An Algorithmic Approach to the Diagnosis of Vascular Proliferations
Omar P. Sangüeza
Wake Forest University School of Medicine
The classification of vascular proliferations into precise categories is difficult; however, we found
that dividing them into different categories such as: hamartomas, malformations, dilatation of
pre-existing vessels, hyperplasias, benign and malignant tumors is useful. Hamartomas and malformations
are rarely seen by practicing surgical pathologists and so for reasons of time and space will not be
considered in this review.
Dilatation of Pre-existing Vessels
Dilatation of pre-existing vessels include spider angioma (nevus araneus), capillary aneurysm-venous
lake, telangiectasies, angiokeratomas and lymphangiectasias. The diagnosis of spider angioma is mostly
clinical and is characterized by a central, slightly elevated, red punctum from which blood vessels
Capillary aneurysm and venous lake are different stages of the same disease. Clinically these are
characterized by the sudden development of a growing dark papule seen on elderly patients.
Histologically, capillary aneurysm presents as a thin-walled venule beneath the epidermis, lined by a
single layer of endothelial cells and filled with a thrombus. When the thrombus dissolves the lesions
acquire the appearance of a venous lake.
Telangiectasia denotes a condition that is characterized by the permanent dilatation of vessels. They
can be either primary or secondary. Primary telangiectases can be seen in the following diseases:
unilateral nevoid telangiectasia, generalized essential telangiectasia, hereditary hemorrhagic
telangiectasia, hereditary benign telangiectasia, ataxia-telangiectasia, and cutaneous collagenous
vasculopathy. Secondary telangiectases are seen in numerous, disparate conditions such as collagen
vascular diseases, cutaneous mastocytosis and chronic graft versus host disease; but they also appear as
a consequence of trauma, sun damage or radiodermatitis. Histopathologically, telangiectases are
characterized by the presence of dilated blood vessels, mostly capillaries in the superficial dermis.
Angiokeratoma is a group of several unrelated conditions, whose common denominator is the presence of
dilated blood vessels in association with epidermal hyperplasia. Four clinical variants of
angiokeratomas have been recognized: solitary, Fordyce's angiokeratoma, Mibelli's angiokeratoma and
angiokeratoma corporis diffusum. The latter has been associated with different diseases of which Fabry's
disease is the most common. Histopathologically, all variants of angiokeratomas are identical under a
conventional microscope. Common features of all angiokeratomas include the presence of dilated
thin-walled blood vessels, lined by a layer of endothelial cells, in the papillary dermis and a variable
degree of hyperkeratosis.
Lymphangiectases are the result of permanent dilatation of lymphatic capillaries and develop in
areas of the skin affected by obstruction or destruction of lymphatic drainage. Clinically,
lymphangiectases are localized on genital or plantar skin and may mimic warts. Histopathologically,
lymphangiectasias are characterized by the presence of dilated lymphatic vessels positioned within
Hyperplasia is defined as an abnormal increase in the absolute number of normal cells, in an
appropriately arranged tissue. Inherent in this terminology is the premise that hyperplasia ceases when
its initiating stimulus has been removed; thereafter the tissue may or may not completely revert to its
normal state. This group includes pyogenic granuloma, bacillary angiomatosis, verruga peruana,
intravascular papillary endothelial hyperplasia, pseudo-Kaposi's sarcoma and reactive
angioendotheliomatosis. The first three lesions, at least in their initial phase, have in common the
presence of an exhuberant proliferation of vessels of different sizes and shapes, lined by prominent
endothelium embedded in an edematous stroma. But there are differences, BA is produced by organisms of
the genus Bartonella (formerly
Rochalimaea).  Two species of Bartonella cause bacillary
angiomatosis: B. quintana and, B. henselae.
This disease is seen mostly in immunosupressed individuals. Verruga Peruana is the cutaneous
manifestation of Bartonellosis and is caused by Bartonella bacilliformis.
Intravascular papillary endothelial hyperplasia (IPEH) is not a specific entity, but a histopathologic
pattern that can be found in multiple vascular proliferations. Histopathologically, the proliferation of
endothelial cells is present within one or more vascular lumina that have been occluded by a thrombus.
In fully developed lesions, numerous papillary fronds lined by a single layer of plump endothelial cells,
extend from the wall of the vessel into the lumina.
