Hepatic hemangioma pathophysiology: Difference between revisions

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==Overview==
==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, classically subcapsular are characteristic 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 characteristic 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>
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==
==Pathophysiology==
==Pathogenesis==
==Pathogenesis==
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*[[Hemolytic anemia]]
*[[Hemolytic anemia]]
*Consumptive coagulopathy
*Consumptive coagulopathy
*[[focal nodular hyperplasia]]
*[[Focal nodular hyperplasia]]
==Gross Pathology==
==Gross Pathology==
On gross pathology, variable in size, well circumscribed, classically subcapsular are characteristic 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 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>
==Microscopic Pathology==
==Microscopic Pathology==
On microscopic histopathological analysis channels lined by benign endothelium containing RBCs, surrounding (non-endothelial) cells without significant atypia are characteristic 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>
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==
<gallery>
<gallery>

Revision as of 18:51, 10 November 2015

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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 hemangiomas has not been elucidated, but there are two competing theories.

First theory

  • The first theory supports the notion that there is overexpression of angiogenic factors such as:[1]
  • Vascular endothelial growth factor
  • Basic fibroblast growth factor
  • Metalloproteinases
  • And there is downregulation of some inhibitors of angiogenesis such as:[1]
  • Tissue inhibitor of metalloproteinase-I

Second theory

  • The second theory is that the presence of liver hemangiomas involves a genetic background of mutations.[1]
  • Zhang et al. presumed that metalloproteinases accumulate in the endoplasmic reticulum of the tumor cells causing:
  • Self-digestion
  • Vacuole formation
  • Additionally, Hu et al. showed the cavernous hemangioma cell to downregulate Derlin-1.
  • Derlin-1 is a protein that when overexpressed 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, variable in size, well circumscribed, and classically subcapsular are findings 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
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