Vascular anomalies: Difference between revisions
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'''For information on vascular tumors, [[Vascular tumor|click here]].''' | |||
'''For information on vascular malformations, [[Vascular malformation|click here]].''' | |||
'''For information on provisionally unclassified vascular anomalies, [[Provisionally unclassified vascular anomalies|click here]].''' | |||
{{Vascular anomalies}} | {{Vascular anomalies}} | ||
{{CMG}}; {{AE}} {{HMHJ}}, {{Anmol}} | {{CMG}}; {{AE}} {{HMHJ}}, {{Anmol}} | ||
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*Malignant | *Malignant | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*Capillary malformations | *[[Capillary malformations]] | ||
*Lymphatic malformations | *[[Lymphatic malformations]] | ||
*Venous malformations | *[[Venous malformations]] | ||
*Arteriovenous malformations** | *[[Arteriovenous malformations]]** | ||
*Arteriovenous fistula** | *[[Arteriovenous fistula]]** | ||
| style="background:#F5F5F5;" + | | | style="background:#F5F5F5;" + | | ||
*Capillary venous malformation | *Capillary venous malformation | ||
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<sup>*</sup> Defined as two or more vascular malformations found in one lesion<br> | <sup>*</sup> Defined as two or more vascular malformations found in one lesion<br> | ||
<sup>**</sup> High flow lesions | <sup>**</sup> High flow lesions | ||
|- | |||
| colspan="5" style="background:#7d7d7d; color: #FFFFFF;" + |<small>'''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | |||
|} | |} | ||
=== Classification of Vascular Tumors === | ===[[Classification of Vascular Tumors]]=== | ||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= '''Vascular tumors'''}} | {{Family tree | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= '''[[Vascular tumors]]'''}} | ||
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{{Family tree | | | | | | | B01 | | | | | | B02 | | | | | | B03 | | | | | | | | B01='''''Benign'''''|B02='''''Locally aggressive or borderline'''''|B03='''''Malignant'''''}} | {{Family tree | | | | | | | B01 | | | | | | B02 | | | | | | B03 | | | | | | | | B01='''''Benign'''''|B02='''''Locally aggressive or borderline'''''|B03='''''Malignant'''''}} | ||
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{{Family tree | | | | | | |)| C01 | | | | |)| D01 | | | | |)| E01 | | | | | | | C01=Infantile hemangioma / Hemangioma of infancy|D01=Kaposiform hemangioendothelioma | {{Family tree | | | | | | |)| C01 | | | | |)| D01 | | | | |)| E01 | | | | | | | C01=[[Infantile hemangioma]] / [[Hemangioma of infancy]]|D01=[[Kaposiform hemangioendothelioma]]|E01=[[Angiosarcoma]]}} | ||
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{{Family tree | | | | | | |)| C02 | | | | |)| D02 | | | | |)| E02 | | | | | | | C02=Congenital hemangioma | {{Family tree | | | | | | |)| C02 | | | | |)| D02 | | | | |)| E02 | | | | | | | C02=[[Congenital hemangioma]]|D02=[[Retiform hemangioendothelioma]]|E02=[[Epithelioid hemangioendothelioma]]}} | ||
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{{Family tree | | | | | | |)| C03 | | | | |)| D03 | | | | |`| E03 | | | | | | | C03=Tufted angioma | {{Family tree | | | | | | |)| C03 | | | | |)| D03 | | | | |`| E03 | | | | | | | C03=[[Tufted angioma]]|D03=[[Papillary intralymphatic angioendothelioma]] ([[PILA]]), [[Dabska tumor]]|E03=Others}} | ||
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{{Family tree | | | | | | |)| C04 | | | | |)| D04 | | | | | | | | | | | | | | | C04=Spindle-cell hemangioma|D04=Composite hemangioendothelioma}} | {{Family tree | | | | | | |)| C04 | | | | |)| D04 | | | | | | | | | | | | | | | C04=[[Spindle-cell hemangioma]]|D04=[[Composite hemangioendothelioma]]}} | ||
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{{Family tree | | | | | | |)| C05 | | | | |)| D05 | | | | | | | | | | | | | | | C05=Epithelioid hemangioma|D05=Pseudomyogenic hemangioendothelioma}} | {{Family tree | | | | | | |)| C05 | | | | |)| D05 | | | | | | | | | | | | | | | C05=[[Epithelioid hemangioma]]|D05=[[Pseudomyogenic hemangioendothelioma]]}} | ||
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{{Family tree | | | | | | |)| C06 | | | | |)| D06 | | | | | | | | | | | | | | | C06=Pyogenic granuloma (also known as lobular capillary hemangioma)|D06=Polymorphous hemangioendothelioma}} | {{Family tree | | | | | | |)| C06 | | | | |)| D06 | | | | | | | | | | | | | | | C06=[[Pyogenic granuloma]] (also known as [[lobular capillary hemangioma]])|D06=[[Polymorphous hemangioendothelioma]]}} | ||