Pseudo-Kaposi's sarcoma is an unfortunate term that is applied to two completely different
processes. These are acro-angiodermatitis of Mali and Stewart-Bluefard syndrome. Acro-angiodermatitis
of Mali, refers to skin lesions on the lower extremities of patients with chronic venous insufficiency;
and Stewart-Bluefarb syndrome, is an arteriovenous malformation that clinically resembles Kaposi's
sarcoma. In the Mali's variant, the histopathologic findings are those of stasis dermatitis, namely
there is an increased number of thick-walled vessels lined by plump-endothelial cells, extravasation of
erythrocytes, and deposits of hemosiderin while in the Stewart-Bluefarb syndrome the entire dermis may be
affected and, in large specimens, an arterio-venous shunt may be identified.
Reactive angioendotheliomatosis is usually limited to the skin, and in contrast to what was initially
thought, is not necessarily associated with an underlying infection. Histopathologically, the
intravascular form of reactive angioendotheliomatosis shows dilated blood vessels that contain a
proliferation of endothelial cells which often occlude the lumina of the vessels; occasionally there are
associated fibrin thrombi.
a) With endothelial differentiation
Angioma serpiginosum is a neoplasm characterized by a proliferation of endothelial cells and
formation of new capillaries not simply a dilatation of pre-existing capillaries as in telangiectases.
Histopathologically, angioma serpiginosum consists of clusters of dilated capillaries housed in the
dermal papillae and lined by thick walls.
Infantile hemangioma is the most common benign vascular proliferation and traditionally, has been
considered a neoplasm. That may be true for a minority of these proliferations, however, the majority of
infantile hemangiomas are better considered as hyperplasias. This particular group of lesions, after an
initial proliferative phase, undergo complete regression, through a process of fibrosis, even in the
absence of therapy. True neoplastic infantile hemangiomas included noninvoluting congenital hemangiomas
and congenital non-progressive hemangiomas. These two lesions do not regress as do the other infantile
hemangiomas. The histopathologic composition of infantile hemangiomas varies with the age of the lesion.
Early hemangiomas are highly cellular and are characterized by plump endothelial cells aligned to
vascular spaces with small inconspicuous lumina. As the lesions mature, blood flow increases,
endothelium flattens, and the lumina of the vessels enlarge and become more obvious. During this
interval the vessels convey a "cavernous" appearance that can be misinterpreted as a venous malformation.
Regression is portrayed as progressive interstitial fibrosis and adipose metaplasia, a process without
Noninvoluting congenital hemangiomas are characterized by lobular collections of small, thin-walled
vessels with large, often stellate, central lumina, separated by variable amounts of fibrous tissue
richly supplied with normal and abnormal veins and arteries. Congenital non-progressive hemangiomas are
highly cellular with multiple well-defined lobules of proliferating capillaries that anastomose with each
other to form ribbons within the dermis or subcutaneous tissue.
Senile or cherry angiomas are among the most frequently acquired cutaneous vascular lesions. They
appear early in adulthood, most commonly on the trunk and with time, may increase in number and size.
Microscopically, the cherry angioma consists of dilated capillary blood vessels localized in the
Arteriovenous hemangioma is a neoplasm that occurs in mid-adult life and presents as a blue to red
papule measuring 0.5 to 1.0 cm, mainly affecting facial skin. Histopathologically, acral arteriovenous
hemangioma consists of a well-circumscribed proliferation of thick-walled muscle-containing blood
vessels, lined by a single layer of endothelial cells involving the upper and mid reticular dermis.
Microvenular hemangioma is an acquired, slow growing asymptomatic lesion with angiomatous appearance.
It is usually solitary and varies in size from 0.5 to 2 cm. It most commonly affects the upper limbs,
particularly the forearms. Histopathologically, microvenular hemangioma appears as a poorly
circumscribed proliferation of irregularly branched, round to oval, thin-walled blood vessels lined by a
single layer of endothelial cells.
