Flattened Endothelial Cells Research Articles

Cavernous Hemangioma of the Middle Turbinate: A Case Report

Most cavernous hemangiomas present at birth or soon after. Cavernous hemangiomas of the nasal cavity, which are rare, usually do not present until adulthood; their incidence peaks in the fourth decade of life. Most affected patients experience epistaxis or hemoptysis and an enlarging lesion in the nose. Histologically, cavernous hemangiomas appear as closely packed, dilated vascular channels lined with a layer of flattened endothelial cells. We describe the case of a 32-year-old man who was admitted to our clinic with the complaint of a nasal obstruction. On anterior rhinoscopy, he was found to have a hypervascularized and hypertrophied left middle turbinate and septal deviation. Computed tomography and magnetic resonance imaging of the paranasal sinuses demonstrated a well-defined cystic lesion that had arisen within the bony left middle turbinate and caused deviation of the septum to the right. The lesion was excised via endoscopic surgery with general anesthesia. No complications occurred during the postoperative period. Histologic examination identified the tumor as a cavernous hemangioma. To the best of our knowledge, this is the first case reported in the English-language literature of a cavernous hemangioma appearing as a cystic mass in the middle turbinate.

Intravenous lobular capillary hemangioma originating in the iliac veins: A case report

Intravenous lobular capillary hemangioma is a rare benign lesion that can mimic other intravascular lesions encountered by vascular surgeons, such as angiosarcoma, papillary endothelial hyperplasia, and deep vein thrombus. These lesions have been described originating in the veins of the head, neck, and upper extremities. To our knowledge, there are no reported cases of intravenous capillary hemangioma arising from within a pelvic vein. We report a case of an elderly woman found to have an extensive intravenous lobular capillary hemangioma originating in the internal iliac vein. She was successfully treated with resection, including the tumor and normal iliac vein. Diagnosis of these lesions can be difficult. We describe the utility of duplex ultrasound and magnetic resonance venography in aiding preoperative diagnosis and surgical planning. The diagnosis is ultimately confirmed with histology that demonstrates multiple capillaries lined with flattened endothelial cells grouped in a lobular fashion admixed with fibromyxoid stroma containing collagenous fibers, spindle cells, and mitotic figures. Preoperative work-up should include a duplex ultrasound and magnetic resonance venogram. Treatment should be with resection and specimen processing to rule-out malignant vascular tumors.

Spindle cell hemangioma: report of a case presenting in the oral cavity

Spindle cell hemangioma, formerly termed spindle cell hemangioendothelioma, is an uncommon benign vascular tumor. Presentation in the oral cavity is rare with only two previously reported cases. We report a case of spindle cell hemangioma that presented as an asymptomatic mass of the buccal mucosa in a 44-year-old man. The tumor was a well-circumscribed vascular proliferation of spindled to epithelioid endothelial cells. Tumor cells with intracytoplasmic vascular lumens were present in several areas. Larger, ectatic, thin-walled vessels lined by a single layer of flattened endothelial cells were evident at the periphery and focally in more cellular areas. The tumor was positive for CD31 and CD34. Spindle cell hemangioma rarely presents in the oral cavity and needs to be considered in the differential diagnosis of oral cavity vascular tumors to avoid misdiagnosis as a more aggressive vascular tumor.

Acquired progressive lymphangioma in an HIV‐positive patient

Acquired progressive lymphangioma (APL) is a rare condition characterized by benign proliferation of thin-walled vessels lined by flattened endothelial cells.(1-4) Although benign, the acquired nature of this tumor may lead to misdiagnosis as a malignant vascular tumor. This is especially true if the patient has risk factors, such as immunodeficiency. In this article, the authors present a case of APL in an HIV-positive man.

