Dilated lymphatic vessels in tufted angioma:  a potential source of diagnostic confusion.
Tufted angioma (TA), an uncommon benign vascular tumor, has a variable clinical presentation, and histopathologic findings are a key component of diagnosis. The presence of lymphatic vessels suggestive of lymphangioma can occasionally be the predominant finding and cause diagnostic confusion. Nine biopsies from 7 cases of TA were studied to assess the frequency and distribution of lymphangioma-like areas. Specimens were also stained with D2-40, VEGF-A, GLUT-1, and HHV-8. In one biopsy, lymphangioma-like vessels were the main finding. In all other cases of TA, lymphatics were present in the stroma but were often overshadowed by tufts of capillaries. D2-40 highlighted the stromal lymphatics and partially stained the capillaries within tufts. VEGF-A showed diffuse nonspecific staining of epidermis and endothelial cells in all specimens. GLUT1 and HHV-8 staining were uniformly negative in all 9 specimens. Accurate diagnosis of TA has important clinical implications given its occasional association with Kasabach-Merritt phenomenon, and the presence of lymphangioma-like vessels in biopsies of vascular lesions is entirely compatible with TA.
Department of Dermatology, Yale University School of Medicine, New Haven, CT 06520, USA. mona.sadeghpour@yale.edu
Mona
M
Sadeghpour
Richard J
RJ
Antaya
Rossitza
R
Lazova
Christine J
CJ
Ko
D000293:Adolescent; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D002196:Capillaries / Q000737:chemistry / Q000473:pathology; D002675:Child, Preschool; D003237:Connecticut; D003951:Diagnostic Errors; D004108:Dilatation, Pathologic; D005260:Female; D051272:Glucose Transporter Type 1 / Q000032:analysis; D006391:Hemangioma / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D042601:Lymphatic Vessels / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; C495677:SLC2A1 protein, human; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C500987:monoclonal antibody D2-40