Tufted angioma most commonly affects children and young adults, but both congenital and very late
onset cases have been described. The lesions have a predilection for the perineal area, thighs, neck,
upper chest, back, and shoulders. Tufted angioma grows slowly and insidiously, and may eventually come to
cover a large area of the trunk or neck. In most cases the growth is halted after some years and there
is a slight tendency towards spontaneous regression. Histologically, TA presents with multiple
individual vascular lobules within the dermis and subcutaneous fat. These aggregations are more
prominent in the middle and lower part of the dermis. Each lobule is composed of aggregates of
endothelial cells that form a concentric whorl around a preexisting vascular plexus. Some lobules bulge
into the walls of dilated thin-walled vascular structures, giving these vessels a slit-like or semilunar
The term glomeruloid hemangiomas describe a distinctive vascular proliferation that occurs in
patients affected with the POEMS syndrome. POEMS is an acronym for the syndrome which includes: polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy
(M protein), and skin lesions. Microscopically, glomeruloid
hemangioma consists of multiple ectatic vascular structures containing aggregates of capillary loops
resembling renal glomeruli. The capillaries are lined with either flat or plump endothelial cells with
vacuoles and surrounded by pericytes. The vacuoles in the cytoplasm of the endothelial cells contain
eosinophilic PAS positive globules that represent deposits of immunoglobulins absorbed through
Acquired elastotic hemangioma develops during adulthood on chronic sun-damaged skin, on the extensor
surface of the forearms or the lateral aspects of the neck. It mainly affects middle aged and elderly
women. Acquired elastotic hemangioma presents as a slightly elevated, irregularly shaped, solitary
lesion with violaceous coloration. Histopathologically, acquired elastotic hemangioma consists of a
proliferation of capillary blood vessels involving the superficial dermis and in a band-like arrangement
parallel to the epidermis. A narrow band of non-involved papillary dermis separates the newly formed
capillaries from the normal or flattened epidermis.
Kaposiform hemangioendothelioma is a rare but distinctive vascular neoplasm that most commonly
affects children. Though the retroperitoneum is the most frequent location,
it may also be
found in the skin. When the neoplasm is positioned in deep soft tissue, mediastinum or retroperitoneum,
it may be associated with the consumption coagulopathy that characterizes Kasabach-Meritt syndrome.
Kaposiform hemangioendothelioma combines features of cellular infantile hemangioma and Kaposi's sarcoma.
Characteristically, the neoplasm is composed of several ill-circumscribed nodules separated by connective
tissue. Each nodule is formed by an admixture of small round capillaries and solid glomeruloid nests
containing round to oval endothelial cells with epithelioid features.
Sinusoidal hemangioma lesions most frequently affect adult women and present as solitary, acquired
subcutaneous nodule, however, examples of sinusoidal hemangioma in children have been also described in
children. Widely dilated, thin-walled vascular channels that interconnect with each other characterize
sinusoidal hemangioma. In some areas the neoplasm shows a pseudopapillary pattern. These thin-walled
vessels branch and anastomose with each other to a much greater extent than conventional hemangiomas do.
Spindle cell hemangiomas most often occur in the distal regions of the extremities of children and
young adults. However, examples of this lesion have been reported in other
locations. Several cases of spindle cell hemangioma have been described in patients with Maffucci
syndrome. Histopathologically, spindle cell hemangioma show well circumscribed but not encapsulated
nodules that combine the features of hemangioma and Kaposi's sarcoma. They are rich in dilated thin
walls and blood vessels sometimes occupied by organized thrombi and phleboliths. Interspersed between
the blood vessels, is a stroma of spindle cells in fascicles closely resembling Kaposi's sarcoma.
The lesions of benign lymphangioendothelioma are reddish or bruise-like, slowly enlarging plaques
that lack site predilection. Benign lymphangioendotheliomas appear histologically as delicate,
thin-walled, endothelium-lined spaces entrapped between collagen bundles. The appearance may be confined
to the papillary dermis but may extend into the reticular dermis and subcutaneous fat. In superficial
areas, the vascular channels are arranged horizontally, often becoming smaller and more twisted at deeper
The cutaneous lesions include: papules, small vesicles and erythematous plaques. Benign lymphangiomatous papules and plaques are the most common. Under low
magnification, these lesions appear as relatively well-circumscribed capillary proliferations centered in
the dermis, without extension into the subcutaneous fat. Most lesions show irregularly dilated lymphatic
spaces, that branch and anastomose within the superficial dermis. Multiple papillary projections,
covered by a single layer of endothelium, project into the lumina of the dilated lymphatic.
Lesions of hobnail hemangioma are characterized by a brown to violaceous central papule, surrounded
by a thin, pale area and a peripheral ecchymotic ring. The ecchymotic halo ultimately disappears in
contrast to the central papule that persists. Histopathologically, hobnail hemangioma shows a
distinctive biphasic appearance. The center of the lesion is composed of dilated, irregular, thin-walled
ectatic vascular spaces positioned in the superficial dermis. These vascular spaces sometimes exhibit
intraluminal papillary projections and fibrin thrombi at different stages of organization. Prominent,
plump, endothelial cells with a hobnail appearance line the papillary projections. The deep areas are
distinct from the peripheral areas of the lesion because they show irregular, angulated thin-walled
slit-shaped vascular channels that dissect the collagen bundles of the dermis.