Acquired Lymphangiectases and Breast Cancer

Acquired lymphangiectases represent superficial lymphatic dilatations caused by a wide range of processes. Many cases reported in the literature develop in patients with upper limb lymphedema secondary to mastectomy, radiotherapy, keloids or scleroderma. Clinically they consist of translucent vesicles in a chronic lymphedematous area. Histologically they are characterized by the presence of dilated spaces with flattened endothelial cells in the papillary dermis. All these cases have a good prognosis and there have not been any reports of malignant transformation. We describe a 67-year-old woman that showed multiple papules along her left upper limb associated with lymphedema. She had undergone a mastectomy followed by radiotherapy fourteen years before due to a breast cancer. Laboratory and radiological exams were within normal limits. The cutaneous lesions showed characteristic clinical and histological features of lymphangiectases and they progressively resolve in several weeks without any treatment.

Thoracic Duct Cyst Presenting as Supraclavicular Mass: Report of a Case

A 25-year-old female complained of a mass on the left supraclavicular fossa for 4 months without any associated symptoms. Computed tomography and magnetic resonance imaging showed a thin-walled monocystic lesion just above the clavicle and dorsal-lateral to the sternocleidomastoid muscle. The aspirated fluid from the cyst showed a milky-white appearance and characteristic composition to coyle such as high concentration of triglyceride. Therefore, the cyst was excised with the preoperative diagnosis of a thoracic duct cyst. Intraoperatively, a branch from the thoracic duct entering the dorsal-medial wall of the cyst was found. The branch was ligated before complete removal of the cyst. Histological findings showed that the cyst wall contained an inner single layer of flat endothelial cells, smooth muscle cells and islets of lymphoreticular tissue.

Solitary Superficial Microcystic Lymphatic Malformation (Lymphangioma Circumscriptum) of the Gingiva

Lymphatic malformations are uncommon, hamartomatous, developmental aberrations of the lymphatic system. The case presented in this report is a rare solitary gingival involvement of a microcystic-type lymphatic malformation. The lesion presented clinically as a small vesicular swelling of a buccal interdental papilla in a 16-year-old girl. Involved tissues were excised and submitted for routine histologic examination. The expression of the endothelial marker CD34 was investigated using immunohistochemical staining. A physical examination failed to reveal similar or other abnormalities elsewhere in the body of the patient, including the oral cavity. Histopathologic analysis of the specimen demonstrated the presence of subepithelial, thin-walled, distended vascular cavities forming confluent vesicles containing lymph. The dilated lymphatic formations were lined by flattened CD34-negative endothelial cells. These features were consistent with a microcystic gingival lymphatic malformation. To the best of our knowledge, only two additional reports of this malformation have been published to date, but both presented with bilateral gingival involvement. Even though lymphatic malformations are encountered very infrequently on gingiva, they should be considered in the differential diagnosis of related conditions with a vesicular clinical appearance.

Amniotic membrane as a carrier for cultivated and labeled corneal endothelial cell transplantation

To investigate the feasibility of using amniotic membrane (AM) as a carrier for cultured corneal endothelial cells transplantation. Rabbit corneal endothelial cells were cultivated, passaged, and labeled with the fluorescent tracker CM-DiI, then transplanted onto denuded AM. The cell density, morphology, histology and ultrastructure of the cultured cells on AM were examined by light microscope, fluorescent microscopy and scanning electron microscope. To determine whether these composite endothelial sheets were functional in vivo, the sheets were transplanted onto rabbit corneas whose deep lamellar with Descemet's membrane and endothelial cells had been completely removed. The deep layer excised rabbit corneas without any transplantation or with transplantation of denuded AM were treated as controls. After transplantation, the corneal appearance and corneal thickness were examined. The grafts were examined for cell density, morphology and histology 4 weeks after the surgery. A monolayer of endothelial cells were confluent on the AM 5 - 7 days after seeding. The density of the endothelial cells was (3202.84 +/- 347.77)/mm(2). Morphologically, the sheets consisted of a fairly continuous layer of flat polygonal endothelial cells that appeared uniform in size with tight junctions. The labeled cells were red in color under fluorescent microscopy. After transplantation, the corneas that received cultured endothelial cells had little edema and retained their thinness and transparency, while the corneas of controls showed prominent edema and opacity, indicating that these cells were transplanted cells rather than the cells migrated from peripheral cornea. Four weeks after surgery, the labeled endothelial cells were still found in the cornea with red fluorescence. AM maintains cultured endothelial cells' morphology and function both in vitro and in vivo. AM could serve as a carrier for corneal endothelial cells transplantation. These results provide a promising method for the treatment of diseases caused by corneal endothelial disorders.

