How airway venous malformations differ from airway infantile hemangiomas.
OBJECTIVE
To compare airway infantile hemangiomas (IHs) and venous malformations (VMs) clinically, radiographically, endoscopically, and histologically.


METHODS
Retrospective cohort study.


METHODS
Tertiary care pediatric hospital.


METHODS
The study included patients seen in the Vascular Anomaly Clinic, Seattle Children's Hospital, Seattle, Washington, between 2001 and 2008.


METHODS
All patients with airway vascular anomalies were identified by searching the Vascular Anomaly Quality Improvement Database and hospital discharge data. The data, which were analyzed with descriptive statistics and the Fisher exact test, included presenting age, sex, presenting signs, lesion site, and radiographic, endoscopic, and histologic findings..


RESULTS
Seventeen patients with airway lesions were identified, 6 with VMs and 11 with IHs. Patients with VMs presented at a mean (SD) age of 11.3 (13.7) months (age range, 3-39 months), while those with IHs presented at 3 (1.8) months of age (age range, 1-6 months) (P = .03). The patients with IHs were predominantly female (9 of 11 [81%]), while no sex difference was noted among the patients with VMs (3 of 6 [50%]). All patients with IHs presented with stridor and cutaneous lesions, whereas patients with VMs more often presented with hemoptysis or dysphagia (P = .001). Computed tomographic angiograms demonstrated enhancing endolaryngeal lesions in all IHs, while VMs enhanced poorly. Endoscopically, IHs were transglottic, while VMs were postcricoid or epiglottic (P < .001). Histologically, immunostained lesions showed submucosal lobules of capillaries lined by GLUT-1 (glucose transporter isoform 1)-positive endothelium in IHs, whereas VMs consisted of loosely organized venous channels that lacked GLUT-1 staining.


CONCLUSIONS
Patients with airway IHs and VMs differ in presenting age and signs, sex, airway lesion location, enhancement on computed tomographic angiograms, and histologic appearance.
DO, Division of Pediatric Otolaryngology, Seattle Children's Hospital, 4800 Sand Point Way NE, Mail Stop W-7729, Seattle, WA 98105-0371, USA.
Nooshin
N
Parhizkar
Scott C
SC
Manning
Andrew F
AF
Inglis
Laura S
LS
Finn
Eunice Y
EY
Chen
Jonathan A
JA
Perkins
D000465:Algorithms; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male; D012137:Respiratory System / Q000098:blood supply*; D012142:Respiratory Tract Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
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