Glomus tumors are uncommon neoplasms that arise from modified smooth muscle cells normally present in
specialized arteriovenous shunts in acral sites, mainly the fingertips. Two types of glomus tumors have
been described, solitary, and multiple. The solitary glomus tumor is more common. It creates a small,
purple nodule preferentially in acral areas of the extremities, especially the nail beds of the fingers
and toes. Frequently, the lesion create severe paroxysmal pain, usually precipitated by exposure to cold
or minor pressure. Multiple glomus tumors are much less common than their solitary counterpart. They
are termed glomangiomas descriptively in accordance with their angiomatous appearance. In contrast to
the solitary glomus lesion, glomangiomas present during childhood as small bluish nodules situated deep
in the dermis and widely scattered in the skin. Histopathologically, solitary glomus tumors are
customarily solid, as a well-circumscribed nodule surrounded by compressed fibrous tissue. The neoplasm
is cytologically formed of clusters of round or polygonal monomorphous glomus cells with large round,
plump nuclei and scant eosinophilic cytoplasm. Glomangiomas are less well-circumscribed lesions than
solitary glomus tumors. Some are made up of several nodules within the dermis and may have an appearance
that calls to mind a hemangioma. These are composed of irregular dilated endothelial lined vascular
channels that contain red blood cells and as a distinctive feature have small intramural aggregations of
glomus cells. Glomus cells may form cords or small clusters in adjacent stroma, but numerically they are
sparse relative to their numbers in a solitary glomus tumor.
The clinical features and the biological behavior of Kaposi's sarcoma are different and depend on the
epidemiological type. There are four types: the classical type of Kaposi's sarcoma which affects
mainly elderly patients; the African-endemic variant; Kaposi's sarcoma associated with immunosuppressive
drugs (iatrogenic) and AIDS-associated Kaposi's sarcoma. The earliest lesions of Kaposi's sarcoma known
as the patch stage are characterized by inconspicuous changes and may produce the erroneous impression of
an inflammatory condition. At scanning magnification these lesions show sparse, superficial and deep
perivascular mononuclear cell infiltrates in conjunction with an increased number of irregular, jagged,
vascular spaces lined by thin endothelial cells. The vessels are mainly found in the upper part of the
dermis. The neoplastic vessels of Kaposi's sarcoma show a tendency to be present around pre-existing
normal adnexae and blood vessels producing the so-called "promontory sign". In other areas, the blood
vessels infiltrate collagen bundles of the dermis giving the appearance that they are "dissecting" the
stroma. The inflammatory cells present are predominantly lymphocytes and plasma cells. The presence of
plasma cells around newly formed irregular blood vessels is a helpful clue in the histopathologic
diagnosis of the patch stage of Kaposi's sarcoma. Plaque lesions of Kaposi's sarcoma tend to involve the
entire dermis and even the upper part of the subcutaneous fat. At this stage, there is an increased
number of spindle cells arranged in short fascicles between collagen bundles centered around
proliferating vascular channels. The spindle cells line irregularly shaped, slit-like vascular spaces
that contain isolated erythrocytes. They display minimal or no atypia, with few or no mitotic figures.
When the number of spindle cells increases, lesions of Kaposi's sarcoma become nodular. Then, the
spindle cells are arranged in interwoven fascicles with erythrocytes scattered in the interstices.
Nuclear atypia, pleomorphism and mitotic figures may be seen, but are usually not very prominent. In
rare instances, however, especially in the African variant, a significant number of mitotic figures and
atypical cells may be seen in lesions of Kaposi's sarcoma. A rather characteristic, but probably not
specific, histopathologic finding is the presence of the so-called hyaline globules. Although these are
most common in the plaque and nodular lesions of Kaposi's sarcoma, they can be present at any stage of
the disease. These globules are located both intra- and extracellularlyand are PAS-positive,
diastase-resistant and consist of eosinophilic spherules measuring between 1 to 10μm, and
are. Most likely these hyaline globules represent degenerated erythrocytes that are phagocytized and
confined to the phagolysosomes of the neoplastic cells.
