Histopathological reporting of paediatric cutaneous vascular anomalies in relation to proposed multidisciplinary classification system.
BACKGROUND
The terminology applied to vascular anomalies has been variable in previously published literature making interpretation suboptimal. The International Society for the Study of Vascular Anomalies (ISSVA) has proposed a revised classification based on clinical features and histopathological findings. This classification is increasingly being accepted as clinically useful and a platform for future studies.


OBJECTIVE
To examine the extent to which the ISSVA classification can be practically applied to diagnostic histopathological specimens.


METHODS
Cutaneous vascular lesions received in a single paediatric pathology unit during a 2-year period (2004-5) were reviewed, including glucose transporter protein 1 (GLUT1) immunostaining where required, and lesions were reclassified according to the ISSVA classification.


RESULTS
144 specimens were identified. Appropriate full clinical information was provided in only 17% of cases at submission. Infantile haemangiomas comprised 46% of cases, 18% of which were regressive type, initially inaccurately identified as vascular malformations before GLUT1 immunostaining. 30% of lymphatic malformations and all lymphovenous malformations were previously classified as vascular malformations, not otherwise specified.


CONCLUSIONS
The ISSVA classification of vascular anomalies provides a useful framework for histopathologists to classify vascular anomalies. However, meaningful and appropriate use of such a system is dependent on the adequacy of clinical information provided and routine use of immunohistochemical markers.
Al-Adnani
M
M
Department of Paediatric Histopathology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, UK.
Williams
S
S
Rampling
D
D
Ashworth
M
M
Malone
M
M
Sebire
N J
NJ
D014408:Biomarkers, Tumor / Q000378:metabolism; D001808:Blood Vessels / Q000002:abnormalities; D002648:Child; D002675:Child, Preschool; D051272:Glucose Transporter Type 1 / Q000378:metabolism; D006391:Hemangioma / Q000145:classification / Q000473:pathology*; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000175:diagnosis; D012867:Skin / Q000098:blood supply; D017445:Skin Diseases, Vascular / Q000145:classification / Q000473:pathology; D012878:Skin Neoplasms / Q000145:classification / Q000473:pathology*
D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; C495677:SLC2A1 protein, human