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1
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Faraz M, Rosenzweig A, Panizo A, Hajiyeva S, Subasi NB, Alghamdi MA, Lightle AA, Kuthi L, Kelemen D, Sangoi AR, Nova-Camacho LM, Martos MG, Movassaghi M, Lobo A, Jha S, Yörükoğlu K, Bayrak BY, Williamson SR, Bhardwaj S, Kandukuri S, Kaushal S, Mohanty SK, Akgul M. Primary intrarenal hemangioma - A series of 39 cases. Ann Diagn Pathol 2025; 75:152436. [PMID: 39793165 DOI: 10.1016/j.anndiagpath.2025.152436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 01/03/2025] [Accepted: 01/06/2025] [Indexed: 01/13/2025]
Abstract
Intrarenal hemangiomas lack concise clinicopathologic information, due to the predominance of single case reports and inclusion of other vascular neoplasms and hemangiomas of perirenal, hilar, and renal vein origin. Herein, in this multi-institutional study we evaluate clinicopathologic features of 39 intrarenal hemangiomas. The median age was 62 years (range = 27-94 years; 2:1 male to female ratio), with left-sided predominance (left = 21, right = 13; one case was bilateral). The median tumor size was 1.5 cm (0.2-10 cm). Two cases arose from transplanted kidneys. Most were asymptomatic (n = 30, 86 %), even though most surgical interventions (19 partial, 19 radical, 1 biopsy) were due to hemangiomas (n = 24, 62 %). Synchronous renal neoplasms were present in 9 (23 %) patients, including clear cell renal cell carcinoma (RCC) (n = 4), angiomyolipoma (n = 2), oncocytoma (n = 2), and chromophobe RCC (n = 1). Multifocal hemangiomas (n = 5) were seen in cases with end stage renal disease. Intrarenal hemangiomas were mostly anastomosing (n = 18; 46 %), followed by capillary (n = 15; 38 %), and cavernous (n = 6; 16 %) subtypes. Fibrin thrombus (n = 9; 23 %) and extramedullary hematopoiesis (n = 4; 10 %) were occasionally present, the latter being only in the anastomosing subtype. Immunohistochemistry was performed on a majority (n = 33, 84 %) of hemangiomas, with vascular markers CD31 and CD34 and lack of PAX8 were most used for diagnosis. 30 patients had follow-up (median 48 months, range 1-241 months), none showed disease progression/recurrence. This study provides comprehensive observation of the largest intrarenal hemangioma cohort, highlighting their frequent cause of surgical intervention when present, predominance of anastomosing subtype, multifocality in end stage kidney disease, and occasional concurrent ipsilateral neoplasms.
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Affiliation(s)
- Maria Faraz
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | | | - Angel Panizo
- Hospital Universitario de Navarra, Pamplona, Spain
| | - Sabina Hajiyeva
- Department of Pathology and Laboratory Medicine, Lenox Hill Hospital, Zucker School of Medicine, New York, NY, USA
| | - Nusret B Subasi
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Mohammed A Alghamdi
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Andrea A Lightle
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Levente Kuthi
- Department of Surgical and Molecular Pathology, Tumor Pathology Center, National Institute of Oncology, Budapest, Hungary
| | - Dora Kelemen
- Pathology Unit, Uzsoki Street Hospital, Budapest, Hungary
| | | | - Luiz M Nova-Camacho
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | | | - Mehrnaz Movassaghi
- Department of Pathology, University of California at Irvine School of Medicine, Irvine, CA, USA
| | - Anandi Lobo
- Kapoor Centre for Urology and Pathology, Raipur, Chhattisgarh, India
| | | | - Kutsal Yörükoğlu
- Dokuz Eylul Universitesi Tip Fakultesi Tibbi Patoloji Anabilim Dali, Izmir, Turkiye
| | - Busra Yaprak Bayrak
- Kocaeli Universitesi Tip Fakultesi Tibbi Patoloji Anabilim Dali, Kocaeli, Turkiye
| | - Sean R Williamson
- Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Swati Bhardwaj
- Department of Pathology and Laboratory Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Shivani Kandukuri
- Department of Pathology and Laboratory Medicine, Keck School of Medicine, Los Angeles, CA, USA
| | - Seema Kaushal
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Mahmut Akgul
- Department of Pathology and Laboratory Medicine, Brigham and Women's Hospital, Boston, USA.