Low grade angiosarcomas
This group of lesions includes: epithelioid hemangioendothelioma, retiform hemangioendothelioma and
Dabska's tumor. These three neoplasms share many similarities both clinically and histologically, so
they are best considered as part of a spectrum. Clinically, they usually appears as solitary, slightly
painful tumors, which in some cases may ulcerate. They occur at any age and affects both sexes in
approximately equal proportion. Histopathologically, the lesions of epithelioid hemangioendothelioma
present as circumscribed dermal or subcutaneous nodules. The neoplasm is composed of cords, strands and
nests of plump, epithelioid cells embedded in a fibromyxoid or sclerotic stroma. Many of the neoplastic
cells contain vacuoles in their cytoplasm as a sign of primitive vascular differentiation. Slight
cellular pleomorphism and occasional mitotic figures may be seen. Dabska's tumor is composed of
interconnecting vascular channels lined by atypical endothelial cells. The vascular spaces vary in size
and shape ranging from narrow channels to large vascular structures. The most characteristic
histopathologic feature consists of papillary plugs of atypical endothelium, with a central sclerotic
core of connective tissue, projecting into the lumina and producing a glomeruloid appearance. The
endothelial cells are round to polyhedral with an atypical, hyperchromatic and eccentrically placed
nuclei, located in the luminal border of the cell, producing a surface bulge, accounting for the term
"hobnail" or "matchstick." Retiform hemangioendothelioma consists of elongated, arborizing blood vessels
involving the dermis, arranged in an architectural pattern reminiscent to that of the normal rete
testis. Monomorphic hobnail endothelial cells line the vessels composing the neoplasm. Cytologic atypia
is minimal in the hobnail cells of retiform hemangioendothelioma and few or no mitotic figures are seen.
In some areas, the retiform pattern is obscured by the presence of a dense inflammatory infiltrate of
Angiosarcomas are highly aggressive neoplasms that can present in three different settings, to wit:
angiosarcoma of the face and scalp, angiosarcoma associated with lymphedema and radiation-induced
angiosarcoma. Angiosarcoma of the face and scalp predominantly affects elderly patients and is usually
located on the scalp and upper forehead. Clinically; the lesions appear as ill-defined bruise-like areas
that simulate a hematoma. More advanced lesions present as indurate plaques with raised, nodular, and
occasionally ulcerated components accompanied by smaller satellite lesions in the same vicinity. More
than 90% of all angiosarcomas associated with chronic lymphedema occur following mastectomy for breast
carcinoma,but it has been described in areas of lymphedema secondary to other mechanisms The arm, most
often the upper inner aspect, is the most frequent site for early involvement. Less commonly, the tumor
appears more distally, on the elbow or on the forearm. Clinically, these lesions appear as bruise-like
areas or violaceous nodules superimposed on the brown non-pitting edema of the affected limb. After the
appearance of the lesions, there is a rapid increase in their number and size and they may undergo
ulceration. Advanced cases spread distally to the hands and proximally to the chest wall. Post
irradiation cutaneous angiosarcoma is a rare condition that has been described following the use of
radiotherapy for the treatment of diverse conditions, both benign and malignant. Regardless of the
clinical variant, angiosarcomas are histopathologically similar. Well-differentiated angiosarcomas
appear as irregular, dilated vascular channels lined by flattened endothelial cells with an innocuous
appearance, which may lead one to confuse them with a hemangioma, lymphangioma or an inflammatory
process. However, careful observation of these lesions reveals the presence of irregular vascular
channels dissecting the dermis. These channels tend to communicate with each other, forming an
anastomosing network. Furthermore, some of the endothelial cells appear large, hyperchromatic, and
pleomorphic, protruding within vascular lumina, forming small papillations. Poorly differentiated
angiosarcomas, demonstrate solid proliferations of polygonal or spindle-shaped pleomorphic endothelial
cells, with prominent mitotic activity and poorly-formed vascular spaces, which sometimes makes it
difficult to distinguish them from carcinoma, melanoma or a high-grade fibrosarcoma. Of considerable
value for the diagnosis of these cases is the presence of cytoplasmic vacuoles within the neoplastic
cells. Patchy lymphoid infiltrates are also a common finding. The number of erythrocytes that are
present within the vascular spaces varies from a few to none in the poorly differentiated areas.
Pre-existing adnexal, neural and vascular structures of the dermis are frequently involved and destroyed
by the tumor.