Cutaneous Manifestations and Massive Genital Involvement in Hennekam Syndrome

We describe a 16-year-old boy with intestinal lymphangiectasia, lymphedema of the limbs and genitalia, mild mental retardation, and facial anomalies (Hennekam syndrome) and cutaneous lesions. Severe edema in the genital area created a gigantic mass that included the scrotum and penis. Numerous grouped red-violaceous pseudo-vesicular lesions and plaques, as well as verrucous brown papules, were present on the penis and scrotum. The prepuce was hypertrophic, with severe phimosis. Histologic analysis revealed dilated lymphatic vessels lined by a discontinuous layer of flat endothelial cells in the papillary dermis and extending down to the reticular dermis. Dilated blood vessels were also present but no cellular abnormalities were identified. A diagnosis of superficial cutaneous lymphatic malformations was made. To the best of our knowledge, this is the first detailed cutaneous histologic investigation in a patient with Hennekam syndrome. We assume that the onset of cutaneous lesions in our patient was likely triggered by a generalized worsening of his lymphedema.

Intracardiac Mass in a Man Infected With Human Immunodeficiency Virus

Intracardiac Mass in a Man Infected With Human Immunodeficiency Virus

Characterization of mussel gill cells in vivo and in vitro

Mussel gill cells are attractive models in ecotoxicological studies because gills are the first uptake site for many toxicants in the aquatic environment; gill cells are thus often affected by exposure to pollutants. Our aim was to characterize mussel gill cells in vivo and in vitro by using morphological, histochemical and functional end-points. In paraffin sections stained with haematoxylin-eosin, three zones were distinguished in the long central gill filaments: frontal, intermediate and abfrontal. Various types of ciliated cells were present in the frontal zone, and both ciliated and non-ciliated cells were found in the abfrontal zone. The intermediate zone was comprised of flattened endothelial cells. Lipofuscin granules occurred in the three zones in variable amounts, depending on the specimen. Haemocytes were found in the haemolymph sinus of gill filaments. Mucocytes were identified in both frontal and abfrontal zones by means of periodic acid Schiff-alcian blue (PAS-AB) staining. In cryostat sections, succinate dehydrogenase (SDH) activity was mainly found in ciliated cells, whereas neutral lipids and acid-phosphatase-reactive lysosomes were present in all portions of the gill filament, mostly being related to lipofuscin granules. In mussels exposed to 5'-bromo-2'-deoxyuridine in vivo, proliferating cells were scattered throughout the gill filament. Gill cells (typically 2x10(7) cells/ml per mussel; 95% viability) were isolated by dissociation with dispase. Gill cell suspensions were heterogeneous: 58% were ciliated epithelial cells (positive for SDH), 42% were non-ciliated cells (including epithelial cells and haemocytes), 2.3% were mucocytes (positive for PAS-AB) and 4.25% were haemocytes (able to phagocytose neutral red-stained zymosan). Gill cell cultures were maintained up to 18 days without changing the culture medium, viability decreasing below 50% at day 18. Primary cultures of mussel gill cells might therefore be useful models for the in vitro assessment of xenobiotic impacts on coastal and estuarine ecosystems.

Endothelial Cells in the Early Murine Yolk Sac Give Rise to CD41-expressing Hematopoietic Cells