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2
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Chen J, Cai DM. Renal anastomosing hemangioma following partial nephrectomy for renal cell carcinoma: A case report. World J Clin Cases 2024; 12:4010-4015. [PMID: 38994314 PMCID: PMC11235457 DOI: 10.12998/wjcc.v12.i19.4010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/25/2024] [Accepted: 05/10/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Renal anastomosing hemangioma (AH) is a rare benign vascular tumor characterized by unique histopathological features. CASE SUMMARY We report a highly unusual case of renal AH. A male patient had undergone partial nephrectomy for clear cell carcinoma of the kidney four years prior. A follow-up computed tomography scan in the third postoperative year revealed a new mass near the surgical site on the same side of the kidney, raising suspicions of tumor recurrence. However, the characteristics on contrast-enhanced magnetic resonance imaging and ultrasonography were more consistent with those of a benign lesion. The patient strongly insisted on undergoing surgery due to concerns about the possibility of renal cancer recurrence. Postoperative pathology confirmed the diagnosis of renal AH. CONCLUSION This case report presents the imaging features of a patient with rare renal AH and a history of renal clear cell carcinoma, providing broader insights into the differential diagnosis of new lesions after surgery for renal cell carcinoma.
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Affiliation(s)
- Juan Chen
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Di-Ming Cai
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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3
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Zhang ZY, Hong P, Deng SH, Tang SY, Liu Z, He HY, Ma LL, Zhang SD, Tian XJ. Spermatic cord anastomosing hemangioma mimicking a malignant inguinal tumor: A case report and literature review. Front Surg 2022; 9:930160. [PMID: 35937604 PMCID: PMC9354528 DOI: 10.3389/fsurg.2022.930160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Anastomosing hemangioma (AH) is a rare vascular tumor and occurs in various organs. It is difficult to distinguish AH from malignant tumors even through multimodal imaging examination. AH located in the inguinal region is even rare. We present the diagnosis and treatment of a patient with spermatic cord AH in detail and conduct a literature review. Case Report An 84-year-old Chinese man had swelling pain in his right scrotum. A hard and fixed mass was palpable in the right inguinal region. Preoperative radiological examination considered it a neurogenic or vascular tumor. Malignant soft tissue sarcoma could not be excluded. He underwent radical inguinal right orchiectomy under intraspinal anesthesia. The diagnosis of spermatic cord AH was confirmed by pathological examination. The patient recovered uneventfully and remained disease-free during an 18-month follow-up. Conclusion Spermatic cord AH is quite rare and could be misdiagnosed as a malignant tumor. Pathological evidence might be necessary. The optimal choice of treatment should be determined through a comprehensive assessment of both tumor and patient factors.
