Multiple Vascular Channels Research Articles

Manufacturing multifunctional vascularized composites by through-thickness frontal polymerization and depolymerization: A numerical study on the impact of sacrificial fiber configurations

Concurrent through-thickness frontal polymerization and vascularization (FP-VaSC) is emerging as a promising alternative to conventional multi-step fabrication approaches for vascularized thermoset polymers and composites. This method relies on a localized and self-propagating exothermic polymerization reaction front of the polymer matrix, to simultaneously cure the matrix, and depolymerize pre-embedded sacrificial templates. It delivers fully cured thermoset polymers and composites rapidly and energy-efficiently with the desired vascular system in a single step. While previous studies demonstrated the capability of this method for making woven laminates with a single vascular channel created by embedding a single straight sacrificial fiber, it is desirable to explore the potential of this method for making composites with multiple channels for more practical applications. We employ a previously validated thermo-chemical model from our prior study, to systematically investigate the reaction process with the presence of multiple sacrificial fibers. Two sacrificial fiber configurations are considered, namely, inline and staggered fiber configurations. Within each configuration, we consider a range of horizontal and vertical fiber spacing, which also lead to different sacrificial fiber volume fractions. This study reveals the interactions between the sacrificial fiber and the reactions, identifies the working window of this method for different sacrificial fiber configurations, and provides guidance for manufacturing laminates with multiple vascular channels. We also propose an analytical model that can quickly approximate the maximum sacrificial fiber volume fraction that can lead to successful FP-VaSC for a given carbon fiber volume fraction and compare the results with those from the thermo-chemical modeling.

Intramuscular hemangioma presenting as pathological femur fracture: A case report

Hemangioma is a common benign soft-tissue tumor; however, intramuscular hemangioma presenting with a pathological fracture is an infrequent occurrence. Imaging plays a key role in diagnosing this entity. We report a case of a 30-year-old male who presented with a pathological fracture of the left femur following trivial trauma. Clinical examination was remarkable for a significant soft-tissue swelling which on further radiological investigation revealed a soft-tissue mass lesion in the left thigh muscles having multiple vascular channels and phleboliths extending into femoral cortex and medulla causing a pathological fracture. Diagnosing it as an aggressive hemangioma, the main feeder artery was embolized by polyvinyl alcohol particles. The patient is on traction and follow-up. Intramuscular hemangioma causing pathological fracture is extremely rare. Understanding the typical and atypical radiological findings of an intramuscular hemangioma will impede misdiagnosis, and unnecessary tissue sampling, and allow for expedited and appropriate management.

Uterine Arteriovenous Malformation Acquired after Cesarean Section: A Case Report

Background: Uterine arteriovenous malformation (AVM) is a rare, potentially life-threatening cause of abnormal uterine bleeding that can be acquired following a cesarean section. The diagnosis is difficult, often misdiagnosed with retained products of conception and placenta accreta. Transarterial embolization (TAE) is an efficacious and effective method of treating AVM, particularly in patients of reproductive age. Case Report: A 41-year-old, nulliparous woman, started with a history of abnormal uterine bleeding 30 days after a cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin (beta-hCG) was negative. The transvaginal color Doppler ultrasound showed multiple vascular channels within myometrium showing colored mosaic patterns suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred to perform a Computed Tomography Angiography and right uterine artery embolization without any vascular complications. Conclusion: AVM is a rare consequence of cesarean section but has to be considered in cases of persistent uterine bleeding in the puerperium. Embolization is a safe and effective choice treatment of AVM and an alternative and less invasive option for patients wishing to preserve fertility.

Recurrent Angiosarcoma on the Back in a Young Male: A Case Report

AbstractAngiosarcoma is a malignant disease of the inner lining of the blood vessel which can occur at any age and anywhere in the body like skin, liver, breast, bone, soft tissues cardiac tissues and after radiotherapy or from chronic lymphatic obstruction.It usually occurs between 60-70 years of age1. In this case, it occurred in a young male, which was previously excised but recurrence occurred and presented as a lump of 20×15 cm, which was non-tender, gradually increasing in size, firm in consistency however other systemic findings were unremarkable. Haematological workup was done which was within normal limits. Ultrasound Doppler of swelling showed multiple vascular channels with fat and soft tissue suggestive of a haemangioma. Excision and biopsy were done under general anaesthesiaand histopathology report showed fibro-fatty tissue with vascular malformation. In view of recurrence, it suggested angiosarcoma, which is treated by surgery followed by chemotherapy and its definitive diagnosis can only be made by biopsy.

