Hepatic hemangioma pathophysiology: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(Mahshid)
 
(40 intermediate revisions by 3 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Hepatic hemangioma}}
{{Hepatic hemangioma}}
{{CMG}}
{{CMG}};{{AE}}{{NM}}
==Overview==
Development of hepatic hemangioma is the result of genetic mutations, overexpression of angiogenic fators and downregulation of inhibitors of angiogenesis.<ref name="PapafragkakisMoehlen2011">{{cite journal|last1=Papafragkakis|first1=Haris|last2=Moehlen|first2=Martin|last3=Garcia-Buitrago|first3=Monica T.|last4=Madrazo|first4=Beatrice|last5=Island|first5=Eddie|last6=Martin|first6=Paul|title=A Case of a Ruptured Sclerosing Liver Hemangioma|journal=International Journal of Hepatology|volume=2011|year=2011|pages=1–5|issn=2090-3456|doi=10.4061/2011/942360}}</ref> Hepatic hemangioma may be associated with [[Kasabach-Merritt syndrome]], [[hereditary hemorrhagic telangiectasia]], hepatic arterio-portal shunts, extra hepatic hemangiomata, [[hemolytic anemia]], [[focal nodular hyperplasia]].<ref name=radiopeadia>Associations of hepatic hemangioma. Dr Yuranga Weerakkody et al. Radiopaedia (2015). http://radiopaedia.org/articles/hepatic-haemangioma-3. Accessed on November 7, 2015</ref> On gross pathology, variable in size, well circumscribed, and classically subcapsular are findings of hepatic hemangioma.<ref name=Librepthology>Gross pathology of hepatic hemangioma. Librepathology 2015. http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref> On microscopic histopathological analysis channels lined by benign endothelium containing RBCs, surrounding (non-endothelial) cells without significant atypia are findings of hepatic hemangioma.<ref name=Librepathology>Microscopic features of hepatic hemangioma. Librepathology 2015. http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref>
==Pathophysiology==
==Pathogenesis==
The pathogenesis of hepatic hemangiomas has not been elucidated, but there are two competing theories.
===First theory===
*The first theory supports the notion that hepatic hemangioma may be the result of overexpression of angiogenic factors and downregulation of inhibitors of angiogenesis.
:*Overexpression of angiographic factors, such as:<ref name="PapafragkakisMoehlen2011">{{cite journal|last1=Papafragkakis|first1=Haris|last2=Moehlen|first2=Martin|last3=Garcia-Buitrago|first3=Monica T.|last4=Madrazo|first4=Beatrice|last5=Island|first5=Eddie|last6=Martin|first6=Paul|title=A Case of a Ruptured Sclerosing Liver Hemangioma|journal=International Journal of Hepatology|volume=2011|year=2011|pages=1–5|issn=2090-3456|doi=10.4061/2011/942360}}</ref>
::*[[Vascular endothelial growth factor]]
::*[[Basic fibroblast growth factor]]
::*[[Metalloproteinases]]
:*Downregulation of inhibitors of angiogenesis, such as:<ref name="PapafragkakisMoehlen2011">{{cite journal|last1=Papafragkakis|first1=Haris|last2=Moehlen|first2=Martin|last3=Garcia-Buitrago|first3=Monica T.|last4=Madrazo|first4=Beatrice|last5=Island|first5=Eddie|last6=Martin|first6=Paul|title=A Case of a Ruptured Sclerosing Liver Hemangioma|journal=International Journal of Hepatology|volume=2011|year=2011|pages=1–5|issn=2090-3456|doi=10.4061/2011/942360}}</ref>
::*[[Metalloproteinase|Tissue inhibitor of metalloproteinase-I]]
 
===Second theory===
*The second theory suggests that the presence of liver hemangiomas involves a genetic background of mutations.<ref name="PapafragkakisMoehlen2011">{{cite journal|last1=Papafragkakis|first1=Haris|last2=Moehlen|first2=Martin|last3=Garcia-Buitrago|first3=Monica T.|last4=Madrazo|first4=Beatrice|last5=Island|first5=Eddie|last6=Martin|first6=Paul|title=A Case of a Ruptured Sclerosing Liver Hemangioma|journal=International Journal of Hepatology|volume=2011|year=2011|pages=1–5|issn=2090-3456|doi=10.4061/2011/942360}}</ref>
:*[[Metalloproteinases]] accumulate in the endoplasmic reticulum of the tumor cells. Accumulation may result in the following:
::*Self-digestion
::*Vacuole formation
*Cavernous hemangioma cell to downregulate Derlin-1.
:*Derlin-1 is a protein encoded by [[DERL1]]. When overexpressed, derlin-1 protein induces the dilated endoplasmic reticulum to return to its normal size.


Please help WikiDoc by adding more content here. It's easy! Click [[help:How to Edit a Page|here]] to learn about editing.
==Associated Conditions==
==Pathophysiology==
Hepatic hemangioma may be associated with:<ref name=radiopeadia>Associations of hepatic hemangioma. Dr Yuranga Weerakkody et al. Radiopaedia (2015). http://radiopaedia.org/articles/hepatic-haemangioma-3. Accessed on November 7, 2015</ref>
*[[Kasabach-Merritt syndrome]]
*[[Hereditary hemorrhagic telangiectasia]] ([[Hereditary hemorrhagic telangiectasia|Osler-Weber-Rendu disease]])
*Hepatic arterio-portal shunts
*Extra hepatic hemangiomata
*[[Hemolytic anemia]]
*[[DIC|Consumptive coagulopathy]]
*[[Focal nodular hyperplasia]]


* They arise from the endothelial cells that line the blood vessels and consists of multiple, large vascular channels lined by a single layer of endothelial cells and supported by collagenous walls.
==Gross Pathology==
* They may be associated with [[focal nodular hyperplasia]].  
On gross pathology, a well circumscribed, subcapsular tumor may be suggestive of hepatic hemangioma.<ref name=Librepthology>Gross pathology of hepatic hemangioma. Librepathology (2015). http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref>
===Associated Conditions===
* May be associated with [[Kasabach-Merritt syndrome]], [[hemolytic anemia]] and consumptive coagulopathy.