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Affiliation(s)
- Zhan-yi Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Peng Hong
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Shao-hui Deng
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Shi-ying Tang
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Zhuo Liu
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Hui-ying He
- Department of Pathology, Peking University Third Hospital, Beijing, China
| | - Lu-lin Ma
- Department of Urology, Peking University Third Hospital, Beijing, China
- Correspondence: Lulin Ma Shudong Zhang Xiaojun Tian
| | - Shu-dong Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China
- Correspondence: Lulin Ma Shudong Zhang Xiaojun Tian
| | - Xiao-jun Tian
- Department of Urology, Peking University Third Hospital, Beijing, China
- Correspondence: Lulin Ma Shudong Zhang Xiaojun Tian
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4
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Omiyale AO. Primary vascular tumours of the kidney. World J Clin Oncol 2021; 12:1157-1168. [PMID: 35070735 PMCID: PMC8716994 DOI: 10.5306/wjco.v12.i12.1157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/01/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Primary vascular tumours of the kidney are rare and may pose diagnostic difficulties because of their similar clinical, morphological, and immunohistochemical features. This article summarizes the clinical and pathological features of primary renal angiosarcoma and anastomosing haemangioma of the kidney including epidemiology, genetics, and prognosis. Renal anastomosing haemangiomas are benign neoplasms characterized by anastomosing capillary-sized vascular channels. These tumours are rare, with about 75 cases reported in the literature. Most anastomosing haemangiomas are found incidentally on ultrasound, computed tomography, or magnetic resonance imaging. Common symptoms include abdominal pain, haematuria, and abdominal mass. Renal anastomosing haemangiomas are characterized by recurrent mutations in GNAQ and GNA14 genes. The prognosis of anastomosing haemangioma is excellent. Primary renal angiosarcomas are malignant tumours showing endothelial differentiation. To date, 76 cases have been described in the literature. Primary renal angiosarcomas are frequently symptomatic. The clinical features of renal angiosarcomas are similar to those of renal anastomosing haemangiomas, including abdominal pain, haematuria, and abdominal mass. Angiogenesis-related genes and vascular-specific receptor tyrosine kinases such as KDR, TIE1, SNRK, TEK, and FLT1 are upregulated in angiosarcomas. Primary renal angiosarcomas are highly aggressive neoplasms with a poor prognosis despite surgical treatment, chemotherapy, radiotherapy, or targeted therapy.
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Affiliation(s)
- Ayo O Omiyale
- Department of Cellular Pathology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, United Kingdom
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5
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Case Report on Anastomosing Haemangioma: An Unusual Vascular Tumor in Kidney. Case Rep Nephrol 2021; 2021:8847998. [PMID: 33505742 PMCID: PMC7810550 DOI: 10.1155/2021/8847998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/30/2020] [Accepted: 12/30/2020] [Indexed: 11/18/2022] Open
Abstract
Anastomosing haemangioma is a rare benign vascular neoplasm, which may mimic angiosarcoma histologically. We here present a case of anastomosing haemangioma arising from the kidney. This patient presented with a large kidney mass and adrenal mass. The clinical and radiological findings were suspicious for renal cell carcinoma with metastasis. Radical nephrectomy and adrenalectomy were thus performed. Histopathological examination and immunohistochemical studies concluded a diagnosis of anastomosing haemangioma of the kidney and concurrent adrenal cortical adenoma. It is important to differentiate this tumor from other borderline or malignant vascular neoplasms.
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6
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Geramizadeh B, Shams N, Iranpour P, Rajabi MJ. Renal Capillary Hemangioma Mimicking Urothelial Carcinoma, A Case Report and Review of the Literature. IRANIAN JOURNAL OF PATHOLOGY 2019; 14:175-179. [PMID: 31528175 PMCID: PMC6679672 DOI: 10.30699/ijp.14.2.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/28/2019] [Indexed: 11/17/2022]
Abstract
Renal hemangioma is a rare tumor which can be capillary or cavernous. There have been less than 30 renal capillary hemangioma cases reported in the English literature. Herein we will report a case of renal hemangioma which was detected in a 74-year-old man operated with the impression of urothelial carcinoma of hilum.
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Affiliation(s)
- Bita Geramizadeh
- MD, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran.,Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Pouya Iranpour
- MD, Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
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7
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Bui TL, Glavis-Bloom J, Liu HK, Ushinsky A, Souccar S, Ibe IO, Sasani A, Houshyar R. Multiple renal capillary hemangiomas in a patient with end-stage renal disease. Radiol Case Rep 2019; 14:750-754. [PMID: 30992734 PMCID: PMC6449744 DOI: 10.1016/j.radcr.2019.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 03/25/2019] [Indexed: 11/09/2022] Open
Abstract
Renal capillary hemangiomas are rare and benign vascular tumors which are typically incidentally discovered on imaging. Surgical excision is often performed, as imaging appearance is similar to malignant lesions. Renal hemangiomas are typically solitary and unilateral. We present a rare case of multiple renal capillary hemangiomas in a patient with end-stage renal disease. Two hemangiomas were detected on imaging and 2 smaller hemangiomas were detected upon pathological evaluation, suggesting there may be a wider prevalence of smaller, radiographically-occult renal hemangiomas.