Angiodysplasia of left colon extending to anal verge landed patient into APR: a rare finding

Angiodysplasias is a kind of vascular malformation preferably involves the veins. Angiodysplasia of colon is the second most common cause of lower gastrointestinal bleeding after diverticulosis. It usually involves caecum and ascending colon. Patient may either present with complaints of fresh bleeding per rectum or with melena. It usually occurs in elderly because of age related degeneration of small blood vessel walls. The case presented here involves a male patient of 25-year age with complains of intermittent bleeding per rectum and generalized weakness from one month. After examination it was found to have vascular ectasia involving mid transverse colon, left colon and the rectum coming down to anal verge which culminated into abdominoperineal resection. Biopsy of resected segment came to be angiodysplasia with external surface of specimen showing dilation of multiple vascular channels in entire length up to anal verge. This case report shows that though angiodysplasia is more common in old age but while exploring a young patient with lower gastrointestinal tract bleeding, and congestive changes are found in left colon possibility of angiodysplasia should also be kept in mind.

AN UNCOMMON CAUSE OF A MEDIASTINAL MASS

SESSION TITLE: Disorders of the Mediastinum SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/09/2018 01:15 pm - 02:15 pm INTRODUCTION: Thymic neuroendocrine tumors rarely occur as a mediastinal mass, with a reported incidence of 0.01-0.02/100,000. We present a case of thymic neuroendocrine tumor that had gone undiagnosed for 15 years. CASE PRESENTATION: 63 year-old female, lifelong nonsmoker, with past medical history of a mediastinal mass discovered incidentally 15 years ago, mesenteric plasmacytoma s/p colectomy in 2007, and anemia was admitted for new onset HFrEF. She complained of worsening dyspnea for the past few months, lower extremity edema, orthopnea, and gradual weight loss over the past few years. She denied chest pain, fever, chills, dizziness and syncope. She had undergone 2 biopsies of the mass in the past, but results were inconclusive. On physical exam, she was cachectic in appearance. Breath sounds were decreased on the left side. There was 4+ pitting edema of the lower extremities. Labs were remarkable for albumin of 2.6 and BNP of 2709. CXR demonstrated an opacification silhouetting the left mediastinum and heart border. CT of the chest showed a 16x13x10cm upper mediastinal centrally necrotic mass with mass effect on the heart and trachea. PFT was attempted, but the patient could only perform spirometry, which revealed severe restriction. She underwent CT-guided biopsy, which revealed thymic neuroendocrine tumor, typical carcinoid, positive for synaptophysin and chromogranin. Surgical resection of the mass was not possible as the mass was highly vascularized. CT angiogram of the chest demonstrated multiple vascular channels from the mass. Embolization of the right internal mammary artery supplying the mass was done, but the left-sided supply to the mass could not be embolized as the patient felt unwell. She was stable and was discharged with planned follow-up with IR to complete embolization and subsequent possible surgical debulking. DISCUSSION: Thymic neuroendocrine tumors are uncommon, accounting for approximately 5% of all thymic and mediastinal tumors, and are often discovered incidentally. Symptoms can range from asymptomatic to cough, dyspnea, chest pain, and possible endocrinopathies. CXR and CT are part of the initial workup, and diagnosis is confirmed by histological examination and immunohistochemical staining of biopsied tissue. More than half are positive for synaptophysin and chromogranin. Radical resection is the preferred treatment, but if not possible, no standard treatment has been defined as these cases are rare. Response to chemotherapy and radiation is poor. The patient in our case was not a candidate for surgery. CT angiogram identified vessels supplying the mass, and embolization was attempted successfully for one side of the vascular supply, and the other side was to be embolized on an outpatient basis. CONCLUSIONS: The rarity of thymic neuroendocrine tumors causes treatment to be complicated. If surgical resection is not possible, other approaches need to be considered. Reference #1: Lausi P, Refai M, Filosso P, et al. Thymic Neuroendocrine Tumors. Thoracic Surgery Clinics. 2014;24:327-332. Reference #2: Song Z, Zhang Y. Primary neuroendocrine tumors of the thymus: Clinical review of 22 cases. Oncology Letters. 2014;8:2125-2129. Reference #3: Bohnenberger H, Dinter H, Konig A, Strobel P. Neuroendocrine tumors of the thymus and mediastinum. Journal of Thoracic Disease. 2017;9:S1448-S1457. DISCLOSURES: No relevant relationships by Mona Alipour, source=Web Response No relevant relationships by Jennifer Chiu, source=Web Response No relevant relationships by Louis Gerolemou, source=Web Response No relevant relationships by Nabil Mesiha, source=Web Response No relevant relationships by Ankur Mogla, source=Web Response