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{{Family tree | | | | | | |)| C07 | | | | |)| D07 | | | | | | | | | | | | | | | | |C07=<table> | {{Family tree | | | | | | |)| C07 | | | | |)| D07 | | | | | | | | | | | | | | | | |C07=<table> | ||
<tr><td>Others</td></tr> | <tr><td>Others</td></tr> | ||
<tr><td>• Microvenular hemangioma<td></tr> | <tr><td>• [[Microvenular hemangioma]]<td></tr> | ||
<tr><td>• Anastomosing hemangioma<td></tr> | <tr><td>• [[Anastomosing hemangioma]]<td></tr> | ||
<tr><td>• Glomeruloid hemangioma<td></tr> | <tr><td>• [[Glomeruloid hemangioma]]<td></tr> | ||
<tr><td>• Papillary hemangioma<td></tr> | <tr><td>• [[Papillary hemangioma]]<td></tr> | ||
<tr><td>• Intravascular papillary endothelial hyperplasia<td></tr> | <tr><td>• [[Intravascular papillary endothelial hyperplasia]]<td></tr> | ||
<tr><td>• Cutaneous epithelioid angiomatous nodule<td></tr> | <tr><td>• [[Cutaneous epithelioid angiomatous nodule]]<td></tr> | ||
<tr><td>• Acquired elastotic hemangioma<td></tr> | <tr><td>• [[Acquired elastotic hemangioma]]<td></tr> | ||
<tr><td>• Littoral cell hemangioma of the spleen<td></tr> | <tr><td>• [[Littoral cell hemangioma of the spleen]]<td></tr> | ||
</table> |D07=Hemangioendothelioma not otherwise specified}} | </table> |D07=Hemangioendothelioma not otherwise specified}} | ||
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{{Family tree | | | | | | |`| C08 | | | | |)| D08 | | | | | | | | | | | | | | | |C08=<table> | {{Family tree | | | | | | |`| C08 | | | | |)| D08 | | | | | | | | | | | | | | | |C08=<table> | ||
<tr><td>Related lesions</td></tr> | <tr><td>Related lesions</td></tr> | ||
<tr><td>• Eccrine angiomatous hamartoma<td></tr> | <tr><td>• [[Eccrine angiomatous hamartoma]]<td></tr> | ||
<tr><td>• Reactive angioendotheliomatosis<td></tr> | <tr><td>• [[Reactive angioendotheliomatosis]]<td></tr> | ||
<tr><td>• Bacillary angiomatosis<td></tr>' | <tr><td>• [[Bacillary angiomatosis]]<td></tr>' | ||
</table> |D08=Kaposi sarcoma}} | </table> |D08=[[Kaposi sarcoma]]}} | ||
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{{Family tree | | | | | | | | | | | | | | |`| D09 | | | | | | | | | | | | | | | D09=Others}} | {{Family tree | | | | | | | | | | | | | | |`| D09 | | | | | | | | | | | | | | | D09=Others}} | ||
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<sup>*</sup>congenital hemangioma (rapidly involuting type) and tufted angioma may be associated with thrombocytopenia and/or consumptive coagulopathy in some cases. Many experts consider tufted angioma and kaposiform hemangioendothelioma to be part of a spectrum rather than distinct entities | <sup>*</sup>[[congenital hemangioma]] (rapidly involuting type) and [[tufted angioma]] may be associated with thrombocytopenia and/or consumptive coagulopathy in some cases. Many experts consider [[tufted angioma]] and [[kaposiform hemangioendothelioma]] to be part of a spectrum rather than distinct entities<br> | ||
'''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | |||
===Classification of Vascular Malformations=== | ===Classification of Vascular Malformations=== | ||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | | | | A01 | | | | | | | |A01= '''Vascular malformations'''}} | {{Family tree | | | | | | | A01 | | | | | | | |A01= '''[[Vascular malformations]]'''}} | ||
{{Family tree | |,|-|-|-|v|-|^|-|v|-|-|-|.| | |}} | {{Family tree | |,|-|-|-|v|-|^|-|v|-|-|-|.| | |}} | ||
{{Family tree | B01 | | B02 | | B03 | | B04 | |B01='''''Simple vascular malformations'''''|B02='''''Combined vascular malformations'''''|B03='''''Vascular malformations of major named vessels'''''|B04='''''Vascular malformations asscoiated with other anomalies'''''}} | {{Family tree | B01 | | B02 | | B03 | | B04 | |B01='''''[[Simple vascular malformations]]'''''|B02='''''[[Combined vascular malformations]]'''''|B03='''''Vascular malformations of major named vessels'''''|B04='''''[[Vascular malformations asscoiated with other anomalies]]'''''}} | ||
{{Family tree | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | |!| | | I02 | | I03 | | I04 | |I02= | {{Family tree | |!| | | I02 | | I03 | | I04 | |I02=<table class="wikitable"> | ||
<tr><td>'''CM + VM'''</td><td>Capillary-venous malformation</td><td>CVM</td></tr> | <tr><td>'''CM + VM'''</td><td>Capillary-venous malformation</td><td>CVM</td></tr> | ||
<tr><td>'''CM + LM'''</td><td>Capillary-lymphatic malformation</td><td>CLM</td></tr> | <tr><td>'''CM + LM'''</td><td>Capillary-lymphatic malformation</td><td>CLM</td></tr> | ||