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Affiliation(s)
- Thanh-Lan Bui
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Justin Glavis-Bloom
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Hanna K Liu
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Alexander Ushinsky
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Sami Souccar
- Department of Pathology, University of California Irvine, Orange, CA, USA
| | - Ifegwu O Ibe
- Department of Pathology, University of California Irvine, Orange, CA, USA
| | - Ali Sasani
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
| | - Roozbeh Houshyar
- Department of Radiological Sciences, University of California Irvine, Orange, CA, USA
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8
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Lappa E, Drakos E. Anastomosing Hemangioma: Short Review of a Benign Mimicker of Angiosarcoma. Arch Pathol Lab Med 2019; 144:240-244. [DOI: 10.5858/arpa.2018-0264-rs] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Anastomosing hemangioma is a rare neoplastic vascular lesion, histologically mimicking angiosarcoma. It is predominantly composed of irregularly anastomosing sinusoidal-like spaces lined by endothelial cells with minimal atypia, a frequently hobnail morphology, and minimally invasive margins. Since its original description in the genitourinary system, an increasing number of anastomosing hemangiomas have been reported, localized deep in the body in various organs, always with similar histologic features. It is more frequently asymptomatic, often discovered incidentally by imaging studies, owing to coexisting benign or malignant tumors. In renal cases, the most frequent clinical context is end-stage renal disease. There is overwhelming evidence of the benign nature of the lesion and an accurate diagnosis could prevent overtreatment. The differential diagnosis includes other benign vascular tumors, well-differentiated angiosarcoma, Kaposi sarcoma, and other vascular-rich neoplasms. We review the clinical and histopathologic characteristics of this peculiar lesion with an emphasis on the differential diagnosis.
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Affiliation(s)
- Eleni Lappa
- From the Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
| | - Elias Drakos
- From the Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, Crete, Greece
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9
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Tsuzuki T, Iwata H, Murase Y, Takahara T, Ohashi A. Renal tumors in end-stage renal disease: A comprehensive review. Int J Urol 2018; 25:780-786. [DOI: 10.1111/iju.13759] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/25/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Toyonori Tsuzuki
- Department of Surgical Pathology; Aichi Medical University Hospital; Nagakute Aichi Japan
| | - Hidehiro Iwata
- Department of Surgical Pathology; Aichi Medical University Hospital; Nagakute Aichi Japan
- Department of Pathology; Japanese Red Cross Nagoya Daini Hospital; Nagoya Aichi Japan
| | - Yota Murase
- Department of Surgical Pathology; Aichi Medical University Hospital; Nagakute Aichi Japan
- Department of Pathology; Japanese Red Cross Nagoya Daini Hospital; Nagoya Aichi Japan
| | - Taishi Takahara
- Department of Surgical Pathology; Aichi Medical University Hospital; Nagakute Aichi Japan
| | - Akiko Ohashi
- Department of Surgical Pathology; Aichi Medical University Hospital; Nagakute Aichi Japan
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10
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Berker NK, Bayram A, Tas S, Bakir B, Caliskan Y, Ozcan F, Kilicaslan I, Ozluk Y. Comparison of Renal Anastomosing Hemangiomas in End-Stage and Non–End-Stage Kidneys: A Meta-Analysis With a Report of 2 Cases. Int J Surg Pathol 2017; 25:488-496. [DOI: 10.1177/1066896917706025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background. Renal anastomosing hemangioma (RAH) is a very rare distinct entity composed of anastomosing sinusoidal (spleen-like) capillary-sized vessels lined by flat or hobnail endothelial cells. Most of the published cases of RAH occurred in the setting of end-stage renal disease (ESRD). Methods. We present 2 cases of RAH in ESRD along with a literature review. We compared clinicopathologic features of RAHs in end-stage and non–end-stage kidneys. A meta-analysis was conducted with PubMed and a manual search through references of relevant publications. Individual patient data gathered from the literature were used in the analysis. Results. Our systematic review revealed 49 RAHs, including our 2 cases. Thirty-two (65.3%) cases were in ESRD, only 17 (34.7%) were in patients with non-ESRD. RAHs in ESRD were in younger patients, smaller in size, multifocal, and seen more with renal epithelial neoplasms when compared with RAHs in non-ESRD ( P < .05). Extramedullary hematopoiesis was seen mostly in RAHs in ESRD kidneys (85% vs 41.7%) ( P = .018). Follow-up data were available for 25 cases with a mean follow-up of 24.58 ± 38.54 months. Recurrence, metastasis, or death have never been described related to RAH in any patients. Conclusions. In conclusion, RAHs are rare and mostly arise in kidneys with end-stage damage. RAHs in ESRD and non-ESRD differ in terms of clinicopathologic features.
