7.5 Vascular Tumors

Nov 08, 2026 23:02 · 5:08 · English · Whisper Turbo · 1 Лектори

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S… Speaker 1 (7.5 Vascular Tumors)

Okay, final section of this chapter is vascular tumors.

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This is a relatively short section.

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We should be able to get through it quickly.

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The first entity is a hemangioma.

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Hemangio,

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blood vessel,

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oma, benign mass.

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So this was a benign tumor comprised of blood vessels.

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It's commonly present at birth,

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but the most important point on this slide is that it often regresses during childhood.

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So that if you have a patient with a hemangioma,

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in particular a kid,

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and you were worried about removing it,

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it'll probably just regress by itself.

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And again,

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that's how yield, especially if it's on the face,

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for example.

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You don't want to remove it surgically and create a scar.

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This will usually just regress on its own.

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It most often involves the skin,

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and I've kind of already briefly hinted at that,

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but it's also important to note that you can get hemangiomas of the liver.

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That's another common location for a hemangioma.

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This is what a hemangioma looks like.

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Basically, this is a tumor comprised of blood vessels.

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Now, important to note that when you have this sort of collection of what appears to

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be blood within tissue on the skin,

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one of the things that can come to mind is a bleed into the skin,

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for example, a purpura.

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S… Speaker 1 (7.5 Vascular Tumors)

And the way by which you would make the distinction is by pressing on it.

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If you pressed on this,

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it would blanch because you'd be able to get the blood out because all the blood is in the blood

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vessels.

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However,

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if it was a bleed into the skin and you pressed on it,

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It would not change color because the blood is in the skin and not within the blood vessels

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itself.

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So that's an important distinction,

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and this is a classic picture of a hemangioma.

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Now, the next tumor is angiosarcoma.

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Angio refers to blood vessel,

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and sarcoma would imply that it's a malignant mesenchymal tumor.

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So this is a malignant proliferation of endothelial cells.

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Remember that the endothelial cells are the cells that line the blood vessel.

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Highly aggressive,

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can occur in multiple sites,

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such as the skin,

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the breast,

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and the liver,

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and very important to know that liver angiosarcoma is associated with exposure

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to PVC.

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That's an association that was made decades ago.

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But again, liver angioma is associated with exposure to PVC,

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and we talked about this in the neoplasia lecture,

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so I'll refer you there.

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You can also get liver angiosarcoma with exposure to arsenic and thorotrast,

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so those are two other risk factors for liver angiosarcoma.

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And the last tumor that we want to discuss,

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and probably the highest yield tumor in this section,

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is Kaposi's sarcoma.

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Now, this is a low -grade malignant proliferation of endothelial cells,

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but what's super important is that it's associated with HHV -8.

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That's the virus that drives this tumor.

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And if you go back to our neoplasia lecture,

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you'll recall that when I talked about viruses that cause tumors,

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one of them was HHV -8 causing Kaposi's sarcoma.

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When you have Kerpozy's sarcoma,

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it presents as purple patches or plaques or nodules on the skin.

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And the reason it looks purple is because you've got this proliferation of endothelial cells.

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However, these are endothelial cells.

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They are not complete blood vessels.

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And so if you were to press on this tumor,

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it would not blanch because the blood is not in an actual vascular

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channel.

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The blood is simply just interspersed in between these endothelial

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cells.

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So that's an important thing to note.

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In Kaposi's sarcoma,

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it usually involves the skin,

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but it can also involve visceral organs.

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Here's what Kaposi's sarcoma can look like,

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and again, you've got these purplish nodules,

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and again, were you to press on them,

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they would not blanch,

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and that's because it's really just a tumor of endothelial cells,

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not the complete blood vessel wall,

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and so the blood is present interspersed with the endothelial cells,

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but again,

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is not present within an actual channel,

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so these would not blanch.

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Now,

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there's three patients that get Kaposi's sarcoma.

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Number one,

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Eastern European males.

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So older Eastern European males,

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that's one group of patients that would get it.

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And when these patients get it,

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it usually is localized to the skin and the treatment is surgical removal.

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So that's the patient with,

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that's one patient with Kaposi's sarcoma.

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The second patient in which is classically seen is AIDS.

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And so patients with AIDS can get an HHV8 infection.

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Of course, this tumor is driven by HHV8 in all of these patients.

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but patients with AIDS can get an HHV8 infection of the endothelial cells,

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which would then result in a Kaposi's sarcoma.

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With AIDS,

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it can spread early and it can go to other tissues.

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The way by which you're gonna treat these patients is to give them antiretroviral

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agents.

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That would then allow the immune system to recover,

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and the immune system would then kill the HHV8 -infected cells

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getting rid of the tumor.

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So that's the way by which you would treat an AIDS patient.

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And the third group of people that can get this are transplant patients.

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And when transplant patients get it,

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it involves the skin,

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but it can also spread early.

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And the treatment would be to give decreased immunosuppression.

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If you decrease the immunosuppression,

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you'll then allow the immune system to come back.

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and the immune system would then kill the HHV -8 infected endothelial cells.

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So these are the three classic patients,

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and if I had to summarize Kaposi's sarcoma in just a couple words,

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HHV -8 infection of endothelial cells,

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so a tumor of endothelial cells,

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creating those purple plaques,

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and then classically seen in these three types of patients.

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And that closes off our vascular section,

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and in addition,

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closes off the chapter.

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