==Microscopic Pathology==
On microscopic histopathological analysis channels lined by benign endothelium containing RBCs, surrounding (non-endothelial) cells without significant atypia are findings of hepatic hemangioma.<ref name=Librepathology>Microscopic features of hepatic hemangioma. Librepathology (2015). http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref>
==Gallery==
<gallery>
Image:
Cavernous_liver_hemangioma_-_intermed_mag.jpg|Intermediate magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.<ref name=Librepathology>Image of microscopy of Hepatic hemangioma. Librepathology (2015). http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref>
Image:
Cavernous liver hemangioma high magnification.jpg|High magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.<ref name=Librepathology>Image of microscopy of Hepatic hemangioma. Librepathology (2015). http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015</ref>
</gallery>
==References==
==References==


Line 17: Line 52:
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Oncology]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs overview]]
[[Category:Needs overview]]
[[Category:needs content]]
[[Category:needs content]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Hepatology]]

Latest revision as of 01:56, 27 November 2017

Hepatic hemangioma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hepatic Hemangioma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hepatic hemangioma pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hepatic hemangioma pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hepatic hemangioma pathophysiology

CDC on Hepatic hemangioma pathophysiology

Hepatic hemangioma pathophysiology in the news

Blogs on Hepatic hemangioma pathophysiology

Directions to Hospitals Treating Hepatic hemangioma

Risk calculators and risk factors for Hepatic hemangioma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

Development of hepatic hemangioma is the result of genetic mutations, overexpression of angiogenic fators and downregulation of inhibitors of angiogenesis.[1] Hepatic hemangioma may be associated with Kasabach-Merritt syndrome, hereditary hemorrhagic telangiectasia, hepatic arterio-portal shunts, extra hepatic hemangiomata, hemolytic anemia, focal nodular hyperplasia.[2] On gross pathology, variable in size, well circumscribed, and classically subcapsular are findings of hepatic hemangioma.[3] On microscopic histopathological analysis channels lined by benign endothelium containing RBCs, surrounding (non-endothelial) cells without significant atypia are findings of hepatic hemangioma.[4]

Pathophysiology

Pathogenesis

The pathogenesis of hepatic hemangiomas has not been elucidated, but there are two competing theories.

First theory

  • The first theory supports the notion that hepatic hemangioma may be the result of overexpression of angiogenic factors and downregulation of inhibitors of angiogenesis.
  • Overexpression of angiographic factors, such as:[1]
  • Downregulation of inhibitors of angiogenesis, such as:[1]

Second theory

  • The second theory suggests that the presence of liver hemangiomas involves a genetic background of mutations.[1]
  • Metalloproteinases accumulate in the endoplasmic reticulum of the tumor cells. Accumulation may result in the following:
  • Self-digestion
  • Vacuole formation
  • Cavernous hemangioma cell to downregulate Derlin-1.
  • Derlin-1 is a protein encoded by DERL1. When overexpressed, derlin-1 protein induces the dilated endoplasmic reticulum to return to its normal size.

Associated Conditions

Hepatic hemangioma may be associated with:[2]

Gross Pathology

On gross pathology, a well circumscribed, subcapsular tumor may be suggestive of hepatic hemangioma.[3]

Microscopic Pathology

On microscopic histopathological analysis channels lined by benign endothelium containing RBCs, surrounding (non-endothelial) cells without significant atypia are findings of hepatic hemangioma.[4]

Gallery

  • Intermediate magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.[4]

    Intermediate magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.[4]

  • High magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.[4]

    High magnification micrograph of a cavernous hemangioma of the liver, also hepatic cavernous hemangioma, liver hemangioma,cavernous liver hemangioma. H&E stain. No liver tissue is observed.[4]

References

  1. ↑ 1.0 1.1 1.2 1.3 Papafragkakis, Haris; Moehlen, Martin; Garcia-Buitrago, Monica T.; Madrazo, Beatrice; Island, Eddie; Martin, Paul (2011). "A Case of a Ruptured Sclerosing Liver Hemangioma". International Journal of Hepatology. 2011: 1–5. doi:10.4061/2011/942360. ISSN 2090-3456.
  2. ↑ 2.0 2.1 Associations of hepatic hemangioma. Dr Yuranga Weerakkody et al. Radiopaedia (2015). http://radiopaedia.org/articles/hepatic-haemangioma-3. Accessed on November 7, 2015
  3. ↑ 3.0 3.1 Gross pathology of hepatic hemangioma. Librepathology 2015. http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015
  4. ↑ 4.0 4.1 4.2 4.3 Microscopic features of hepatic hemangioma. Librepathology 2015. http://librepathology.org/wiki/index.php/Hemangioma_of_the_liver. Accessed on October 20, 2015
Retrieved from "https://www.wikidoc.org/index.php?title=Hepatic_hemangioma_pathophysiology&oldid=1394234"