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Affiliation(s)
| | - Aysel Bayram
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serap Tas
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Baris Bakir
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yasar Caliskan
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Faruk Ozcan
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Isin Kilicaslan
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Yasemin Ozluk
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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11
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Perdiki M, Datseri G, Liapis G, Chondros N, Anastasiou I, Tzardi M, Delladetsima JK, Drakos E. Anastomosing hemangioma: report of two renal cases and analysis of the literature. Diagn Pathol 2017; 12:14. [PMID: 28118845 PMCID: PMC5260082 DOI: 10.1186/s13000-017-0597-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/04/2017] [Indexed: 01/13/2023] Open
Abstract
Background Anastomosing hemangioma (AH) is a very rare vascular tumor mimicking angiosarcoma, predominately observed in kidney and less frequently in other organs. We present two new renal cases of AH at opposite ends of the clinical presentation spectrum, provide review of the literature and compare the epidemiological, clinical and pathological profiles of renal and non-renal cases. Case presentation The first occurred in a 64-year-old woman presented with back pain and the second, a multifocal lesion, in a 47-year-old man with end stage renal disease (ESRD). Histology disclosed a vascular tumor with striking anastomosing pattern, minimal nuclear atypia and locally infiltrative pattern, mimicking superficially angiosarcoma. Extramedullary hematopoiesis, extensive perirenal fat entrapment and increased number of mast cells were additional features in the second lesion. Both patients are well, without disease, 25 and 14 months after diagnosis. Conclusion Comprehensive review and analysis of the published literature show that the growing number of non-renal AHs exhibits similar epidemiologic, clinical, biologic and histologic characteristics with renal AHs and most mild differences vanish after exclusion of cases associated with ESRD. Better understanding of AH pathogenesis will contribute to optimal treatment choices.
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Affiliation(s)
- Marina Perdiki
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Goudi, Mikras Asias 75, 11527, Athens, Greece
| | - Galateia Datseri
- Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, 71110, Greece
| | - George Liapis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Goudi, Mikras Asias 75, 11527, Athens, Greece
| | - Nikolaos Chondros
- Department of Urology-University Hospital of Heraklion, Medical School, University of Crete, Voutes, Heraklion, 71110, Greece
| | - Ioannis Anastasiou
- First Department of Urology, Medical School, National and Kapodistrian University of Athens, Goudi, Mikras Asias 75, 11527, Athens, Greece
| | - Maria Tzardi
- Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, 71110, Greece
| | - Johanna K Delladetsima
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Goudi, Mikras Asias 75, 11527, Athens, Greece
| | - Elias Drakos
- Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, 71110, Greece.
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12
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Arias-Stella JA, Williamson SR. Updates in Benign Lesions of the Genitourinary Tract. Surg Pathol Clin 2015; 8:755-87. [PMID: 26612226 DOI: 10.1016/j.path.2015.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The genitourinary tract is a common site for new cancer diagnosis, particularly for men. Therefore, cancer-containing specimens are very common in surgical pathology practice. However, many benign neoplasms and nonneoplastic, reactive, and inflammatory processes in the genitourinary tract may mimic or cause differential diagnostic challenges with malignancies. Emerging clinicopathologic, immunohistochemical, and molecular characteristics have shed light on the pathogenesis and differential diagnosis of these lesions. This review addresses differential diagnostic challenges related to benign genitourinary tract lesions in the kidney, urinary bladder, prostate, and testis, with emphasis on recent advances in knowledge and areas most common in diagnostic practice.