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<tr><td>'''CM + LM + VM + AVM'''</td><td>Capillary-lymphatic-venous-arteriovenous malformation</td><td>CLVAVM</td></tr> | <tr><td>'''CM + LM + VM + AVM'''</td><td>Capillary-lymphatic-venous-arteriovenous malformation</td><td>CLVAVM</td></tr> | ||
</table>|I03=<br>(also known as "channel type" or "truncal" vascular malformations)<br><table> | </table>|I03=<br>(also known as "channel type" or "truncal" vascular malformations)<br><table> | ||
<tr><td>Affect</td></tr> | <tr><td>'''Affect'''</td></tr> | ||
<tr><td>• Lymphatics<td></tr> | <tr><td>• [[Lymphatics]]<td></tr> | ||
<tr><td>• Veins</tr> | <tr><td>• [[Veins]]</tr> | ||
<tr><td>• Arteries</tr> | <tr><td>• [[Arteries]]</tr> | ||
<tr><td>Anomalies of</td></tr> | <tr><td>'''Anomalies of'''</td></tr> | ||
<tr><td>• Origin<td></tr> | <tr><td>• Origin<td></tr> | ||
<tr><td>• Course<td></tr> | <tr><td>• Course<td></tr> | ||
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<tr><td>• Persistence (of<br>embryonal vessel)<td></tr> | <tr><td>• Persistence (of<br>embryonal vessel)<td></tr> | ||
</table>|I04=<table class="wikitable"> | </table>|I04=<table class="wikitable"> | ||
<tr><td>'''Klippel-Trenaunay syndrome'''</td><td>CM + VM +/-LM + limb overgrowth</td></tr> | <tr><td>'''[[Klippel-Trenaunay syndrome]]'''</td><td>CM + VM +/-LM + limb overgrowth</td></tr> | ||
<tr><td>'''Parke's Weber syndrome'''</td><td>CM + AVF + limb overgrowth</td></tr> | <tr><td>'''[[Parke's Weber syndrome]]'''</td><td>CM + AVF + limb overgrowth</td></tr> | ||
<tr><td>'''Servelle-Martorell syndrome'''</td><td>Limb VM + bone undergrowth</td></tr> | <tr><td>'''[[Servelle-Martorell syndrome]]'''</td><td>Limb VM + bone undergrowth</td></tr> | ||
<tr><td>'''Sturge-Weber syndrome'''</td><td>Facial + leptomeningeal CM + eye anomalies +/-bone and/or soft tissue overgrowth</td></tr> | <tr><td>'''[[Sturge-Weber syndrome]]'''</td><td>Facial + leptomeningeal CM + eye anomalies +/-bone and/or soft tissue overgrowth</td></tr> | ||
<tr><td>'''Maffucci syndrome'''</td><td>VM +/-spindle-cell hemangioma + enchondroma</td></tr> | <tr><td>'''[[Maffucci syndrome]]'''</td><td>VM +/-spindle-cell hemangioma + enchondroma</td></tr> | ||
<tr><td>'''CLOVES syndrome'''</td><td>LM + VM + CM +/-AVM+ lipomatous overgrowth</td></tr> | <tr><td>'''[[CLOVES syndrome]]'''</td><td>LM + VM + CM +/-AVM+ lipomatous overgrowth</td></tr> | ||
<tr><td>'''Proteus syndrome'''</td><td>CM, VM and/or LM + asymmetrical somatic overgrowth</td></tr> | <tr><td>'''[[Proteus syndrome]]'''</td><td>CM, VM and/or LM + asymmetrical somatic overgrowth</td></tr> | ||
<tr><td>'''Bannayan-Riley-Ruvalcaba | <tr><td>'''[[Bannayan-Riley-Ruvalcaba syndrome]]'''</td><td>lower lip CM + face and neck LM + asymmetry and partial/generalized overgrowth</td></tr> | ||
<tr><td colspan="2">'''Limb CM + congenital non-progressive limb overgrowth'''</td></tr> | <tr><td colspan="2">'''Limb CM + congenital non-progressive limb overgrowth'''</td></tr> | ||
<tr><td colspan="2">'''Macrocephaly-CM (M-CM / MCAP)'''</td></tr> | <tr><td colspan="2">'''Macrocephaly-CM (M-CM / MCAP)'''</td></tr> | ||
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{{Family tree | |!| | |}} | {{Family tree | |!| | |}} | ||
{{Family tree | |)|-|-|-|v|-|-|-|v|-|-|-|v|-|-|-|.| | |}} | {{Family tree | |)|-|-|-|v|-|-|-|v|-|-|-|v|-|-|-|.| | |}} | ||
{{Family tree | | C01 | | C02 | | C03 | | C04 | | C05 | |C01=Capillary malformations (CM)|C02=Lymphatic malformations (LM)|C03=Venous malformations (VM)|C04=Arteriovenous | {{Family tree | | C01 | | C02 | | C03 | | C04 | | C05 | |C01=[[Capillary malformations]] (CM)|C02=[[Lymphatic malformations]] (LM)|C03=[[Venous malformations]] (VM)|C04=[[Arteriovenous malformation]] (AVM)|C05=[[Arteriovenous fistula]]}} | ||
{{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |}} | {{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |}} | ||
{{Family tree | |)| D01 |)| E01 |)| F01 |)| G01 |)| H01 |D01=Nevus simplex / salmon patch, | {{Family tree | |)| D01 |)| E01 |)| F01 |)| G01 |)| H01 |D01=[[Nevus simplex]] / [[salmon patch]], “[[angel kiss]]”, “[[stork bite]]”|E01=<table> | ||
<tr><td>Common (cystic) LM </td></tr> | <tr><td>[[Common (cystic) LM]] </td></tr> | ||
<tr><td>• Macrocystic LM<td></tr> | <tr><td>• [[Macrocystic LM]]<td></tr> | ||
<tr><td>• Microcystic LM<td></tr> | <tr><td>• [[Microcystic LM]]<td></tr> | ||
<tr><td>• Mixed cystic LM<td></tr> | <tr><td>• [[Mixed cystic LM]]<td></tr> | ||
</table>|F01=Common VM|G01=Sporadic|H01=Sporadic}} | </table>|F01=[[Common VM]]|G01=Sporadic|H01=Sporadic}} | ||
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{{Family tree | |)| D02 |)| E02 |)| F02 |)| G02 |)| H02 |D02=<table> | {{Family tree | |)| D02 |)| E02 |)| F02 |)| G02 |)| H02 |D02=<table> | ||