Hematopoietic and endothelial cells may be derived from a common precursor cell (hemangioblast) during embryogenesis; however, some evidence suggests that hematopoietic cells may emerge from endothelial cells. The onset of definitive hematopoiesis at E8.25 in the murine embryo is marked by high-level CD41 expression. We questioned whether these hematopoietic cells were derived directly from mesoderm cells or emerged from endothelium. At 8.25 days post coitus (dpc), CD41 was coexpressed with CD31, CD34, and Flk1 in some intraluminal round cells that appeared to arise from flattened endothelial cells lining yolk sac capillary vessels. Cell-sorting studies revealed that all subpopulations of cells expressing CD41 possessed hematopoietic activity. Surprisingly, Tie2(+)Flk1(+) cells, a phenotype enriched in adult endothelial progenitors, also displayed some hematopoietic progenitor activity in vitro, but this activity was restricted to the CD41(+) fraction; only endothelial cells were derived from freshly isolated Tie2 (+)Flk1(bright) CD41() cells. Tie2(+)Flk1(dim)CD41() 8.25-dpc yolk sac cells devoid of hematopoietic progenitor activity gave rise to endothelial-like capillary networks in vitro and differentiated upon co-culture with OP9 stromal cells into definitive hematopoietic progenitors. These results demonstrate that CD41-expressing definitive hematopoietic cells appear to arise from endothelial cells lining nascent capillaries in vivo.

Primary Intranodal Cellular Angiolipoma

Angiolipoma is a distinct, benign soft tissue tumor that most commonly occurs in young males as multiple small, subcutaneous, tender to painful nodules with predilection for the forearms. We report a case of angiolipoma that developed within a lymph node. The patient was a 67-year-old man who underwent radical retropubic prostatectomy with diagnostic pelvic lymphadenectomy because of adenocarcinoma of the prostate. The prostate and 3 lymph nodes located in the obturator fossa were removed. On gross examination, the cut surface of 1 of the lymph nodes revealed an 8 x 5 mm, ovoid, sharply demarcated, nonencapsulated, gray lesion being suspicious for adenocarcinoma metastasis. Microscopically, the major portion of the lymph node was replaced by mature metaplastic adipose tissue. The angiolipoma was seen as a well-demarcated, nonencapsulated lesion composed of numerous small blood vessels lined by monomorphous flattened or spindled endothelial cells. Many vascular lumina were filled with fibrin thrombi. There were scanty mature adipocytes. Focally, areas with increased cellularity and a suggestion of solid growth of the endothelial cells were seen. Lymph nodes are known to be a rare primary site of various tumors usually occurring in other organs. The knowledge of these tumors is important in order not to interpret them as metastatic lesions. The most recognized examples are pigmented nevi, palisading myofibroblastoma, various benign epithelial inclusions, serous cystic tumors of borderline malignancy, and hyperplastic mesothelial inclusions. As we present in this report, angiolipoma is another neoplasm whose primary occurrence in the lymph node should not be misinterpreted as a metastatic tumor or malignant vascular tumor.

Lymphatic malformation of the sphenoid sinus in a pediatric patient

Lymphatic malformation is a benign vascular lesion resulting from lymphatic tissue being isolated from the remainder of the lymphatic system. They are present at birth and up to 90% are diagnosed by 2 years of age. More aggressive lesions are usually diagnosed earlier, with low-grade lesions presenting later with fewer complications. These lesions are hamartomas and not true neoplasms. The term hamartoma is used to describe an abnormally large mass of histologically normal tissue in a normal location. The lymphatic malformation is composed of lymph-filled channels lined with a single layer of flat endothelial cells on a basement membrane. They present with either generalized edema and poorly defined borders (microcystic) or a localized area of multilocular cysts (macrocystic). The term lymphatic malformation has replaced many other outdated terms, such as lymphangioma, cystic hygroma, lymphangioma circumscriptum, and lymphangiomatosis. In this study, we present a case report of a pediatric lymphatic malformation of the sphenoid sinus. To our knowledge, this lesion has not been described in the pediatric population and has been described only once in an adult in the German literature. 1 EBM rating: C.

