Abstract
Vascular tumors represent one of the most difficult group of soft tissue tumors. This relates to many features: (1) a very large number of entitities exist, some of which are extremely rare (not all existing types are discussed in this chapter); (2) the morphology can overlap considerably between entities; (3) the vasoformative character is not always evident and some tumors are very spindly or epithelioid; (4) to separate benign from malignant lesions can be a true challenge, (5) the clinical setting is often of utmost importance; (6) different classification schemes have been used; and (7) the distinction between malformative and neoplastic lesions becomes more and more difficult to define. In this chapter, we divided the vascular lesions based on clinical and morphological parameters. They include the following: (A) malformative vascular lesions, (B) classical vasoformative tumors, (C) reactive vascular lesions, (D) vascular tumors with hobnail endothelium, (E) spindled vascular tumors, (F) epithelioid vascular tumors. Various immunohistochemical markers exist but the most interesting and useful ones are CD31 and ERG to confirm the endothelial nature; podoplanin (D2-40) in search for lymphatic differentiation; alpha-smooth muscle actin (alpha-SMA) to evaluate vascular architecture; human herpesvirus 8 (HHV8) to confirm suspicion of Kaposi sarcoma; and C-MYC for the differential diagnosis between atypical vascular lesions and (post-radiotherapy/lymphedema related) angiosarcoma.
The purpose of this chapter is to evaluate the morphological, immunohistochemical, molecular genetic, and clinical characteristics of vascular tumors, with the aim of giving surgical pathologists a pattern-based approach, which, with the help of drawings for each tumor entity, makes the interpretation of this complex group of soft tissue neoplasms easier and more reproducible. In addition, tips and trics represent potential handles that can be used in the approach of a vascular lesion.
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Sciot, R., Gerosa, C., Floris, G., Fanni, D., Debiec-Rychter, M., Faa, G. (2020). Vascular Tumors. In: Sciot, R., Gerosa, C., Faa, G. (eds) Adipocytic, Vascular and Skeletal Muscle Tumors. Current Clinical Pathology. Humana, Cham. https://doi.org/10.1007/978-3-030-37460-0_2
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DOI: https://doi.org/10.1007/978-3-030-37460-0_2
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