<tr><td>Cutaneous and/or mucosal CM (also known as “port-wine” stain) </td></tr> | <tr><td>[[Cutaneous and/or mucosal CM]] (also known as [[“port-wine” stain]]) </td></tr> | ||
<tr><td>• Nonsyndromic CM<td></tr> | <tr><td>• [[Nonsyndromic CM]]<td></tr> | ||
<tr><td>• CM with CNS and/or ocular anomalies (Sturge-Weber syndrome)<td></tr> | <tr><td>• CM with CNS and/or ocular anomalies ([[Sturge-Weber syndrome]])<td></tr> | ||
<tr><td>• CM with bone and/or soft tissues overgrowth <td></tr> | <tr><td>• CM with bone and/or soft tissues overgrowth <td></tr> | ||
<tr><td>• Diffuse CM with overgrowth (DCMO) <td></tr> | <tr><td>• [[Diffuse CM with overgrowth]] ([[DCMO]]) <td></tr> | ||
</table>|E02=Generalized lymphatic anomaly (GLA)<br>Kaposiform lymphangiomatosis (KLA)|F02=Familial VM cutaneo-mucosal (VMCM)|G02=In HHT|H02=In HHT|}} | </table>|E02=[[Generalized lymphatic anomaly]] ([[GLA]])<br>[[Kaposiform lymphangiomatosis]] ([[KLA]])|F02=[[Familial VM cutaneo-mucosal]] ([[VMCM]])|G02=In [[HHT]]|H02=In [[HHT]]|}} | ||
{{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |}} | {{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | |}} | ||
{{Family tree | |)| D03 |)| E03 |)| F03 |)| G03 |)| H03 |D03=<table> | {{Family tree | |)| D03 |)| E03 |)| F03 |)| G03 |)| H03 |D03=<table> | ||
<tr><td>Reticulate CM </td></tr> | <tr><td>[[Reticulate CM]] </td></tr> | ||
<tr><td>• CM of MIC-CAP (microcephaly-capillary malformation)<td></tr> | <tr><td>• CM of MIC-CAP (microcephaly-capillary malformation)<td></tr> | ||
<tr><td>• CM of MCAP (megalencephaly-capillary malformation-polymicrogyria)<td></tr> | <tr><td>• CM of MCAP (megalencephaly-capillary malformation-polymicrogyria)<td></tr> | ||
</table> | </table> | ||
|E03=LM in Gorham-Stout disease|F03=Blue rubber bleb nevus (Bean) syndrome VM|G03=In CM-AVM|H03=In CM-AVM|}} | |E03=LM in [[Gorham-Stout disease]]|F03=[[Blue rubber bleb nevus (Bean) syndrome]] VM|G03=In [[CM-AVM]]|H03=In [[CM-AVM]]|}} | ||
{{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | | |}} | {{Family tree | |!| | | |!| | | |!| | | |!| | | |!| | | | |}} | ||
{{Family tree | |)| D04 |)| E04 |)| F04 |`| G04 |`| H04 |D04=CM of CM-AVM|E04=Channel type LM|F04=Glomuvenous malformation (GVM)|G04=Others|H04=Others|}} | {{Family tree | |)| D04 |)| E04 |)| F04 |`| G04 |`| H04 |D04=[[CM of CM-AVM]]|E04=Channel type LM|F04=[[Glomuvenous malformation]] ([[GVM]])|G04=Others|H04=Others|}} | ||
{{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | {{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | ||
{{Family tree | |)| D05 |)| E05 |)| F05 | | | | | | | | |D05=Cutis marmorata telangiectatica congenita (CMTC)|E05=“Acquired” progressive lymphatic anomaly (so called acquired progressive "lymphangioma")|F05=Cerebral cavernous malformation (CCM) |}} | {{Family tree | |)| D05 |)| E05 |)| F05 | | | | | | | | |D05=[[Cutis marmorata telangiectatica congenita]] ([[CMTC]])|E05=[[“Acquired” progressive lymphatic anomaly]] (so called [[acquired progressive "lymphangioma"]])|F05=[[Cerebral cavernous malformation]] ([[CCM]]) |}} | ||
{{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | {{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | ||
{{Family tree | |)| D06 |)| E06 |)| F06 | | | | | | | | |D06=Others|E06=Primary lymphedema |F06=Familial intraosseous vascular malformation (VMOS)|}} | {{Family tree | |)| D06 |)| E06 |)| F06 | | | | | | | | |D06=Others|E06=[[Primary lymphedema]] |F06=[[Familial intraosseous vascular malformation]] ([[VMOS]])|}} | ||
{{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | {{Family tree | |!| | | |!| | | |!| | | | | | | | | | | |}} | ||
{{Family tree | |`| D07 |`| E07 |)| F07 | | | | | | | | |D07=<table> | {{Family tree | |`| D07 |`| E07 |)| F07 | | | | | | | | |D07=<table> | ||
<tr><td>Telangiectasia </td></tr> | <tr><td>[[Telangiectasia]] </td></tr> | ||
<tr><td>• Hereditary hemorrhagic telangiectasia (HHT) <td></tr> | <tr><td>• [[Hereditary hemorrhagic telangiectasia]] (HHT) <td></tr> | ||
<tr><td>• Others<td></tr> | <tr><td>• Others<td></tr> | ||
</table>|E07=Others|F07=Verrucous venous malformation (formerly verrucous hemangioma)|}} | </table>|E07=Others|F07=[[Verrucous venous malformation]] (formerly [[verrucous hemangioma]])|}} | ||
{{Family tree | | | | | | | | | |!| | | | | | | | | | | |}} | {{Family tree | | | | | | | | | |!| | | | | | | | | | | |}} | ||
{{Family tree | | | | | | | | | |`| F08 | | | | | | | | |F08=Others|}} | {{Family tree | | | | | | | | | |`| F08 | | | | | | | | |F08=Others|}} | ||
{{Family tree/end}} | {{Family tree/end}} | ||
