Aravind Amrutha, Ahuja Sana, Malik Shaivy, Zaheer Sufian
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Int J Surg Case Rep. 2025 Jan;126:110659. doi: 10.1016/j.ijscr.2024.110659. Epub 2024 Nov 23.
Hemangiomas are benign vascular neoplasms primarily affecting the skin and soft tissues but can also occur in visceral organs, with the liver being the most common site. Renal hemangiomas are exceedingly rare, with fewer than 300 cases reported. Various subtypes, including cavernous, capillary, and anastomosing hemangiomas, have been identified. Anastomosing hemangioma (AH), a histological subtype of capillary hemangioma, was first described in 2009. AH has a distinctive histological architecture of anastomosing sinusoidal-like vascular spaces and often mimics angiosarcoma.
A 28-year-old male presented with an incidentally detected left renal mass found during an evaluation for abdominal pain and dyspepsia. The patient was asymptomatic with no history of hematuria or dysuria. Physical examination was unremarkable. Contrast computed tomography revealed a heterogeneously enhancing solid mass in the left kidney, suggesting a neoplastic etiology. Laparoscopic enucleation of the tumor was performed, and histopathological examination revealed a well-circumscribed tumor composed of irregular capillary-sized vascular spaces lined by plump endothelial cells with mild atypia. Immunohistochemical analysis showed positivity for CD34, CD31, and Factor VIII, confirming the diagnosis of anastomosing hemangioma. The patient has been under follow-up with no evidence of recurrence.
Anastomosing hemangioma of the kidney, although rare, is an important benign entity that can mimic malignant vascular tumors like angiosarcoma. Accurate diagnosis relies on histopathological examination and immunohistochemistry.
Despite its benign nature, AH often leads to overtreatment due to its diagnostic challenges. Increased awareness and reporting of AH cases are essential to improve diagnostic accuracy and management strategies.
血管瘤是一种良性血管肿瘤，主要影响皮肤和软组织，但也可发生于内脏器官，其中肝脏是最常见的部位。肾血管瘤极为罕见，报道的病例不足300例。已确定了多种亚型，包括海绵状、毛细血管状和吻合性血管瘤。吻合性血管瘤（AH）是毛细血管瘤的一种组织学亚型，于2009年首次被描述。AH具有独特的吻合性窦状样血管腔隙的组织学结构，常酷似血管肉瘤。
一名28岁男性在因腹痛和消化不良进行评估时偶然发现左肾肿块。患者无症状，无血尿或排尿困难病史。体格检查无异常。增强计算机断层扫描显示左肾有一个不均匀强化的实性肿块，提示肿瘤性病因。进行了腹腔镜肿瘤剜除术，组织病理学检查显示肿瘤边界清晰，由不规则的毛细血管大小的血管腔隙组成，内衬丰满的内皮细胞，有轻度异型性。免疫组织化学分析显示CD34、CD31和因子VIII呈阳性，确诊为吻合性血管瘤。患者一直在接受随访，无复发迹象。
肾吻合性血管瘤虽然罕见，但却是一种重要的良性病变，可酷似血管肉瘤等恶性血管肿瘤。准确诊断依赖于组织病理学检查和免疫组织化学。
尽管AH本质上是良性的，但由于其诊断困难，常导致过度治疗。提高对AH病例的认识和报告对于提高诊断准确性和管理策略至关重要。