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Affiliation(s)
- Javier A Arias-Stella
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Sean R Williamson
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI, USA.
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13
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Omiyale AO. Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:151. [PMID: 26244138 DOI: 10.3978/j.issn.2305-5839.2015.06.16] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/12/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Anastomosing hemangioma (AH) of the kidney is a recently described morphological variant of hemangioma. It poses a diagnostic dilemma for clinicians because of its rarity and the overlapping features it shares with other renal vascular tumors. The aim of this paper is to review all the cases of AH of the kidney in the literature. METHODS The literature was extensively searched for case reports of AH of the kidney and the clinical and pathological characteristics of the tumor were extracted. RESULTS A total of 45 cases were reviewed. The mean age of presentation was 50 years (range, 15-83 years) and male sex accounted for 68.8% of the cases reviewed. AH of the kidney was mostly unilateral with only 4 cases of bilateral involvement of the kidney. The average size of the tumor is 1.5 cm (range, 0.1-7 cm). Incidental finding of AH of the kidney accounted for 62% of the cases reviewed. The ultrasound findings demonstrated varying echogenicity and the tumor appeared as solid and well demarcated heterogeneous masses on CT. The average follow up of the patients in this review was 26 months (range, 1-156 months). CONCLUSIONS AH of the kidney is a rare vascular tumor and a morphological variant of hemangioma. It has a characteristic sinusoidal architecture with a semblance of splenic sinusoids. It has overlapping clinical and imaging features with other vascular tumors of the kidney. Histological review and immunohistochemical studies are essential for accurate diagnosis. AH runs a benign course without evidence of disease recurrence during follow up.
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15
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Kryvenko ON, Haley SL, Smith SC, Shen SS, Paluru S, Gupta NS, Jorda M, Epstein JI, Amin MB, Truong LD. Haemangiomas in kidneys with end-stage renal disease: a novel clinicopathological association. Histopathology 2014; 65:309-18. [PMID: 24548339 DOI: 10.1111/his.12394] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/12/2014] [Indexed: 02/06/2023]
Abstract
AIMS The study of haemangiomas in end-stage renal disease (ESRD). METHODS AND RESULTS Twenty ESRD nephrectomies from 16 patients (aged 9 months-68 years) were due to hypertension (four), focal segmental glomerulosclerosis (four), lupus nephritis (three), diabetes (one), IgA nephropathy (one), hereditary nephritis (one), congenital nephrotic syndrome (one) and unknown cause (one). Haemangiomas appeared as a single mass (15), two masses (one), three masses (one), four masses (two) and eight masses (one) per kidney. Tumours measured 0.2-3.5 cm. Four patients had bilateral haemangiomas. All tumours were in the medulla and often abutted renal sinus fat. All except one of the tumours were anastomosing haemangiomas, showing isolated or interconnected sinusoidal capillary-sized vascular channels lined by a single layer of benign cuboidal CD34(+) , CD31(+) , D2-40(-) endothelial cells, separated by loose stroma with spindle cells. One tumour was a cellular capillary haemangioma. Intravascular growth was seen in nine specimens. All haemangiomas had extramedullary haematopoiesis. Acquired cystic kidney disease (ACKD) was seen in 11 kidneys (nine patients), renal cell carcinoma (RCC) in five, ACKD-associated RCC precursors in three, Wilms' tumour in one and papillary adenomas in five. CONCLUSIONS Anastomosing haemangioma appears as a distinctive clinicopathological entity developing in kidneys with ESRD, with or without ACKD.
