Mulliken J B, Glowacki J
Plast Reconstr Surg. 1982 Mar;69(3):412-22. doi: 10.1097/00006534-198203000-00002.
Forty-nine specimens from a variety of vascular lesions were analyzed for cellular characteristics. Two major categories of lesions emerged from this investigation: hemangiomas and vascular malformations. This classification and its implications are justified by several considerations. Hemangiomas in the proliferating phase (n = 14) were distinguished by (1) endothelial hyperplasia with incorporation of [3H]thymidine, (2) multilaminated basement membrane formation beneath the endothelium, and (3) clinical history of rapid growth during early infancy. Hemangiomas in the involuting phase (n = 12) exhibited (1) histologic fibrosis and fat deposition, (2) low to absent [3H]thymidine labeling of endothelial cells, and (3) rapid growth and subsequent regression. The endothelium in hemangiomas had many characteristics of differentiation: Weibel-Palade bodies, alkaline phosphatase, and factor VIII production. Vascular malformations (n = 23) demonstrated no tritiated thymidine incorporation and normal ultrastructural characteristics. These lesions were usually noted at birth, grew proportionately with the child, and consisted of abnormal, often combined, capillary, arterial, venous, and lymphatic vascular elements. This cell-oriented analysis provides a simple yet comprehensive classification of vascular lesions of infancy and childhood and serves as a guide for diagnosis, management, and further research.
对49份来自各种血管病变的标本进行了细胞特征分析。本次研究出现了两大类病变：血管瘤和血管畸形。这种分类及其意义基于以下几点考虑。增殖期血管瘤（n = 14）的特征为：（1）内皮细胞增生并掺入[3H]胸腺嘧啶核苷；（2）内皮细胞下方形成多层基底膜；（3）婴儿早期有快速生长的临床病史。消退期血管瘤（n = 12）表现为：（1）组织学纤维化和脂肪沉积；（2）内皮细胞的[3H]胸腺嘧啶核苷标记低或无；（3）快速生长并随后消退。血管瘤的内皮细胞具有许多分化特征：有魏-帕小体、碱性磷酸酶和因子VIII生成。血管畸形（n = 23）未显示掺入氚标记胸腺嘧啶核苷，且超微结构特征正常。这些病变通常在出生时就被注意到，与患儿成比例生长，由异常的、常为组合的毛细血管、动脉、静脉和淋巴管血管成分组成。这种以细胞为导向的分析为婴儿期和儿童期的血管病变提供了一种简单而全面的分类，并可作为诊断、治疗和进一步研究的指导。
