Tobouti Priscila L, Olegário Isabel, de Sousa Suzana C O M
School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil.
J Cutan Pathol. 2017 May;44(5):451-455. doi: 10.1111/cup.12911. Epub 2017 Feb 16.
Although not rare, vascular lesions occurring in the lips sometimes poses a difficult in properly diagnosing and handling them. In this study, vascular lesions occurring in the lips were retrieved from an Oral Pathology Service.
Among 5600 biopsies, 131 cases were found. The following diagnoses were attributed: caliber-persistent artery, infantile hemangioma, vascular malformation, venous lake, thrombus, papillary endothelial hyperplasia and pyogenic granuloma. Clinical data were obtained from patients' records.
The lesions' frequency were: pyogenic granuloma (48%), followed by venous lake (17.5%), thrombus (14.5%), papillary endothelial hyperplasia (9.1%), infantile hemangioma (6.1%), caliber-persistent artery (3%) and vascular malformation (1.5%). Glucose transporter protein of the erythrocyte type was positive only in infantile hemangioma. The other markers (CD34 and smooth muscle action) were positive in all lesions, except for podoplanin, which was negative.
It is important to be aware of the occurrence of different vascular lip lesions and their histomorphologies in order to properly handle them. Despite most lesions do not represent any risk to the patient, some of them can reach large dimensions and thus cause aesthetical trouble. Immunohistochemistry may help when the vascular character of the lesion is not promptly determined and to differentiate among some lesions.
唇部血管病变虽不罕见,但有时在正确诊断和处理方面存在困难。在本研究中,从口腔病理科收集唇部血管病变病例。
在5600例活检病例中,发现131例。诊断结果如下:持续性管径动脉、婴儿血管瘤、血管畸形、静脉湖、血栓、乳头状内皮增生和化脓性肉芽肿。临床数据来自患者记录。
病变的发生率依次为:化脓性肉芽肿(48%),其次是静脉湖(17.5%)、血栓(14.5%)、乳头状内皮增生(9.1%)、婴儿血管瘤(6.1%)、持续性管径动脉(3%)和血管畸形(1.5%)。红细胞型葡萄糖转运蛋白仅在婴儿血管瘤中呈阳性。其他标志物(CD34和平滑肌肌动蛋白)在所有病变中均呈阳性,但血小板内皮细胞黏附分子呈阴性。
了解不同唇部血管病变的发生情况及其组织形态学对于正确处理这些病变很重要。尽管大多数病变对患者无任何风险,但其中一些病变可能长得很大,从而造成美观问题。当病变的血管特征不能迅速确定以及鉴别某些病变时,免疫组织化学可能会有所帮助。