<small>'''Abbreviations:''' CM:capillary malformation; VM:venous malformation; CVM:capillary venous malformation; LM:lymphatic malformation; CLM:capillary lymphatic malformation; AVM:arteriovenous malformation; CAVM:capillary arteriovenous malformation; LVM:lymphatic venous malformation; CLVM:capillary lymphatic venous malformation; CVAVM:capillary venous arteriovenous malformation; CLVAVM:capillary lymphatic venous arteriovenous malformation; AVF:arteriovenous fistula; CLOVES:congenital lipomatous overgrowth, vascular malformations, epidermal nevi, skeletal/scoliosis and spinal abnormalities; M-CM:macrocephaly-capillary malformation; MCAP:megalencephaly-capillary malformation-polymicrogyria; MICCAP:microcephaly-capillary malformation; CNS:central nervous system; DCMO:diffuse capillary malformation with overgrowth; CM-AVM:capillary malformation-arteriovenous malformation; CMTC:cutis marmorata telangiectatica congenita; HHT:hereditary hemorrhagic telangiectasia; GLA:generalized lymphatic anomaly; KLA:kaposiform lymphangiomatosis; VMCM:venous malformation cutaneo mucosal; GVM:glomuvenous malformation; CCM:cerebral cavernous malformation.</small> | |||
== Provisionally unclassified vascular anomalies == | '''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | ||
===Provisionally unclassified vascular anomalies=== | |||
{| class="wikitable" | {| class="wikitable" | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Provisionally unclassified vascular anomalies | ! style="background:#4479BA; color: #FFFFFF;" align="center" + |Provisionally unclassified vascular anomalies | ||
|- | |- | ||
|Intramuscular hemangioma * | |[[Intramuscular hemangioma]] * | ||
|- | |||
|[[Angiokeratoma]] | |||
|- | |- | ||
| | |[[Sinusoidal hemangioma]] | ||
|- | |- | ||
| | |[[Acral arteriovenous "tumour"]] | ||
|- | |- | ||
| | |[[Multifocal lymphangioendotheliomatosis with thrombocytopenia / cutaneovisceral angiomatosis with thrombocytopenia (MLT/CAT)]] | ||
|- | |- | ||
| | |[[PTEN (type) hamartoma of soft tissue]] / [["angiomatosis" of soft tissue]] | ||
([[PHOST]]) | |||
|- | |- | ||
| | |[[Fibro adipose vascular anomaly]] ([[FAVA]]) | ||
|- | |- | ||
| | | style="background:#DCDCDC;" + |<sup>*</sup> Distinct from [[infantile hemangioma]], from intramuscular common VM, [[PHOST]]/[[AST]], [[FAVA]] and [[AVM]].<br>Some lesions may be associated with thrombocytopenia and/or consumptive coagulopathy. | ||
|- | |- | ||
| style="background:# | | colspan="2" style="background:#7d7d7d; color: #FFFFFF;" + |<small>'''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | ||
|} | |} | ||
== Genetics in Vascular Anomalies == | <small>'''Abbreviations:''' VM:venous malformation; AVM:arteriovenous malformation; CAVM:capillary arteriovenous malformation; MLT:Multifocal lymphangioendotheliomatosis with thrombocytopenia; CAT:cutaneovisceral angiomatosis with thrombocytopenia; PHOST:PTEN hamartoma of soft tissue; FAVA:Fibro adipose vascular anomaly; AST:angiomatosis of soft tissue.</small> | ||
==Genetics in Vascular Anomalies== | |||
{| class="wikitable" | {| class="wikitable" | ||
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Causal genes of vascular anomalies | ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Causal genes of vascular anomalies | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |ACVRL1 | ||
|Telangiectasia, AVM and AVF of | |[[Telangiectasia]], [[AVM]] and [[AVF]] of [[HHT]]2 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |AKT1 | ||
|Proteus syndrome | |[[Proteus syndrome]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |BRAF | ||
|Pyogenic granuloma PG | |[[Pyogenic granuloma]] PG | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC" align="center" + |CAMTA1 | ||
|Epithelioid hemangioendothelioma EHE | |[[Epithelioid hemangioendothelioma]] EHE | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC" align="center" + |CCBE1 | ||
|Primary generalized lymphatic anomaly (Hennekam lymphangiectasia-lymphedema syndrome) | |[[Primary generalized lymphatic anomaly]] (Hennekam lymphangiectasia-lymphedema syndrome) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |ELMO2 | ||
|Familial intraosseous vascular malformation VMOS | |[[Familial intraosseous vascular malformation]] [[VMOS]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |ENG | ||
|Telangiectasia, AVM and AVF of | |[[Telangiectasia]], [[AVM]] and [[AVF]] of [[HHT]]1 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |EPHB4 | ||
|CM-AVM2 | |CM-AVM2 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |FLT4 | ||
|Nonne-Milroy syndrome (gene also named VEGFR3) | |[[Nonne-Milroy syndrome]] (gene also named VEGFR3) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |FOS | ||