Ovarian hemangioma presenting with hyperandrogenism and endometrial cancer: a case report

Background. Hemangiomas are very rare tumors of the ovary. Here, we report a case of a mixed capillary and cavernous ovarian hemangioma and endometrial carcinoma presenting with postmenopausal bleeding, male pattern receding frontal hairline, and high serum androgen and estradiol levels. Case. A 70-year-old White female underwent laparotomy for endometrial carcinoma. Intraoperative frozen-section examination of the uterus revealed a 3.5 × 3 cm, grade 1 endometrioid adenocarcinoma of the endometrium with more than 50% myometrial invasion. The left ovary contained a 1.5 × 1 × 1 cm, well-circumscribed hemorrhagic nodule on the cut surface. Final histopathological examination of the small nodule demonstrated multiple, enlarged, blood-filled vascular channels lined by a single layer of flattened regular endothelial cells with no atypical features. Vascular spaces within the tumor were of different sizes, ranging from small to large, and were separated by connective tissue. The surrounding ovarian stroma was hyperplastic and contained clusters of luteinized stromal cells. Microscopy of the right ovary showed minimal stromal proliferation and no luteinization of the ovarian stroma. Conclusion. This is the first case of an ovarian hemangioma synchronous with a well-differentiated endometrial carcinoma. Absence of estrogen and progesterone receptors in the endothelial cells of the hemangioma suggests that ovarian hemangiomas may occur independent of stimulation by estrogen and progesterone.

Amniotic membrane as a carrier for cultivated human corneal endothelial cell transplantation.

It would be advantageous if cultivated human corneal endothelial cells (cHCECs) could be transplanted for the treatment of diseases caused by corneal endothelial disorders. To achieve this, a matrix that can serve as a carrier for cHCECs is needed. The present study was conducted to examine the feasibility of using amniotic membrane (AM) as a carrier for this application. HCECs obtained from peripheral corneal tissue were cultivated, passaged, and transplanted onto denuded AM. The cell density and morphology of the resultant cHCECs on AM were examined by light, scanning electron, and transmission electron microscopy. To determine whether these cHCEC sheets on AM carrier were functional in vivo, the cHCEC sheets on AM were transplanted onto rabbit corneas whose Descemet's membrane and endothelial cells had been completely removed. After transplantation, the corneal appearance was examined by slit lamp biomicroscopy, and corneal thickness was measured daily by pachymetry. At 7 days after surgery, the grafts were examined by light, scanning electron, and transmission electron microscopy. The density of the cHCECs on AM was greater than 3000 cells/mm(2). Morphologically, the cHCEC sheets consisted of a fairly continuous layer of flat squamous polygonal endothelial cells that appeared uniform in size with tightly opposed cell junctions in vitro and in vivo after transplantation. The corneas that received transplanted cHCEC sheets had little edema and retained their thinness and transparency. The cell density and morphology of cHCECs on AM were similar to those of normal corneas, and cHCECs on AM were functional in vivo. These results indicate that AM maintains HCEC morphology and function and could serve as a carrier for cHCEC transplantation.

Investigation of Laser-Induced Choroidal Neovascularization in the Rat

Choroidal neovascularization plays an important role in pathogenesis of age-related macular degeneration. Induction of neovascularization by laser photocoagulation in the rat fundus is an established animal model in which the effects of new therapeutic approaches are assessed. The purpose of this study was to compare different detection methods of laser-induced neovascularization in the rat. Laser spots were applied to the fundus of Long-Evans rats. Ten days after, four different methods were used to detect laser-induced neovascularization: (1) high-resolution angiography with fluorescein isothiocyanate-dextran, (2) immunohistochemical visualization of platelet endothelial cell adhesion molecule (PECAM)-1, (3) visualization of intravascular lumens by peroxidase perfusion in the living rat with subsequent histologic analysis, and (4) histochemical representation of alkaline phosphatase in endothelial cells. At the rim of the laser scars vessel-forming endothelial cells with intravasal dextran and peroxidase were present. Cross-sections demonstrated that these vessels originated from the retina. The center of the scars contained homogenous endothelial cells of choroidal origin, which was confirmed by immunohistochemistry and electron microscopy. In laser-treated eyes without FITC-dextran perfusion, scars showed unspecific fluorescence, making differentiation from specific FITC-dextran-associated fluorescence difficult. In the rat model of laser-induced neovascularization, newly developed endothelial cells originate from the retina and the choroid. Whereas ring-like surrounding vessels come from the retina, flat endothelial cells in deeper layers are of choroidal origin or may originate from circulating endothelial precursor cells. Dextran angiography has to be regarded critically for visualizing the choriocapillaris and CNV in laser scars. PECAM-1 immunohistochemistry is best for detection and quantification of neovascularization in laser scars.

