Difference between revisions of "Anastomosing hemangioma of the kidney"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Anastomosing hemangioma of the kidney -- intermed mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Anastomosing hemangioma of the kidney. [[H&E stain]].
| Synonyms  =
| Synonyms  = renal anastomosing hemangioma
| Micro      =
| Micro      = vascular tumour with architecture similar to splenic sinsoids, hobnailing, +/-[[hyaline globules]], +/-[[extramedullary hematopoiesis]]
| Subtypes  =
| Subtypes  =
| LMDDx      =
| LMDDx      = [[angiosarcoma]], other [[hemangioma]]s, other [[vascular tumours]], [[angiomyolipoma]]
| Stains    =
| Stains    =
| IHC        =
| IHC        = CD34 +ve, CD31 +ve, HHV-8
| EM        =
| EM        =
| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      =
| Gross      = brown/mahogany lesion, classically centered on medulla of kidney
| Grossing  =
| Grossing  = [[total nephrectomy for tumour grossing]], [[partial nephrectomy grossing]]
| Staging    =
| Staging    =
| Site      =
| Site      = [[kidney]]
| Assdx      =
| Assdx      = +/-[[end stage renal disease]]
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx =  
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence =
| Prevalence = very rare
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      = may mimic [[renal cell carcinoma]]
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  = benign
| Other      =
| Other      =
| ClinDDx    =
| ClinDDx    = [[renal tumours]]
| Tx        =
| Tx        = excision for definitive diagnosis?
}}
}}
'''Anastomosing hemangioma''' a rare benign [[vascular tumour]] that is typically found in the [[kidney]] and may mimic [[angiosarcoma]].<ref name=pmid19606014>{{Cite journal  | last1 = Montgomery | first1 = E. | last2 = Epstein | first2 = JI. | title = Anastomosing hemangioma of the genitourinary tract: a lesion mimicking angiosarcoma. | journal = Am J Surg Pathol | volume = 33 | issue = 9 | pages = 1364-9 | month = Sep | year = 2009 | doi = 10.1097/PAS.0b013e3181ad30a7 | PMID = 19606014 }}</ref>
'''Anastomosing hemangioma of the kidney''' a rare benign [[vascular tumour]] of [[kidney]] that may mimic [[angiosarcoma]].<ref name=pmid19606014>{{Cite journal  | last1 = Montgomery | first1 = E. | last2 = Epstein | first2 = JI. | title = Anastomosing hemangioma of the genitourinary tract: a lesion mimicking angiosarcoma. | journal = Am J Surg Pathol | volume = 33 | issue = 9 | pages = 1364-9 | month = Sep | year = 2009 | doi = 10.1097/PAS.0b013e3181ad30a7 | PMID = 19606014 }}</ref>


==General==
==General==
*Rare - case reports.
*Rare - case reports.
**The bigger category ''vascular tumours of the kidney'' is rare; in the world literature (as of 2015), according to Omiyale, there are approximately 40 angiosarcoma and 220 hemangiomas.<ref name=pmid26244138>{{Cite journal  | last1 = Omiyale | first1 = AO. | title = Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma. | journal = Ann Transl Med | volume = 3 | issue = 11 | pages = 151 | month = Jul | year = 2015 | doi = 10.3978/j.issn.2305-5839.2015.06.16 | PMID = 26244138 }}</ref>
*Typically seen in [[end stage renal disease]].<ref name=pmid27543862/>
*Typically seen in [[end stage renal disease]].<ref name=pmid27543862/>
 
*May mimic renal cell carcinoma clinically.<ref name=pmid28727378>{{Cite journal  | last1 = Silva | first1 = MA. | last2 = Fonseca | first2 = EKUN. | last3 = Yamauchi | first3 = FI. | last4 = Baroni | first4 = RH. | title = Anastomosing hemangioma simulating renal cell carcinoma. | journal = Int Braz J Urol | volume = 43 | issue = 5 | pages = 987-989 | month =  | year =  | doi = 10.1590/S1677-5538.IBJU.2016.0653 | PMID = 28727378 }}</ref>
==Gross==
==Gross==
Features:
Features:
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==Microscopic==
==Microscopic==
Features:
Features:
*Vascular tumour characterized by vessels that fuse/join (anastomose) - also described as ''splenic sinusoids-like''.<ref name=pmid27543862/>
*Vascular tumour characterized by vessels that fuse/join (anastomose); described as ''splenic sinusoids-like''.<ref name=pmid27543862/>
**+/-[[Hobnail morphology]].
**+/-[[Hobnail morphology]].
**+/-Cytoplasmic hyaline globules.
**+/-Cytoplasmic hyaline globules.
*+/-Extramedullary hematopoiesis.
*+/-[[Extramedullary hematopoiesis]].
**Nucleated red blood cells.
**[[Nucleated red blood cell]]s.
**Megakaryocytes.  
**Megakaryocytes.  


