Ortopedia Generale, Orthopaedic Service, Istituto Ortopedico Rizzoli, Rizzoli-Sicilia, Bagheria, Italy.
Skeletal Radiol. 2012 Dec;41(12):1495-507. doi: 10.1007/s00256-012-1510-6. Epub 2012 Sep 21.
The classification of vascular bone tumors remains challenging, with considerable morphological overlap spanning across benign to malignant categories. The vast majority of both benign and malignant vascular tumors are readily diagnosed based on their characteristic histological features, such as the formation of vascular spaces and the expression of endothelial markers. However, some vascular tumors have atypical histological features, such as a solid growth pattern, epithelioid change, or spindle cell morphology, which complicates their diagnosis. Pathologically, these tumors are remarkably similar, which makes differentiating them from each other very difficult. For this rare subset of vascular bone tumors, there remains considerable controversy with regard to the terminology and the classification that should be used. Moreover, one of the most confusing issues related to vascular bone tumors is the myriad of names that are used to describe them. Because the clinical behavior and, consequently, treatment and prognosis of vascular bone tumors can vary significantly, it is important to effectively and accurately distinguish them from each other. Upon review of the nomenclature and the characteristic clinicopathological, radiographic and genetic features of vascular bone tumors, we propose a classification scheme that includes hemangioma, hemangioendothelioma, angiosarcoma, and their epithelioid variants.
血管源性骨肿瘤的分类仍然具有挑战性，良性到恶性之间存在着相当大的形态重叠。绝大多数良性和恶性的血管肿瘤都可以根据其特征性的组织学特征进行诊断，例如血管腔的形成和内皮标记物的表达。然而，一些血管肿瘤具有非典型的组织学特征，例如实性生长模式、上皮样改变或梭形细胞形态，这使得它们的诊断变得复杂。从病理上看，这些肿瘤非常相似，这使得彼此之间的区分变得非常困难。对于这一小部分罕见的血管源性骨肿瘤，在术语和应使用的分类方面仍然存在很大的争议。此外，与血管源性骨肿瘤相关的最令人困惑的问题之一是用于描述它们的众多名称。由于血管源性骨肿瘤的临床行为，以及因此治疗和预后可能有很大差异，因此有效地和准确地区分它们非常重要。在回顾了血管源性骨肿瘤的命名法以及特征性的临床病理、影像学和遗传学特征后，我们提出了一个分类方案，包括血管瘤、血管内皮细胞瘤、血管肉瘤及其上皮样变体。
