Clinicopathological characteristics of anastomosing hemangioma

SHI Deng-chao; YIN Xia; XU De

doi:10.3969/j.issn.1007-8096.2025.02.010

Abstract：Objective To explore the clinicopathological characteristics,diagnosis and differential diagnosis of anastomosing hemangioma(AH).Methods Four cases of AH were collected.The clinical featuers,histomorphology,immunohistochemistry and prognosis were analyzed and the relevant literature was reviewed.Results Patients consisted of 3 men and 1 woman with ages ranging from 42 years to 58 years.Locations included the kidney,adrenal gland and retroperitoneal.The tumors measured in maximum diameter from 1.6 cm to 4.0 cm.All cases were found accidentally during physical examination.Imaging showed well-defined space-occupying lesions,and case 1 was accompanied by a space-occupying lesion of contralateral kidney(pathological diagnosis was clear cell renal cell carcinoma).Histopathological examination showed that the tumor had a clear boundary with surrounding tissues,and a fibrous capsule was visible in case 4.The tumor were composed of significantly proliferated anastomosing small blood vessels,lined with a single layer of flat to hobnail endothelial cells,without or slight atypia and no mitotic figures.Fibrinous thrombus was seen in three cases and extramedullary hematopoiesis was observed in two cases.Immunohistochemical study showed that the vascular endothelial cells were diffuse positive for CD34,CD31 and ERG,and Ki-67 proliferative index was 1％～3％.Follow-up information(range from 6 to 60 months,with mean 33 months)showed that no evidence of local recurrence or metastasis were identified in four cases.Conclusion Anastomosing hemangioma is a rare benign vascular tumor easily misdiagnosed as highly differentiated angiosarcoma due to its characteristics of extensive vascular anastomosis.Improving the understanding of its pathogenesis and diagnostic features can help avoid misdiagnoses.