Volume rendering of superficial optic disc drusen

Optic disc drusen (ODD) are calcified deposits potentially caused by disturbances in axonal metabolism. The clinical course and visual impairment of ODD is usually mild; however, significant ocular morbidity may occur, such as visual field defects and retinal haemorrhages. Optic disc drusen may pose a diagnostic dilemma and differentiating these from other entities that can lead to similar compressive axonal distress is imperative. We present a novel technique for three-dimensional (3D) characterisation of superficial ODD based on 3D volume rendering of optical coherence tomography angiography (3DOCTA) scans. Optical coherence tomography (Cirrus™ HD-OCT Model 5000 with AngioPlex, Carl Zeiss Meditec, Inc., Dublin, USA) scans were obtained from the optic nerve head of a healthy 22-year-old female. Consequently, 3D structural OCT data and OCTA were analysed, enabling ODD segmentation and spatial characterization. Volumetric analysis of superficial ODD showed a maximal drusen horizontal diameter of 223 μm, maximal vertical diameter of 268 μm, surface area of 6617 μm2 and volume measurement of 12,875 μm3. The drusen were characterised by a connected network of multiple drusen islands instead of forming a dense mass. Multiple vascular channels with perforating vessels were found across the drusen. Three-dimensional volume rendering of OCTA scans provided new insight on the spatio-anatomical features of superficial ODD. The new features herein described, namely multilobulated drusen islands and intradrusen channels, may directly contribute to the pathogenic events leading to transient non-embolic visual loss and small vessel occlusion secondary to ODD.

Nano-channels in the spider fang for the transport of Zn ions to cross-link His-rich proteins pre-deposited in the cuticle matrix

We identify the presence of multiple vascular channels within the spider fang. These channels seem to serve the transport of zinc to the tip of the fang to cross-link the protein matrix by binding to histidine residues. According to amino acid and elemental analysis of fangs extracted shortly after ecdysis, His-rich proteins are deposited before Zn is incorporated into the cuticle. Microscopic and spectroscopic investigations in the electron microscope and synchrotron radiation experiments suggest that Zn ions are transported through these channels in a liable (yet unidentified) form, and then form stable complexes upon His binding. The resulting cross-linking through the Zn–His complexes is conferring hardness to the fang. Our observations of nano-channels serving the Zn-transport within the His-rich protein matrix of the fibre reinforced spider fang may also support recent bio-inspired attempts to design artificial polymeric vascular materials for self-healing and in-situ curing.

Tumor-induced Osteomalacia Due to Phosphaturic Mesenchymal Tumor, Mixed Cell Type, of the Sphenoid Bone

ABSTRACT Objective: Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome caused by small endocrine tumors that secrete fibroblast growth factor 23 (FGF23), a phosphaturic hormone. Methods: A 44-year-old male was evaluated following complaints of progressive leg pain, difficulty walking, and muscle pain over the previous 9 years. Biochemical evaluation showed low serum phosphorus, high urine phosphorus, and elevated FGF23 levels. These findings were suggestive of TIO. A whole-body (68)Gallium-labeled (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid)-1-NaI(3)-octreotide positron emission tomography–computed tomography scan revealed a large vascular lesion in the anterior squamous portion of the right temporal lobe and right greater wing of the sphenoid bone, involving the posterolateral wall of the right orbit. Axial T1-weighted magnetic resonance imaging revealed isointense lesions containing multiple vascular channels. The histomorphologic feature of the excised tumor was compatible...

A case of verrucous hemangioma and its dermoscopic features.

