Printer Friendly

Hemangioma of the parotid. (Pathology Clinic).

Hemangiomas are benign tumors of endothelial cell origin (benign hemangioendotheliomas). They are the most common salivary gland tumor in children younger than 1 year of age, accounting for 90% of cases. Hemangiomas in adults are uncommon. The characteristic features of hemangiomas are the rapid enlargement of a unilateral (usually on the left), compressible, bluish mass shortly after birth, particularly in girls. Hemangiomas are not associated with any syndrome.

Macroscopically, these tumors are lobular, dark, and as large as 8 cm in maximum dimension. Histologically, they are characterized by an unencapsulated intralobular growth with replacement of salivary gland acini by capillary-sized vessels (vessels without muscle walls). These vessels are marked by compressed vascular lumina and increased cellularity (figure 1). The cellularity can be so great that it obscures the vascular lumina altogether. The capillaries are lined with two or more layers of spindle-shaped endothelial cells that feature ample eosinophilic cytoplasm (figure 2). Their nuclei contain clear nuclear chromatin (vesicular nuclei; open chromatin). Mitotic figures are frequent, but atypical forms are not seen. Vascular arborization and anastomoses are not observed. Although peri- and intraneural invasion can be seen, it is not an indicator of tumor behavior. A reticulin stain outlines the vessels in which the endothelial cells proliferate. The vascular origin of the neoplasm is confirmed by positive factor VIII-related antigen, CD34, or CD31 immunohistochemical reactions. Whereas lymphangioma is included in the differential diagnosis, separation from malignant hemangioendothelioma or angiosarcoma is more important. Anastomosing vascular channels lined with remarkably atypical endothelial cells herald angiosarcoma, which is rare in infants.

Although complete surgical excision has been advocated, a conservative wait-and-see approach provides an opportunity for spontaneous regression and an overall decrease in size. Malignant transformation does not occur. If surgery is needed later in childhood, there will be a lower likelihood of possible facial nerve damage.

Suggested reading

Lack EE, Upton MP. Histopathologic review of salivary gland tumors in childhood. Arch Otolaryngol Head Neck Surg 1988;114:898-906.

From the Department of Endocrine and Otorhinolaryngic-Head and Neck Pathology, Armed Forces Institute of Pathology, Washington, D.C.
COPYRIGHT 2002 Medquest Communications, LLC
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2002, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
Printer friendly Cite/link Email Feedback
Author:Thompson, Lester D.R.
Publication:Ear, Nose and Throat Journal
Date:Nov 1, 2002
Previous Article:Integrated imaging. (Practice Management Clinic).
Next Article:Orbital infection as a complication of sinusitis: are diagnostic and treatment trends changing?

Related Articles
Vocal fold hemangioma.
Pneumoparotid: A case report and review of its pathogenesis, diagnosis, and management.
Adult laryngeal hemangioma: Report of four cases.
Granular cell tumor of the parotid: A case report and literature review.
Multiple primary pleomorphic adenomas in a single parotid gland: report of a new case. (Original Article).
Hemangioma of the sphenoid and ethmoid sinuses: Two case reports. (Original Article).
Multiple intraparenchymal parotid calculi: a case report and review of the literature.
Pleomorphic adenoma of the accessory parotid gland.
Oncocytoma of the parotid gland.

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters