Marr Jacqueline, Miranda Ileana C, Miller Andrew D, Summers Brian A
5922Cornell University, Ithaca, NY, USA.
Vet Pathol. 2021 Sep;58(5):864-880. doi: 10.1177/0300985820980707. Epub 2020 Dec 11.
In disease, blood vessel proliferation has many salient roles including in inflammation, when granulation tissue fills superficial defects, or in the recanalization of an occluded blood vessel. Sometimes angiogenesis goes awry-granulation can be exuberant, and plexiform proliferation of vascular components can contribute to pulmonary hypertension. This review focuses on the diverse manifestations of pathologic vascular overgrowth that occur in the brain, spinal cord, and meninges of animals from birth until old age. Entities discussed include systemic reactive angioendotheliomatosis in which glomeruloid vascular proliferations are encountered in various organs including the central nervous system (CNS). The triad of CNS vascular malformations, hamartomas, and benign vascular proliferations are an especially fraught category in which terminology overlap and the microscopic similarity of various disorders makes diagnostic classification incredibly challenging. Pathologists commonly take refuge in "CNS vascular hamartoma" despite the lack of any unique histopathologic features and we recommend that this diagnostic category be abandoned. Malformative lesions that are often confusing and have similar features; the conditions include arteriovenous malformation, cavernous angioma, venous angioma, and capillary telangiectases. Meningioangiomatosis, a benign meningovascular proliferation with dual components, is a unique entity seen most commonly in young dogs. Last, accepted neoplastic conditions range from lower-grade locally acquired growths like hemangioblastoma (a tumor of mysterious interstitial stromal cells encountered in the setting of abundant capillary vasculature proliferation), the rare hemangioendothelioma, and the highly malignant and invariably multifocal metastatic hemangiosarcoma. Additionally, this review draws on the comparative medical literature for further insights into this problematic topic in pathology.
在疾病中,血管增殖具有许多显著作用,包括在炎症反应中(如肉芽组织填充浅表缺损时),或在闭塞血管的再通中。有时血管生成会出现异常——肉芽组织可能过度增生,血管成分的丛状增殖可导致肺动脉高压。本综述重点关注从出生到老年动物脑、脊髓和脑膜中病理性血管过度生长的多种表现。所讨论的疾病包括系统性反应性血管内皮瘤病,其中在包括中枢神经系统(CNS)在内的各个器官中可出现肾小球样血管增殖。CNS血管畸形、错构瘤和良性血管增殖这一组疾病尤其复杂,其中术语重叠,各种疾病的微观相似性使得诊断分类极具挑战性。尽管缺乏任何独特的组织病理学特征,病理学家通常会采用“CNS血管错构瘤”这一诊断,我们建议放弃这一诊断类别。常常令人困惑且具有相似特征的畸形病变包括动静脉畸形、海绵状血管瘤、静脉血管瘤和毛细血管扩张症。脑膜血管外皮细胞瘤是一种具有双重成分的良性脑膜血管增殖,是最常见于幼犬的独特疾病。最后,公认的肿瘤性疾病范围从低级别局部生长的如成血管细胞瘤(在丰富的毛细血管血管增殖情况下遇到的一种具有神秘间质基质细胞的肿瘤)、罕见的血管内皮瘤,到高度恶性且总是多灶性转移的血管肉瘤。此外,本综述借鉴了比较医学文献,以进一步深入了解病理学中这个有问题的主题。