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VascularTumors
Semester 4 Pathology -Vascular/cardiac tumors
Question | Answer |
---|---|
List the benign tumors covered | Hemangioma (including von hipple-lindau syndrome), Lymphangioma, glomus tumor, vascular ectasia. |
Tumors of intermediate malignancy | Menangioendothelioma and hemangiopericyotma |
Malignant tumors | kaposi sarcoma, angiosarcoma, lymphangiosarcoma` |
What is the tx for cardiac rhabdomyoma? | Heart xplant. Surgical tumor resection is not an option due to its location in the ventricle. |
Compare the key morphological features of benign vs malignant vascular tumors. | Benign: Distinct vascular channels filled with blood or lymph. One layer of benign endothelium and no cellular atypia. Malignant: solid, cellular, NO WELL FORMED VESSELS. Cellular atypia. Identied with CD31, CD34, vWF, and Factor VII |
What is granuloma gravidarum? What kind of tumor is? | hemangioma of the gum found in pregnant women. It is a type of capillary hemangioma (benign) pyogenic granuloma |
What are the major types of hemangioma? | Capillary hemangioma (pyogenic granuloma ((ie granuloma graviderum)) and juvenile/strawberry granuloma) and Cavernous hemangioma. |
What is the behavior of hemangioma | typical regresses spontaneously. |
Pregnant women presents with grown in mouth.... dx? | granuloma graviderum... a type of pyogenic granuloma (capillary hemangioma) |
von hippel lindau syndrome is an example of what kind of tumor | cavernous hemanioma. cysts in kidneys and pancrease, as well as tumors in cerebellum, retina, and liver. |
What is a glomus tumor? | A benign tumor that grows under the fingernail. |
What is an ectasia? | Localized dilation of preexisted blood vessels. NOT a neoplasm. (ie; teleangiectasia: dilation of small blood vessels [arteriols, capillaries, venules] |
What are the major types of vascular ectasia? | Nevus flammus - a birth mark in the head or neck region that regresses spontaneously. (Port wine stain, sturge weber syndrome), and spider teleangeiectasia. |
Contrast nevus flammeus from port wine stain | Port wine stain is nevus flammeus that persists into adulthood. |
What is sturge weber sydrome | Neurological disorder present at birth which is characterized by **seizures** and mental retardation accompanied by a large port-wine stain birthmark of the forehead |
Spidertelangiectasia. Description? Cause? | Radial arrat f dilated sucutaneous arteries/arterioles around a central core. Caused by hyperestinism in pregnancy or liver cirrhosis |
Hemangiopericytoma is commonly found where? What age group? What cell type? | in the PERICYTES of the retroperitoneum and lower extremities. Commonly in elderly patients. Intermediate malignancy (2/3 of cases are benign, 1/3 malig) |
What is the cause of kaposi sarcoma? | HHV-8... commonly in AIDS pts, but not always |
Chronic kaposi sarcoma (KS) effects what parts of body? Benign or malig? | Skin, distal lower extremities. Benign |
What are the 4 major types of Kaposi Sarcoma (KS) | 1) Chronic (europian/classic) KS (benign. fx skin and distal lower extremities), (2) Lymphadenopathic KS (african/endemic) -fx LN and skin; aggressive. Not related to AIDS. (3) Transplant Asso. KS and (4) AIDS asso KS |
Describe the morphology of lesions in KS? | Pink-Purple-Red patch --> plaque -> nodule. Histologically sppears as cords of pleopmorphic spindle shapred cells with scattered small vessels and slit like spaces |
Histological finding of cords of pleomorphic spindle shaped cells with scattered small vessels and slit like spaces. DX? | KS |
What morphological finding is NEVER found is kaposi sarcoma? | Collagen production is never found. |
What is the cause of hepatic hemangiosarcoma? | Hepatic hemangiosarcoma is causes by arsenic, thorotrast (X-ray contrast media), and PVC (poly vinyl chloride |
Compare consistency of carcinoma to sarcomas | Carcinomas, as a rule, are usually hard, while sarcomas are usually soft (fish skin like consistency) |
What are the major complications of cardiac myxoma | Valvular obstruction and systemic embolization with brain infarcts. **Not metastasis, only embolization** |
Where in the heart is a cardiac myxoma most likely to be found? | Left Atrium (may obstruct mitral valve) |
What kind of cells is a rhabdomyoma made of? | Spider cells (primitive rhabdomyocytes) |
Where is a rhabdomyoma located? | Right or LEft ventricle |
aortic calcific sclerosis is associated with what congenital valve abnormality> | Bicuspid aortic valve. |
Aschoff bodies are found in asso with what disease | RF |
IV drug user presents with fevers, fatigue, weight loss, hemorrhagic lesions and heart murmums. What is the likely dx, what findings are likely to present with this dx? | infective endocarditis. Findings of bulky and friable vegetations. |
What is the major cause of non-bacterial thrombotic endocarditis (NBTE) | mucus producing adenocarcinoma (any origin, but mainly pancrease) |
Pt. With history of mucus producing adenocarcinoma is at increased risk for what cardiac disease? | non-bacterial thrombotic endocarditis. |
What is the morphological finding of non-bacterial thrombotic endocarditis? | sterile vegetations n the leaflets or cusps of heart (usually mitral or aortic). |
How is RF differentiated from NBTE? | By the pt hx. Child in developing country w/ recent strep - -> HF. Pt with cancer ‡ NBTE. Diseases have similar lesions on heart valves. |
What is a carcinoid? | a tumor of neuroendocrine cells which secrete hormones. 5-HT. Kallikrien, histamine, bradkinin, etc |
What side of the heart is effected by GI carcinoids? | Right side of heart |
What side of the heart is effected by uterine or ovarian carcinoids? | right side of heart |
What side of heart is effected by brochial carcinoid? | Left side of heart. |
Compare the vegetations of infective endocarditis to the vegetations of RF | IE: Bulky and friable vegetation on the aortic, mitral, or tricuspid valves. RF: small semitranslucent along the valve margins |
Bundles of spindle shaped cells are found histologically in what dz | kaposi sarcoma. These do NOT produce collagen |
Pt exposed to PVC or thorotrast are at increased risk for what vasular tumor? | Hemangiosarcoma. Highly metastatic. |
Chronic lymphedema following a radical mastectomy can progress into what kind of tumor? | Lymphangiosarcoma |
How are lymphangiosarcomas differentiated from hemangiosarcomas? | Hemangiosarcomas have RBCs, lymphangiosarcomas do not. |
Where are cardiac myxoma most commonly located? | Left atrium. |
What kind of cardiac tumor never metastasizes, only forms embolism? | Cardiac myxoma |
Cardiac rhabdomyoma vs cardiac myxoma | Myxoma located in left atrium, rhabdomyoma is in left or right ventricle and is made of SPIDER CELLS |