|Epithelioid hemangioma EH | |[[Epithelioid hemangioma]] EH | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |FOSB | ||
|Pseudomyogenic hemangioendothelioma | |[[Pseudomyogenic hemangioendothelioma]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |FOXC2 | ||
|Lymphedema-distichiasis | |[[Lymphedema-distichiasis]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |GATA2 | ||
|Primary lymphedema with myelodysplasia | |[[Primary lymphedema with myelodysplasia]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |GJC2 | ||
|Primary hereditary lymphedema | |[[Primary hereditary lymphedema]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |Glomulin | ||
|Glomuvenous malformation | |[[Glomuvenous malformation]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |GNA11 | ||
|Congenital hemangioma CH | |[[Congenital hemangioma]] CH | ||
CM with bone and/or soft tissue hyperplasia | CM with bone and/or soft tissue hyperplasia | ||
Diffuse CM with overgrowth DCMO | [[Diffuse CM with overgrowth]] [[DCMO]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |GNA14 | ||
|Tufted angioma TA | |[[Tufted angioma]] TA | ||
Pyogenic granuloma PG | [[Pyogenic granuloma]] PG | ||
Kaposiform hemangioendothelioma KHE | [[Kaposiform hemangioendothelioma]] KHE | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |GNAQ | ||
|Congenital hemangioma CH | |[[Congenital hemangioma]] CH | ||
CM "Port-wine" stain, nonsyndromic CM | CM [["Port-wine" stain]], [[nonsyndromic CM]] | ||
CM of Sturge-Weber syndrome | CM of [[Sturge-Weber syndrome]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |IDH1 | ||
|Maffucci syndrome | |[[Maffucci syndrome]] | ||
Spindle-cell hemangioma | [[Spindle-cell hemangioma]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |IDH2 | ||
|Maffucci syndrome | |[[Maffucci syndrome]] | ||
Spindle-cell hemangioma | [[Spindle-cell hemangioma]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |KIF11 | ||
|Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation syndrome | |Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation syndrome | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |KRIT1 | ||
|Cerebral cavernous malformation | |[[Cerebral cavernous malformation]] [[CCM]]1 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |Malcavernin | ||
|Cerebral cavernous malformation | |[[Cerebral cavernous malformation]] [[CCM]]2 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |MAP2K1 | ||
|Arteriovenous malformation AVM (sporadic) | |[[Arteriovenous malformation]] AVM (sporadic) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |MAP2K1 | ||
|Ateriovenous fistula AVF (sporadic) | |[[Ateriovenous fistula]] [[AVF]] (sporadic) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |MAP3K3 | ||
|Verrucous venous malformation (somatic) | |[[Verrucous venous malformation]] (somatic) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |MYC | ||
|Post radiation angiosarcoma | |Post radiation [[angiosarcoma]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |NPM11 | ||
|Maffucci syndrome | |[[Maffucci syndrome]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |PDCD10 | ||
|Cerebral cavernous malformation | |[[Cerebral cavernous malformation]] [[CCM]]3 | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |PIK3CA | ||
|Common (cystic) LM (somatic)* | |[[Common (cystic) LM]] (somatic)* | ||
Common VM (somatic)* | [[Common VM]] (somatic)* | ||
Klippel-Trenaunay syndrome* | [[Klippel-Trenaunay syndrome]]* | ||
Megalencephaly-capillary malformation-polymicrogyria (MCAP)* | Megalencephaly-capillary malformation-polymicrogyria (MCAP)* | ||
CLOVES syndrome* | [[CLOVES syndrome]]* | ||
CLAPO syndrome* | [[CLAPO syndrome]]* | ||
Fibro adipose vascular anomaly FAVA | [[Fibro adipose vascular anomaly]] [[FAVA]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |PTEN | ||
|Bannayan-Riley-Ruvalcaba syndrome | |[[Bannayan-Riley-Ruvalcaba syndrome]] | ||
PTEN (type) Hamartoma of soft tissue / "angiomatosis" of soft tissue | PTEN (type) Hamartoma of soft tissue / [["angiomatosis" of soft tissue]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |PTPN14 | ||
|Lymphedema-choanal atresia | |[[Lymphedema-choanal atresia]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |RASA1 | ||
|CM-AVM1 | |CM-AVM1 | ||
Parkes Weber syndrome | [[Parkes Weber syndrome]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |SMAD4 | ||
|Telangiectasia, AVM and AVF of Juvenile polyposis hemorrhagic telangiectasia JPHT | |[[Telangiectasia]], [[AVM]] and [[AVF]] of [[Juvenile polyposis hemorrhagic telangiectasia]] JPHT | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |SOX18 | ||