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DDx:
DDx:
*[[Angiosarcoma]] - [[nuclear atypia]], more proliferative activity.
*[[Angiosarcoma]] - [[nuclear atypia]], more proliferative activity.
*[[Angiomyolipoma]].
===Images===
<gallery>
Image: Anastomosing hemangioma of the kidney -- low mag.jpg | AH - low mag. (WC)
Image: Anastomosing hemangioma of the kidney -- intermed mag.jpg | AH - intermed. mag. (WC)
Image: Anastomosing hemangioma of the kidney -- high mag.jpg | AH - high mag. (WC)
Image: Anastomosing hemangioma of the kidney -- very high mag.jpg | AH - very high mag. (WC)
Image: Anastomosing hemangioma of the kidney - alt -- extremely low mag.jpg | AH - extremely low mag. (WC)
Image: Anastomosing hemangioma of the kidney - alt -- very low mag.jpg | AH - very low mag. (WC)
Image: Anastomosing hemangioma of the kidney - alt -- low mag.jpg | AH - low mag. (WC)
Image: Anastomosing hemangioma of the kidney - alt -- intermed mag.jpg | AH - intermed. mag. (WC)
Image: Anastomosing hemangioma of the kidney - b -- intermed mag.jpg | AH - intermed. mag. (WC)
Image: Anastomosing hemangioma of the kidney - b -- high mag.jpg | AH - high mag. (WC)
</gallery>


==IHC==
==IHC==
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[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Soft tissue lesions]]
[[Category:Soft tissue lesions]]
[[Category:Kidney tumours]]

Latest revision as of 13:33, 28 December 2018

Anastomosing hemangioma of the kidney
Diagnosis in short

Anastomosing hemangioma of the kidney. H&E stain.
Synonyms renal anastomosing hemangioma
LM vascular tumour with architecture similar to splenic sinsoids, hobnailing, +/-hyaline globules, +/-extramedullary hematopoiesis
LM DDx angiosarcoma, other hemangiomas, other vascular tumours, angiomyolipoma
IHC CD34 +ve, CD31 +ve, HHV-8
Gross brown/mahogany lesion, classically centered on medulla of kidney
Grossing notes total nephrectomy for tumour grossing, partial nephrectomy grossing
Site kidney
Associated Dx +/-end stage renal disease
Prevalence very rare
Radiology may mimic renal cell carcinoma
Prognosis benign
Clin. DDx renal tumours
Treatment excision for definitive diagnosis?

Anastomosing hemangioma of the kidney a rare benign vascular tumour of kidney that may mimic angiosarcoma.[1]

General

  • Rare - case reports.
    • The bigger category vascular tumours of the kidney is rare; in the world literature (as of 2015), according to Omiyale, there are approximately 40 angiosarcoma and 220 hemangiomas.[2]
  • Typically seen in end stage renal disease.[3]
  • May mimic renal cell carcinoma clinically.[4]

Gross

Features:

  • Mahogany/brown - centered on medulla of kidney.[3]

Microscopic

Features:

Note:

  • Tumour may extend into surrounding adipose tissue.

DDx:

Images

  • AH - low mag. (WC)

  • AH - intermed. mag. (WC)

  • AH - high mag. (WC)

  • AH - very high mag. (WC)

  • AH - extremely low mag. (WC)

  • AH - very low mag. (WC)

  • AH - low mag. (WC)

  • AH - intermed. mag. (WC)

  • AH - intermed. mag. (WC)

  • AH - high mag. (WC)

IHC

Features:[3]

  • CD31 +ve.
  • CD34 +ve.
  • HHV8 -ve.

See also

References

  1. ↑ Montgomery, E.; Epstein, JI. (Sep 2009). "Anastomosing hemangioma of the genitourinary tract: a lesion mimicking angiosarcoma.". Am J Surg Pathol 33 (9): 1364-9. doi:10.1097/PAS.0b013e3181ad30a7. PMID 19606014.
  2. ↑ Omiyale, AO. (Jul 2015). "Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma.". Ann Transl Med 3 (11): 151. doi:10.3978/j.issn.2305-5839.2015.06.16. PMID 26244138.
  3. ↑ 3.0 3.1 3.2 3.3 Kuroda, N.; Ohe, C.; Deepika, S.; Yorita, K.; Mikami, S.; Furuya, M.; Nagashima, Y.; Hes, O. et al. (Jun 2016). "Review of renal anastomosing hemangioma with focus on clinical and pathological aspects.". Pol J Pathol 67 (2): 97-101. PMID 27543862.
  4. ↑ Silva, MA.; Fonseca, EKUN.; Yamauchi, FI.; Baroni, RH.. "Anastomosing hemangioma simulating renal cell carcinoma.". Int Braz J Urol 43 (5): 987-989. doi:10.1590/S1677-5538.IBJU.2016.0653. PMID 28727378.
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