrounding adipose tissue of the renal hilum (2A, x 20) with clusters of fat cells (arrow) between the vascular channels (2B, x 40) (H & E stain).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921769&req=5

Figure 0002: Encapsulated tumor, well demarcated from surrounding adipose tissue of the renal hilum (2A, x 20) with clusters of fat cells (arrow) between the vascular channels (2B, x 40) (H & E stain).
Mentions: Under low power examination, the lesion was well circumscribed and appeared encapsulated (Fig. 2a). The wall-like capsule was composed predominantly of smooth muscle as highlighted by immunohistochemistry for smooth muscle actin. However, the capsule was devoid of elastic fibers and internal elastic lamina based on evaluation of Verhoeff's elastic stain. The tumor was composed of dilated sinusoidal capillary-like vessels that were lined by hobnail endothelial cells with a mild degree of nuclear atypia (Fig. 3B). Rare medium-sized vessels with thick muscular walls were present at the periphery of the tumor. Fibrin thrombi and extramedullary hematopoiesis were easily identified in the lumen of the small vessels (Fig. 3a and 3b). In several areas, the architecture of the capillary-like vessels was reminiscent of splenic parenchyma (Fig. 3a). A small focus of intravascular extension was observed at the periphery of the tumor (Fig. 4). The central portion of the tumor appeared sclerotic and edematous. Of interest was the presence of several clusters of fat cells distributed throughout the lesion (Fig. 2b). Immunohistochemical studies for CD31 and Factor VIII highlighted the extensive endothelial cell-lined vascular network. The tumor demonstrated no immunoreactivity for Melan-A, HMB-45, and EMA. Although the tumor was negative for S-100 protein, the fat cells were strongly positive for this antibody. The overall histologic and immunohistochemical findings of the tumor were consistent with those of an anastomosing hemangioma of the genitourinary tract with fatty changes.

Bottom Line: Anastomosing hemangioma of the genitourinary tract is a recently described vascular lesion of the kidneys and testes.We described a case of an anastomosing hemangioma associated with fatty changes of the stromal component in a 59-year-old female patient.This unusual morphologic finding not only represents a novel curiosity in this rare type of vascular lesion, but also could potentially pose significant diagnostic challenges as it is commonly mistaken as an angiomyolipoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Florida Hospital Orlando, FL, USA.

ABSTRACT
Anastomosing hemangioma of the genitourinary tract is a recently described vascular lesion of the kidneys and testes. Although these lesions can occur in the renal hilum with infiltration of the hilar adipose tissue, the presence of adipocytes in this type of vascular tumor has not been reported. We described a case of an anastomosing hemangioma associated with fatty changes of the stromal component in a 59-year-old female patient. This unusual morphologic finding not only represents a novel curiosity in this rare type of vascular lesion, but also could potentially pose significant diagnostic challenges as it is commonly mistaken as an angiomyolipoma.

No MeSH data available.


Related in: MedlinePlus