|Hypotrichosis-lymphedema-telangiectasia | |[[Hypotrichosis-lymphedema-telangiectasia]] | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |STAMBP | ||
|Microcephaly-CM (MIC-CAP) | |Microcephaly-CM (MIC-CAP) | ||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |TEK (TIE2) | ||
|Common VM (somatic) | |[[Common VM]] (somatic) | ||
Familial VM cutaneo-mucosal VMCM | [[Familial VM cutaneo-mucosal]] [[VMCM]] | ||
Blue rubber bleb nevus (Bean) syndrome (somatic) | [[Blue rubber bleb nevus (Bean) syndrome]] (somatic) | ||
|- | |||
| style="background:#DCDCDC;" align="center" + |TFE3 | |||
|[[Epithelioid hemangioendothelioma]] EHE | |||
|- | |||
| style="background:#DCDCDC;" align="center" + |VEGFC | |||
|[[Primary hereditary lymphedema]] | |||
|- | |- | ||
| style="background:# | | style="background:#DCDCDC;" align="center" + |VEGFR3 | ||
| | |[[Nonne-Milroy syndrome]] (gene also named FLT4) | ||
|- | |- | ||
| style="background:# | | colspan="2" style="background:#DCDCDC;" + |<sup>*</sup>Some of these lesions, associated with overgrowth, belong to the PIK3CA related overgrowth spectrum PROS | ||
|- | |- | ||
| style="background:#7d7d7d; color: #FFFFFF;" | | colspan="2" style="background:#7d7d7d; color: #FFFFFF;" + |<small>'''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | ||
| | |||
|} | |} | ||
== | ==Vascular anomalies possibly associated with platelet count / coagulation disorders== | ||
{| class="wikitable" | |||
|+ | |||
!style="background:#4479BA; color: #FFFFFF;" align="center" + |Anomalies | |||
!style="background:#4479BA; color: #FFFFFF;" align="center" + |Hematological disorders | |||
|- | |||
|[[Tufted angioma]] | |||
[[Kaposiform hemangioendothelioma]] | |||
|Profound and sustained thrombocytopenia with profound | |||
hypofibrinogenemia, consumptive coagulopathy and | |||
elevated D-dimer (Kasabach-Merritt phenomenon) | |||
|- | |||
|[[Rapidly involuting congenital hemangioma]] | |||
|Transient mild/moderate thrombocytopenia, +/- | |||
consumptive coagulopathy and elevated D-dimer | |||
|- | |||
|[[Venous malformations]] / | |||
Lymphatic-venous malformations | |||
|Chronic localized intravascular coagulopathy with | |||
elevated D-dimer, +/- hypofibrinogenemia, and +/- | |||
moderate thrombocytopenia (may progress to DIC | |||
after trauma or operation) | |||
|- | |||
|[[Lymphatic malformations]] | |||
|Chronic localized intravascular coagulopathy with | |||
elevated D-dimer and +/- mild to moderate | |||
thrombocytopenia | |||
(consider [[Kaposiform lymphangiomatosis]]) | |||
(may progress to DIC after trauma or operation) | |||
|- | |||
|[[Multifocal lymphangioendotheliomatosis with thrombocytopenia]] / | |||
[[Cutaneovisceral angiomatosis with thrombocytopenia]] | |||
|Sustained, fluctuating, moderate to profound | |||
thrombocytopenia with gastrointestinal tract bleeding or | |||
pulmonary hemorrhage | |||
|- | |||
|[[Kaposiform lymphangiomatosis]] | |||
|Mild/moderate thrombocytopenia, +/- | |||
hypofibrinogenemia, and D-dimer elevation | |||
|- | |||
| colspan="2" style="background:#7d7d7d; color: #FFFFFF;" + |<small>'''Adapted from International Society for the Study of Vascular Anomalies'''<ref name="urlClassification | International Society for the Study of Vascular Anomalies">{{cite web |url=http://www.issva.org/classification |title=Classification | International Society for the Study of Vascular Anomalies |format= |work= |accessdate=}}</ref></small> | |||
|} | |||
==See also== | ==See also== | ||
* [[Vascular disease]] | * [[Vascular disease]] |
Latest revision as of 15:32, 23 October 2018
For information on vascular tumors, click here.
For information on vascular malformations, click here.
For information on provisionally unclassified vascular anomalies, click here.
Vascular Anomalies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hannan Javed, M.D.[2], Anmol Pitliya, M.B.B.S. M.D.[3]
Overview
Vascular anomalies constitute a wide array of disorders ranging from benign lesions such as infantile hemangioma to aggressive malignant tumors such as angiosarcoma. Commonly used misnomers and confusing nomenclature has often presented difficulties for accurate diagnosis and appropriate management. International Society for the Study of Vascular Anomalies (ISSVA) has now classified vascular anomalies into vascular tumors and vascular malformations with an unclassified category for lesions that show clinical and histological characteristics unique from disorders classified in vascular tumors and vascular malformations.
