Department of Pathology, Northwestern University, Chicago, IL, US.
Department of Pathology, Johns Hopkins Medicine, Baltimore, MD, US.
Am J Clin Pathol. 2023 Oct 3;160(4):411-416. doi: 10.1093/ajcp/aqad064.
Lobular capillary hemangioma (LCH) rarely involves the gastrointestinal (GI) tract. This study describes clinicopathologic features of LCH in a cohort of GI cases.
We defined lobular capillary hemangioma as "a proliferation of capillary-sized blood vessels arranged at least focally in a lobular configuration," searched departmental archives for cases, and recorded clinicopathologic findings.
We identified 34 GI tract LCHs from 16 men and 10 women; 4 patients had multiple lesions. Mean age was 64 years. Cases arose in the esophagus (n = 7), stomach (n = 3), small bowel (n = 7), and colorectum (n = 17). Twelve patients had anemia or rectal bleeding. No patients had a known genetic syndrome. The lesions manifested as mucosal polyps, with median size of 1.3 cm. Microscopically, 20 lesions were ulcerated, and most involved the mucosa, with 9 extending into the submucosa. Vessel dilation was present in 27 patients, endothelial hobnailing in 13, hemorrhage in 13, and focal reactive stromal atypia in 2. Follow-up information was available for 10 patients, none of whom developed same-site recurrence. Six of the 26 cases (23%) were extradepartmental consultations, including 2 of the multifocal cases.
Gastrointestinal tract LCHs often arise as colorectal polyps. They are typically small but can reach a few centimeters in size and can be multifocal.
小叶状毛细血管血管瘤（LCH）很少累及胃肠道（GI）。本研究描述了一组 GI 病例中 LCH 的临床病理特征。
我们将小叶状毛细血管血管瘤定义为“至少局灶性呈小叶状排列的毛细血管大小的血管增生”，在科室档案中搜索病例，并记录临床病理发现。
我们从 16 名男性和 10 名女性中确定了 34 例胃肠道 LCH；4 例患者有多发性病变。平均年龄为 64 岁。病例发生于食管（n=7）、胃（n=3）、小肠（n=7）和结直肠（n=17）。12 例患者有贫血或直肠出血。无患者有已知的遗传综合征。病变表现为黏膜息肉，平均大小为 1.3cm。显微镜下，20 个病变为溃疡型，大多数累及黏膜，9 个病变延伸至黏膜下层。27 例患者有血管扩张，13 例患者有内皮钉突，13 例患者有出血，2 例患者有局灶性反应性间质异型性。10 例患者有随访信息，均无原位复发。26 例中有 6 例（23%）为院外会诊，包括 2 例多灶性病例。
胃肠道 LCH 常作为结直肠息肉出现。它们通常较小，但可达数厘米大小，并且可以是多灶性的。
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