Papillary haemangiomas occur across a wide age range, including children. There is no association with POEMS syndrome.
Lesions are located on the head or neck. There is a solitary non-tender bluish skin papule.
The lesion is within the dermis.
The lesion is within the dermis, in some cases extending into the subcutis. It consists of discontinuous foci of branching papillary proliferations which surround skin adnexa and invaginate thin-walled blood vessels. Within the stromal cores of the papillae, there are capillaries lined by normal endothelial cells surrounded by several layers of pericytes. The endothelial cells covering the papillae have swollen cytoplasm containing multiple intracytoplasmic hyaline globules or clear vacuoles, which may indent nuclei. The hyaline globules are positive with PAS.
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The hyaline globules within endothelial cells are electron-dense. There were also electron-light round globules.
Glomeruloid haemangioma has hyaline globules containing polytypic immunoglobulins. It is associated with POEMS syndrome and Castleman's disease. The vascular lesions are multiple, most often on the trunk and arms. The capillaries are small and arranged in a glomeruloid structure.
Intravascular lobular capillary haemangioma is identical to pyogenic granuloma, protruding into a vein
Papillary intralymphatic angioendothelioma usually occurs outside the head and neck, comprising thin-walled lymphatic vessels, positive for D2-40.
Papillary endothelial hyperplasia is a type of organising thrombus with endothelial cells proliferating around fibrin. Hyaline globules are lacking.
Kaposi sarcoma has hyaline globules associated with erythrophagocytosis
Excision
Benign, may recur
This page last revised 28.11.2007.
©SMUHT/PW Bishop