Classification
Vascular Anomalies | ||||
---|---|---|---|---|
Vascular Tumors | Vascular Malformations | |||
Simple vascular malformation | Combined vascular malformation* | Vascular malformation of major named vessels | Vascular malformation associated with other anomalies | |
|
For details, Click here |
For details, Click here | For details, Click here | |
* Defined as two or more vascular malformations found in one lesion | ||||
Adapted from International Society for the Study of Vascular Anomalies[1] |
Classification of Vascular Tumors
Vascular tumors | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Benign | Locally aggressive or borderline | Malignant | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Infantile hemangioma / Hemangioma of infancy | Kaposiform hemangioendothelioma | Angiosarcoma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Congenital hemangioma | Retiform hemangioendothelioma | Epithelioid hemangioendothelioma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tufted angioma | Papillary intralymphatic angioendothelioma (PILA), Dabska tumor | Others | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Spindle-cell hemangioma | Composite hemangioendothelioma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Epithelioid hemangioma | Pseudomyogenic hemangioendothelioma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Pyogenic granuloma (also known as lobular capillary hemangioma) | Polymorphous hemangioendothelioma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Hemangioendothelioma not otherwise specified | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
'
| Kaposi sarcoma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Others | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
*congenital hemangioma (rapidly involuting type) and tufted angioma may be associated with thrombocytopenia and/or consumptive coagulopathy in some cases. Many experts consider tufted angioma and kaposiform hemangioendothelioma to be part of a spectrum rather than distinct entities
Adapted from International Society for the Study of Vascular Anomalies[1]
Classification of Vascular Malformations
Vascular malformations | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Simple vascular malformations | Combined vascular malformations | Vascular malformations of major named vessels | Vascular malformations asscoiated with other anomalies | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| (also known as "channel type" or "truncal" vascular malformations)
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Capillary malformations (CM) | Lymphatic malformations (LM) | Venous malformations (VM) | Arteriovenous malformation (AVM) | Arteriovenous fistula | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nevus simplex / salmon patch, “angel kiss”, “stork bite” |
| Common VM | Sporadic | Sporadic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Generalized lymphatic anomaly (GLA) Kaposiform lymphangiomatosis (KLA) | Familial VM cutaneo-mucosal (VMCM) | In HHT | In HHT | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| LM in Gorham-Stout disease | Blue rubber bleb nevus (Bean) syndrome VM | In CM-AVM | In CM-AVM | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CM of CM-AVM | Channel type LM | Glomuvenous malformation (GVM) | Others | Others | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cutis marmorata telangiectatica congenita (CMTC) | “Acquired” progressive lymphatic anomaly (so called acquired progressive "lymphangioma") | Cerebral cavernous malformation (CCM) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Others | Primary lymphedema | Familial intraosseous vascular malformation (VMOS) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Others | Verrucous venous malformation (formerly verrucous hemangioma) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Others | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Abbreviations: CM:capillary malformation; VM:venous malformation; CVM:capillary venous malformation; LM:lymphatic malformation; CLM:capillary lymphatic malformation; AVM:arteriovenous malformation; CAVM:capillary arteriovenous malformation; LVM:lymphatic venous malformation; CLVM:capillary lymphatic venous malformation; CVAVM:capillary venous arteriovenous malformation; CLVAVM:capillary lymphatic venous arteriovenous malformation; AVF:arteriovenous fistula; CLOVES:congenital lipomatous overgrowth, vascular malformations, epidermal nevi, skeletal/scoliosis and spinal abnormalities; M-CM:macrocephaly-capillary malformation; MCAP:megalencephaly-capillary malformation-polymicrogyria; MICCAP:microcephaly-capillary malformation; CNS:central nervous system; DCMO:diffuse capillary malformation with overgrowth; CM-AVM:capillary malformation-arteriovenous malformation; CMTC:cutis marmorata telangiectatica congenita; HHT:hereditary hemorrhagic telangiectasia; GLA:generalized lymphatic anomaly; KLA:kaposiform lymphangiomatosis; VMCM:venous malformation cutaneo mucosal; GVM:glomuvenous malformation; CCM:cerebral cavernous malformation.
Adapted from International Society for the Study of Vascular Anomalies[1]
Provisionally unclassified vascular anomalies
Provisionally unclassified vascular anomalies | |
---|---|
Intramuscular hemangioma * | |
Angiokeratoma | |
Sinusoidal hemangioma | |
Acral arteriovenous "tumour" | |
Multifocal lymphangioendotheliomatosis with thrombocytopenia / cutaneovisceral angiomatosis with thrombocytopenia (MLT/CAT) | |
PTEN (type) hamartoma of soft tissue / "angiomatosis" of soft tissue
(PHOST) | |
Fibro adipose vascular anomaly (FAVA) | |
* Distinct from infantile hemangioma, from intramuscular common VM, PHOST/AST, FAVA and AVM. Some lesions may be associated with thrombocytopenia and/or consumptive coagulopathy. | |
Adapted from International Society for the Study of Vascular Anomalies[1] |
Abbreviations: VM:venous malformation; AVM:arteriovenous malformation; CAVM:capillary arteriovenous malformation; MLT:Multifocal lymphangioendotheliomatosis with thrombocytopenia; CAT:cutaneovisceral angiomatosis with thrombocytopenia; PHOST:PTEN hamartoma of soft tissue; FAVA:Fibro adipose vascular anomaly; AST:angiomatosis of soft tissue.
Genetics in Vascular Anomalies
Vascular anomalies possibly associated with platelet count / coagulation disorders
Anomalies | Hematological disorders |
---|---|
Tufted angioma | Profound and sustained thrombocytopenia with profound
hypofibrinogenemia, consumptive coagulopathy and elevated D-dimer (Kasabach-Merritt phenomenon) |
Rapidly involuting congenital hemangioma | Transient mild/moderate thrombocytopenia, +/-
consumptive coagulopathy and elevated D-dimer |
Venous malformations /
Lymphatic-venous malformations |
Chronic localized intravascular coagulopathy with
elevated D-dimer, +/- hypofibrinogenemia, and +/- moderate thrombocytopenia (may progress to DIC after trauma or operation) |
Lymphatic malformations | Chronic localized intravascular coagulopathy with
elevated D-dimer and +/- mild to moderate thrombocytopenia (consider Kaposiform lymphangiomatosis) (may progress to DIC after trauma or operation) |
Multifocal lymphangioendotheliomatosis with thrombocytopenia / | Sustained, fluctuating, moderate to profound
thrombocytopenia with gastrointestinal tract bleeding or pulmonary hemorrhage |
Kaposiform lymphangiomatosis | Mild/moderate thrombocytopenia, +/-
hypofibrinogenemia, and D-dimer elevation |
Adapted from International Society for the Study of Vascular Anomalies[1] |