Clinical Manifestations and Pathological Diagnosis of Anastomosing Hemangioma

Abstract

Objective: To explore the clinical manifestations, histopathological features and differential diagnosis of anastomosing hemangioma. Methods: Histopathological observation and immunohistochemical study were performed on 3 cases of anastomosing hemangioma. Results: Among the 3 cases, 2 occurred in the adrenal gland and 1 in the mediastinum. The tumor had a thin fibrous capsule, with interlacing and anastomosing vascular-like arrangement. The vessel walls were irregular, with varying numbers of wall cells and uneven thickness, only a single layer of cells in the thin areas, while dense cell regions with abundant cells forming thick trabeculae. The cells were small with a low nuclear-cytoplasmic ratio, abundant eosinophilic cytoplasm, small round nuclei, thin nuclear membranes, fine chromatin and inconspicuous nucleoli. Eosinophilic edematous and fibrinoid stroma were visible. A small number of scattered irregular thick-walled blood vessels were found in the tumor; some areas resembled splenic medulla, some contained abundant edematous and hyaline stroma, and some endothelial cells could be hobnail-shaped. Conclusion: Anastomosing hemangioma is a newly reported benign vascular tumor, which is relatively rare. It generally has no obvious clinical symptoms and is occasionally found during physical examination. Due to the significant anastomosing arrangement of neoplastic blood vessels, it is easily misdiagnosed as angiosarcoma.