Malignant glomus tumor (glomangiosarcoma)
The lesions of glomangiosarcoma are larger and deeper than conventional glomus tumors, and they are
predominantly located on the extremities where they appear as subcutaneous masses. The tumors equally
affect both men and women. Metastatic disease has been documented in only ten cases of
histopathologically malignant glomus tumor, and in eight of these patients, death was a consequence of
the widespread metastases from the glomangiosarcoma. Locally aggressive behavior appears to
be more common in these neoplasms. There are three proposed categories for malignant glomus tumors:
- locally infiltrative glomus tumor; these are neoplasms that lack atypical features but show locally aggressive behavior (LIGT)
- glomangiosarcomas that result from the transformation of a glomus tumor (GABG); these are the most common type of MGT, and remaining areas of typical GT can be identified
- de novo glomangiosarcoma (GADN), the most unusual form of MGT
In the second group, there are sarcomatous areas intermingled with areas of benign glomus tumor. In
these cases it is important to identify the benign component, as it is the most important clue to the
diagnosis of glomangiosarcoma. The malignant areas appear as poorly circumscribed and infiltrative
neoplasms composed of fascicles of spindle cells or aggregations of round glomoid cells with nuclear
pleomorphism, frequent mitotic figures and foci of necrosis en masse. In some neoplasms, there is a
peculiar arrangement of neoplastic cells, with small round glomus cells at the periphery and central
areas of spindle cells. A diagnosis of glomangiosarcoma should be not misconstructed in cases of
long-standing glomus tumors in which it is possible to see glomus cells with large hyperchromatic nuclei
probably as result of degenerative changes similar to those seen in ancient schwannoma. Some authors
have proposed the name symplastic glomus tumor for these benign glomus tumors with nuclear atypia.
- BENIGN PROLIFERATIONS
- DILATATION OF PREEXISTING VESSELS
- Blood vessels:
- Spider angioma (nevus araneus)
- Capillary aneurism-venous lake
- Unilateral nevoid telangiectasia
- Generalized essential telangiectasia
- Hereditary hemorrhagic telangiectasia (Osler-Rendu-Weber disease)
- Hereditary benign telangiectasia
- Ataxia-telangiectasia (Louis-Bar syndrome)
- Cutaneous collagenous vasculopathy
- Solitary angiokeratoma
- Angiokeratoma of Fordyce
- Angiokeratoma of Mibelli
- Angiokeratoma corporis diffusum
- Lymphatic vessels:
- Pyogenic granuloma
- Bacillary angiomatosis
- Verruga peruana
- Intravascular papillary endothelial hyperplasia (Masson's pseudoangiosarcoma)
- Pseudo-Kaposi's sarcoma:
- Acroangiodermatitis of Mali
- Stewart-Bluefarb syndrome
- "Benign" angioendotheliomatosis (reactive angioendotheliomatosis)
- BENIGN NEOPLASMS
- Endothelial differentiation:
- Capillaries and venules:
- Angioma serpiginosum
- Infantile hemangioma
- Cherry angioma (senile angioma)
- Acral arteriovenous hemangioma
- Angiolymphoid hyperplasia with eosinophilia
- Microvenular hemangioma
- Tufted angioma (angioblastoma)
- Glomeruloid hemangioma
- Acquired elastotic hemangioma
- Kaposiform hemangioendothelioma
- Veins and arteries:
- Sinusoidal hemangioma
- Giant-cell angioblastoma
- Spindle-cell hemangioma (formerly, spindle cell hemangioendothelioma)
- Lymphatic vessels:
- Benign lymphangioendothelioma
- Benign vascular proliferations in irradiated skin
- Hobnail hemangioma (Targetoid hemosiderotic hemangioma)
- Glomus cell differentiation:
- Solitary glomus tumor
- Multiple glomus tumors (glomangiomas)
- Intravenous glomus tumor
- MALIGNANT PROLIFERATIONS
- Kaposi's sarcoma
- Low-grade cutaneous angiosarcomas:
- Epithelioid hemangioendothelioma
- Endovascular papillary angioendothelioma (Dabska's tumor)
- Retiform hemangioendothelioma
- Composite hemangioendothelioma
- High-grade cutaneous angiosarcomas:
- Classic angiosarcoma of the face and scalp of elderly patients
- Cutaneous angiosarcoma associated with lymphedema
- Radiation-induced cutaneous angiosarcoma
- Epithelioid angiosarcoma
- Malignant glomus tumor (glomangiosarcoma)
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