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A vascular tumor arising from the right subclavian artery. Figure 3 Microscopic cross-section of the tumor (H&E ×100). Arrow indicates marked lymphoid hyperplasia.
Source publication
A 22-year-old woman presented with a 3-month history of a pulsatile swelling in the right supraclavicular region. A CT angiogram revealed an aneurysm arising from the distal right subclavian artery. At surgery, the subclavian artery was almost entirely replaced by a well-vascularized tumor mass. The vascular tumor along with the native vessel was e...
Context in source publication
Context 1
... EH has to be distinguished from Kimura's disease. The distinctive features of EHs are exuberant proliferation of vessels lined by cuboidal to hobnail endothelial cells with irregular nuclei and cytoplasmic vacuoles, fibromyxoid matrix, involvement of the muscular coat of blood vessels and zonation of inflammatory infiltrate towards the peripheral portion of the lesion (Fig- ures 3 and 4). The distinctive features of Kimura's disease are florid lymphoid infiltrate with promi- nent lymphoid follicles, vascularization of germinal centers, germinal center necrosis, marked eosino- philia with or without eosinophil abscess formation, proliferation of high endothelial venules, and sclero- sis. ...
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We present here two patients that had an aberrant right subclavian artery and an anomalous origin of the right vertebral artery from the right common carotid artery. We review the previous literature and discuss herein the embryologic mechanism and clinical implications of this variation.
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Citations
... However, the development of EH inside a large muscular artery is rarely seen. About 22 cases have been reported, involving in order of decreasing frequency: temporal artery [14][15][16][17][18][19][20], radial artery [21][22][23][24], brachial artery [11,12], ulnar artery [25,26], axillary artery [27,28], subclavian artery [29], facial artery [30], post-auricular artery [31], popliteal artery [32], common carotid artery [33] and occipital artery [12]. The lesion can grow entirely in the lumen of the blood vessel developing occlusive symptoms (such as weakening of the pulse in peripheral arteries) or it can originate from the vascular wall and developing outside with compression of adjacent structures. ...
Epithelioid hemangioma (EH) is an uncommon benign vascular lesion, also known as angioblastic lymphoid (or angiolymphoid) hyperplasia with eosinophilia, characterized by an unclear etiopathogenesis.
It usually affects young to middle-aged adults and develops in the head and neck region, as painless cutaneous or subcutaneous reddish papules or nodules.
Large vessels involvement is extremely rare, and to date only two cases affecting the brachial artery have been cited in literature.
In this report we present a further case of EH of the brachial artery and review the pertinent literature.
A woman in her 20s noticed pain and a mass in her left forearm. She was referred to our hospital for a cardiovascular surgery consultation. Ultrasound images: In this case, some changes in ultrasound images of the radial artery were observed over 4 years; the size got bigger, the thickness of the arterial wall increased, and a solid lesion with little blood in the wall was observed. Surgical findings: The tumor was a membrane-covered lesion and had no adhesions around it. Histopathological examination of the aneurysm removed during surgery was performed, and the diagnosis was epithelioid hemangioma. We report the changes in ultrasound images over 4 years in a case of radial artery epithelioid hemangioma.
Background:
Current knowledge of angiolymphoid hyperplasia with eosinophilia (ALHE) derives from retrospective reports and case series, leading to a nonevidence-based treatment approach.
Objective:
We sought to systematically review the literature relating to cutaneous ALHE to estimate its epidemiology and treatment outcomes.
Methods:
A literature search of PubMed, EMBASE, Web of Science, and Google Scholar was conducted. Articles detailing cases of histologically confirmed cutaneous ALHE were included.
Results:
In all, 416 studies were included in the review, representing 908 patients. There was no sex predominance among patients with ALHE. Mean age at presentation was 37.6 years. There was a significant association between presence of multiple lesions and pruritus, along with bleeding. Surgical excision was the most commonly reported treatment for ALHE. Treatment failure was lowest for excision and pulsed dye laser. Mean disease-free survival after excision was 4.2 years. There were higher rates of recurrence postexcision with earlier age of onset, longer duration of disease, multiple lesions, bilateral lesions, pruritus, pain, and bleeding.
Limitations:
Potential for publication bias is a limitation.
Conclusions:
Surgical excision appears to be the most effective treatment for ALHE, albeit suboptimal. Pulsed dye and other lasers may be effective treatment options. More studies are needed to improve the treatment of ALHE.
This case report describes a rare vascular tumor (epithelioid hemangioma) in the ulnar artery of a young male patient, treated by excision and bypass grafting.
