Perdiki Marina, Datseri Galateia, Liapis George, Chondros Nikolaos, Anastasiou Ioannis, Tzardi Maria, Delladetsima Johanna K, Drakos Elias
First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Goudi, Mikras Asias 75, 11527, Athens, Greece.
Department of Pathology, Medical School, University of Crete, Voutes, Heraklion, 71110, Greece.
Diagn Pathol. 2017 Jan 24;12(1):14. doi: 10.1186/s13000-017-0597-4.
Anastomosing hemangioma (AH) is a very rare vascular tumor mimicking angiosarcoma, predominately observed in kidney and less frequently in other organs. We present two new renal cases of AH at opposite ends of the clinical presentation spectrum, provide review of the literature and compare the epidemiological, clinical and pathological profiles of renal and non-renal cases.
The first occurred in a 64-year-old woman presented with back pain and the second, a multifocal lesion, in a 47-year-old man with end stage renal disease (ESRD). Histology disclosed a vascular tumor with striking anastomosing pattern, minimal nuclear atypia and locally infiltrative pattern, mimicking superficially angiosarcoma. Extramedullary hematopoiesis, extensive perirenal fat entrapment and increased number of mast cells were additional features in the second lesion. Both patients are well, without disease, 25 and 14 months after diagnosis.
Comprehensive review and analysis of the published literature show that the growing number of non-renal AHs exhibits similar epidemiologic, clinical, biologic and histologic characteristics with renal AHs and most mild differences vanish after exclusion of cases associated with ESRD. Better understanding of AH pathogenesis will contribute to optimal treatment choices.
吻合性血管瘤（AH）是一种非常罕见的血管肿瘤，酷似血管肉瘤，主要见于肾脏，在其他器官中较少见。我们报告了两例临床表现截然不同的肾脏AH新病例，对文献进行了综述，并比较了肾脏和非肾脏病例的流行病学、临床和病理特征。
第一例发生在一名64岁出现背痛的女性身上，第二例为多灶性病变，发生在一名患有终末期肾病（ESRD）的47岁男性身上。组织学检查显示为一种血管肿瘤，具有显著的吻合模式、最小的核异型性和局部浸润模式，表面上酷似血管肉瘤。第二例病变的其他特征包括髓外造血、广泛的肾周脂肪包绕和肥大细胞数量增加。两名患者在诊断后25个月和14个月时情况良好，无疾病复发。
对已发表文献的全面综述和分析表明，越来越多的非肾脏AH与肾脏AH表现出相似的流行病学、临床、生物学和组织学特征，并且在排除与ESRD相关的病例后，大多数细微差异消失。更好地了解AH的发病机制将有助于做出最佳治疗选择。