Thrombosed Urethral Hemangioma

Genitourinary hemangiomas are a rare entity that can affect any portion of the urinary system. The urethra is rarely involved, and most reported cases occur in the male urethra.1 We report a thrombosed urethral hemangioma occurring in a female patient. CASE REPORT An 81-year-old woman presented with a 1-week history of a painful urethral mass and difficulty voiding. The mass was reportedly reducible elsewhere 1 week previously. The patient had had no prior episodes and no other pertinent urological or medical history. On examinatio na4c merythematous, ischemic appearing mass was arising from the urethra. The mass was extremely tender and not reducible. The patient was afebrile with normal white blood cell count and serum creatinine. Excision of a presumed strangulated urethral prolapse was elected. Before excision cystoscopy was performed, showing the mass to be localized to the external meatus and nonobstructive in nature. The proximal urethra appeared somewhat ischemic with a normal bladder neck and bladder mucosa. A Foley catheter was placed without difficulty (fig. 1). The mass was then excised in its entirety and the urethral mucosa was everted circumferentially with interrupted polyglactin sutures. Final pathological examination revealed a thrombosed cavernous hemangioma. Large dilated blood vessels lined by flattened endothelial cells were identified (fig. 2). Fibrin within the vessels suggested thrombosis and ongoing organization. The Foley catheter was removed at 2 weeks and the patient was subsequently continent.

Hemangioma Associated with Urethral Stricture

No AccessJournal of UrologyCLINICAL UROLOGY: Case Reports1 Oct 2003Hemangioma Associated with Urethral Stricture LARA HAMMOND, ONSI W. KAMEL, and LOREN OST LARA HAMMONDLARA HAMMOND More articles by this author , ONSI W. KAMELONSI W. KAMEL More articles by this author , and LOREN OSTLOREN OST More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000086925.11485.8bAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Hemangioma Associated with Urethral Stricture." The Journal of Urology, 170(4 Part 1), p. 1309 References 1 Jezior, J., and Jordan, G.H.: Management of the bulbous urethral stricture. AUA Update Series, volume XXII, lesson 1, 2002 Google Scholar 2 : Urethral hemangioma. J Urol1987; 137: 116. Link, Google Scholar 3 : Surgery of the penis and urethra. In: Campbell's Urology. Edited by . Philadelphia: W. B. Saunders Co.2002: 3915. Google Scholar From the Southern Illinois University School of Medicine, Springfield, Illinois© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 170Issue 4 Part 1October 2003Page: 1309 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsurethral stricture etiologyhemangiomaurethral neoplasmsMetricsAuthor Information LARA HAMMOND More articles by this author ONSI W. KAMEL More articles by this author LOREN OST More articles by this author Expand All Advertisement PDF downloadLoading ...

Solitary fibrous tumor of the oral mucosa—morphological and immunohistochemical profile in the differential diagnosis with hemangiopericytoma

The objective was to investigate two cases of solitary fibrous tumor (SFT) of oral mucosa, emphasizing the differential diagnosis with one case of oral hemangiopericytoma (HPC), in terms of their morphological and immunohistochemical features. Solitary fibrous tumors showed cellularity and collagenization varying from area to area, focal perivascular hyalinization, scattered giant nuclei cells and abundant mast cells throughout the tumor. The hemangiopericytoma case exhibited thin-walled and dilated vessels lined with flat endothelial cells, identified by “staghorn appearance”. Tumoral cells of solitary fibrous tumor exhibited immunohistochemical positivity for CD34, as well as endothelial cells. The hemangiopericytoma was positive only in endothelial cells. In solitary fibrous tumor, α-smooth muscle actin, h-caldesmon and laminin stained the wall vessels. In hemangiopericytoma, on the other hand, the wall vessels were positive only for laminin, which staining was also observed in perivascular tumoral cells. The morphological and immunohistochemical differences observed allowed us to infer these lesions constitute distinct entities.