Angiomatosis of soft tissue as an important differential diagnosis for intramuscular venous malformations.
Background We aimed to improve management of extremity low-flow vascular malformations by analyzing the histology and imaging of venous malformations (VMs) not responsive to sclerotherapy. Method We reviewed patient records of 102 consecutive patients treated with sclerotherapy for extremity VM in our institution to identify patients who had undergone surgery due to insufficient response. We semi-quantitatively analysed the tissue specimens and compared histological findings to those in preoperative imaging. Result The number of patients operated on was 19 (18.6%); 15 of them had lower-extremity intramuscular lesions. The histological pattern of 13 of these 15 lesions corresponded to angiomatosis of soft tissue (AST). All other lesions treated surgically were VMs. The histology of AST was distinctive but magnetic resonance imaging findings often overlapped with those of VM. Conclusion AST is easily mixed with intramuscular VM. The differentiation of these two entities has therapeutic importance. We emphasize the role of histology in the differential diagnostics of intramuscular slow-flow vascular malformations.
1 University of Helsinki, Helsinki, Finland.|2 Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland.
Johanna
J
Aronniemi
1 University of Helsinki, Helsinki, Finland.|3 Department of Pathology, HUSLAB, Helsinki University Hospital, Helsinki, Finland.
Jouko
J
Lohi
1 University of Helsinki, Helsinki, Finland.|4 Department of Pediatric Surgery, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
Päivi
P
Salminen
1 University of Helsinki, Helsinki, Finland.|5 Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland.
Pia
P
Vuola
1 University of Helsinki, Helsinki, Finland.|2 Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland.
Kimmo
K
Lappalainen
1 University of Helsinki, Helsinki, Finland.|6 Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, Institute of Clinical Medicine, Helsinki, Finland.
Anne
A
Pitkäranta
1 University of Helsinki, Helsinki, Finland.|2 Department of Radiology, HUS Medical Imaging Center, Helsinki University Hospital, Helsinki, Finland.
Johanna
J
Pekkola
D000293:Adolescent; D000328:Adult; D000368:Aged; D000798:Angiomatosis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D012189:Retrospective Studies; D015911:Sclerotherapy; D014652:Vascular Diseases / Q000000981:diagnostic imaging*; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D014680:Veins / Q000002:abnormalities / Q000000981:diagnostic imaging*; D055815:Young Adult
Differential diagnostics; histology; sclerotherapy; surgery; vascular anomaly