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1/4. Clinicopathological features of unusual vascular lesions of the pelvis, retroperitoneum and colon in females: a report of five cases and review of the literature.

    Vascular lesions comprise benign and malignant neoplasms as well as non-neoplastic conditions that may be located in various sites but only rarely in the pelvis or the retroperitoneum. In our study we describe five diverse and unusual cases of vascular lesions of the pelvis, retroperitoneum and colon in female patients: a case of retroperitoneal angiosarcoma, pelvic hemangioendothelioma, pelvic angiomyxoma, retroperitoneal lymphangioleiomyomatosis and a case of diffuse cavernous hemangiomatosis of the colon, with emphasis on their clinicopathological features and differential diagnosis. The recent literature on the subject is also briefly reviewed.
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ranking = 1
keywords = angiomatosis
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2/4. Locally metastasizing vascular tumor. Spindle cell, epithelioid, or unclassified hemangioendothelioma?

    The authors report the case of a 2-year-old boy with a recurrent and locally metastasizing, spindle cell, vascular tumor with histiocytoid cells involving the skin, subcutaneous tissue, and muscle of the right forearm, the right distal radius and ulna, and multiple lymph nodes of the right axilla. Diagnoses of hemangioma, hemangiopericytoma, angiomatosis, spindle cell hemangioendothelioma, and malignant hemangioendothelioma were made on successive excision specimens. The soft tissue of the right arm became diffusely enlarged, and a severe syndrome developed that was similar to that described by Kasabach and Merritt. The limb was amputated above the elbow, the axillary lymph nodes were cleared, and a total dose of 6,000 centigrays axillary radiation was given. After operation, the kasabach-merritt syndrome resolved. Despite the lymph node metastases and multiple tissues involved, the patient has remained well 6 years after surgery. Although the tumor exhibited some of the histologic features of a spindle cell hemangioendothelioma, the low-grade aggressive behavior resembled that of an epithelioid hemangioendothelioma. The reported case cannot be classified into any of the recognized categories or subdivisions of vascular tumors.
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ranking = 1
keywords = angiomatosis
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3/4. Exuberant granulation tissue mimicking vascular tumours associated with burns.

    A case of simultaneous development of multiple vascular neoplasms in a patient with a previous history of burns and lymphoblastic lymphoma is reported. Microscopic examination revealed angiomatosis made up of diffuse capillary proliferation. We speculate that endogenous factors could have played an important role in the development of these neoplasms. We discuss the clinical and histological differential diagnosis of the case presented: a disseminated variant of lobular capillary haemangioma, Kaposi's sarcoma, bacillary angiomatosis and hyperplastic granulation tissue.
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ranking = 2
keywords = angiomatosis
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4/4. Multifocal vascular lesions of bone: imaging characteristics.

    OBJECTIVE: Multifocal vascular processes which arise in bone are a very inhomogeneous class of diseases. Four of these processes are derived from endothelial precursors, however, and share a similar radiographic spectrum. These four entities are reviewed in order to clarify their imaging patterns and the diagnostic utility of imaging modalities. methods: Eight cases of cystic angiomatosis, multifocal hemangioma, hemangioendothelioma and angiosarcoma presenting to a tertiary referral center over a 7-year period were reviewed. The medical literature was also reviewed for information concerning the imaging of these processes. RESULTS: All four diseases produced radiolucent defects on plain radiographs with variable margination reflecting the aggressiveness of the lesions. Computed tomography was used to examine five patients and provided supportive, though generally non-diagnostic, information in the five cases in which it was performed. Radionuclide bone scintigraphy, as reported in the literature, underestimated the extent of skeletal involvement in all eight cases, though some lesions were identified. radionuclide imaging with labeled red blood cells, performed in three cases, did not add any information, which is contrary to some reports in the literature. magnetic resonance imaging proved the most sensitive for identifying lesions, although the imaging characteristics were not diagnostic. CONCLUSIONS: Plain radiographs are the mainstay for imaging multifocal endothelial processes. Radiographs provide information on aggressiveness, multifocality and distribution of lesions. Computed tomography provides similar information. magnetic resonance imaging often detects additional lesions. The insensitivity of radionuclide bone scintigraphy is surprising. Reports of unique deposition of radionuclide in tagged red blood cell scanning has been reported to support the diagnosis of vascular lesions, but it did not do so in these cases.
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ranking = 1
keywords = angiomatosis
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