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Affiliation(s)
- Oleksandr N Kryvenko
- Department of Pathology, University of Miami, Miami, FL, USA; Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Pathology, Henry Ford Hospital, Detroit, MI, USA
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16
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Murasawa H, Koie T, Hatakeyama S, Hashimoto Y, Yoneyama T, Saitoh H, Ohyama C, Funyu T. Fat-poor renal angiomyolipoma in a patient with an end-stage kidney. Int Cancer Conf J 2014. [DOI: 10.1007/s13691-013-0114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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17
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Chou S, Subramanian V, Lau HMH, Achan A. Renal Anastomosing Hemangiomas With a Diverse Morphologic Spectrum: Report of Two Cases and Review of Literature. Int J Surg Pathol 2013; 22:369-73. [PMID: 23816823 DOI: 10.1177/1066896913492850] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Benign vascular lesions have a diverse appearance and can be extremely difficult to classify. We present renal anastomosing hemangiomas from 2 patients that exemplify the potential diverse range of appearances that can occur in this recently described, rare variant of capillary hemangioma. The lesion from one patient was an intravenous hemangioma with closely packed, fenestrated vascular channels that were reminiscent of the splenic red pulp. Also, the endothelial cells contained hyaline globules. On the other hand, the second patient had multifocal tumor. The lesions showed more extensive hyalinization and vascular ectasia reminiscent of cavernous hemangioma. Extramedullary hematopoiesis was a feature in all the tumors, particularly in the second patient where numerous immature blasts were present within vascular spaces.
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Affiliation(s)
- Shaun Chou
- Pathology West, ICMPR, Westmead Hospital, Westmead, New South Wales, Australia
| | - Vishnu Subramanian
- Pathology West, ICMPR, Westmead Hospital, Westmead, New South Wales, Australia
| | - Howard M H Lau
- Department of Urology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Anita Achan
- Pathology West, ICMPR, Westmead Hospital, Westmead, New South Wales, Australia
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Mehta V, Ananthanarayanan V, Antic T, Krausz T, Milner J, Venkataraman G, Picken MM. Primary benign vascular tumors and tumorlike lesions of the kidney: a clinicopathologic analysis of 15 cases. Virchows Arch 2012; 461:669-76. [PMID: 23090628 DOI: 10.1007/s00428-012-1333-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 10/08/2012] [Accepted: 10/15/2012] [Indexed: 02/06/2023]
Abstract
Primary benign vascular lesions of the kidney are uncommonly encountered in routine surgical pathology practice. They can, however, mimic malignancy or be an incidental finding adjacent to a malignancy. Fifteen specimens harboring 16 primary benign renal lymphatic/vascular lesions were identified from our files from 1999 to 2011 and subjected to a detailed pathologic evaluation and clinicopathologic correlation. Clinical and demographic data were available for all the 15 cases. There were ten males and five female patients with age range of 33-74 years (mean 54 years). Lesions ranged from 0.5 cm to 40 cm (average, 6.6 cm). There were six arteriovenous malformations (AVMs), four hemangiomas, three anastomosing hemangiomas, two lymphangiomas, and one solid intravascular papillary endothelial hyperplasia (IPEH). Five AVMs were located in the kidney parenchyma and one in the pelviureteric system. Additional associated lesions ranged from renal stones to renal cell carcinoma in two cases (one lymphangioma and one AVM). One AVM was associated with a capillary hemangioma in the vicinity, and another with a history of renal cell carcinoma in the contralateral kidney. Capillary hemangiomas and lymphangiomas were noninfiltrative and lacked cytological atypia and mitotic activity. Except for a renal pelvic AVM, all other renal AVMs radiologically mimicked malignancy. The patients had undergone partial or radical nephrectomies except for the renal pelvic AVM which was laparoscopically excised. To the best of our knowledge, none of the cases had any syndromic/systemic associations. Benign vascular lesions of the kidney are rarely seen in routine surgical pathology practice, partly because a vast majority of them are medically treated by embolization. However, lesions mimicking renal malignancy are subjected to surgery. They may exist as isolated lesions or coexist with malignant lesions either in the ipsilateral or the contralateral kidney.
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Affiliation(s)
- Vikas Mehta
- Department of Pathology, Loyola University Medical Center, Maywood, IL, USA
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