Sir, Verrucous hemangioma is a congenital, vascular lesion characterized by a gradual, progressive development of hyperkeratosis on the surface. Rarely the lesions may present for the first time in childhood and adulthood. The lesions usually present as solitary hyperkeratotic, bluish, and partly confluent lesions. A 20-year-old male patient presented with purplish skin lesions restricted to the left lower limb. The lesions had been present since birth and there was a history of occasional bleeding from the lesions especially after trauma. The lesions had gradually increased in size and number and many of the lesions developed scaling on the surface. On examination multiple lesions were seen restricted to the left lower limb. While most of the lesions were purplish nodules, some of them had significant hyperkeratosis over the surface [Figures ​[Figures11–3]. There was no difference in limb girth between the limbs. No other significant skin or mucosal lesions were noted. Figure 1 Verrucous hemangioma lesions in different stages of evolution Figure 3 Close up of early hemangiomatous lesions Figure 2 Verrucous hemangioma lesions in different stages of evaluation—early flat lesions and evolved hyperkeratotic lesions The dermoscopic features were different depending on the type and area of the lesions. The most striking feature was a prominent bluish shade with many areas showing an appearance of a blue-white veil. Hyperkeratosis was observed in most lesions but was the dominant feature in the verrucous lesions. The periphery of the lesions showed well-defined dark blue lacunae characteristic of vascular lesions [Figures ​[Figures44–7]. Figure 4 Dermoscopy of relatively early lesions of verrucous hemangioma showing a prominent bluish white hue similar to a blue-white veil in some areas, indicating the hyperkeratosis over the underlying vascular channels, which is seen in the histopathology Figure 7 Peripheral areas of the lesion showing the dark blue lacunae characteristic of vascular lesions correlating with the vascular channels seen in histopathology Figure 5 Dermoscopy of the late lesions showing the more prominent hyperkeratosis along with the bluish lacunae indicating the underlying dilated vascular channels Figure 6 Dermoscopy showing very prominent hyperkeratosis in the fully developed lesions Biopsy from one of the lesions showed hyperkeratosis, acanthosis, papillomatous and proliferation in the epidermis. Multiple vascular channels were seen extending from the papillary dermis to the deep dermis. The histopathological appearance was suggestive of verrucous hemangioma. The location of the dilated vascular channels in the deeper dermis ruled out other possibilities such as angiokeratoma circumscriptum naeviforme [Figure 8]. Figure 8 Histopathology H and E ×20 showing hyperkeratosis, acanthosis, and multiple vascular channels in the dermis The patient was referred to reconstructive surgery for excision of the lesions. All the lesions were excised with a 1 cm margin, under tourniquet control. The smaller lesions were closed primarily while the larger lesions were covered with a skin graft. Verrucous hemangioma typically presents as solitary and localized lesions present since birth.[1,2] To the best of our knowledge, there is only one report demonstrating the dermoscopic features in verrucous hemangioma. Popadic reported the case of a solitary verrucous hemangioma over the right leg. The main dermoscopic features in the case reported by Popadic included an alveolar appearance with numerous small, oval to polygonal elements surrounded by slightly darker pigmentation. Popadic described different shades of blue, including light blue, indigo blue, and dark bluish-black and a blue-white veil. Well-defined dark lacunae were seen in the periphery. The same case described by Popadic on follow up became a dark bluish-black, raised nodule, with irregular borders and hyperkeratotic surface, and dermoscopic examination showed a more marked alveolar appearance, with more pronounced sulci. There was a dominant bluish color to the lesion.[3,4] In our case we could not find a significant alveolar pattern, but all the other features were seen. The main highlight in our case was the expected dominant hyperkeratosis seen in the verrucous lesions. The treatment of choice for verrucous hemangiomas is surgical excision, the general concept being that smaller lesions are excised in a single sitting, whereas larger lesions require multiple sessions with or without combination treatment using other modalities. Various other options that have been tried with limited results include ultrasound, lasers, and cryotherapy.[1,2,5] This particular case was interesting not only because of its rarity, but also the presence of both verrucous and preverrucous stages in the same patient and the characteristically different dermoscopic patterns in both types of lesions. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Angiokeratoma with lysosomal dilatation in keratinocytes in a dog: a case report

Herein, we report the histopathology of angiokeratoma characterised by non-invasive, proliferative, ectatic vascular malformations accompanying lysosomal dilation in the canine skin. Two cutaneous angiokeratomas were diagnosed in a six-year-old spayed female Pekinese dog. Physical examination of the skin revealed two small erythematous papules on the axillary and abdominal regions. The masses were approximately 2–3 mm in diameter, well-circumscribed, purple to red in colour, and slightly elevated above the skin surface. The two small masses had similar histopathological features, characterised by exophytic proliferation of a mixture of multiple vascular channels resembling a cavernous haemangioma on the superficial dermis. The entire lesion was well circumscribed and the overlying epidermal hyperplasia formed a collarette. Ultrastructural analysis with transmission electron microscopy revealed electron-lucent lysosomal dilatation in the keratinocytes of the irregular hyperplastic epithelial trabeculae like rete pegs.  

Transcatheter Intervention for Infantile Hepatic Hemangioendothelioma with Amplatzer Duct Occluder II

Introduction: Infantile Hepatic hemangioendothelioma is characterized by multifocal benign vascular dilatations involving the liver. The clinical course depends on tumor size, localization and complications. Case Report: 15 days old neonate with stormy postnatal period was referred for intractable congestive cardiac failure. Transthoracic 2D echocardiography showed multiple vegetations on all the four valves, noncompaction of left ventricle with multiple vascular channels in left lobe of liver. Computed tomography angiogram showed 58x29x50 mm markedly enhancing lesion in left lobe of liver suggestive of infantile hepatic hemangioendothelioma. The neonate was treated for bacterial endocarditis. Later 6x6 Amplatzer duct occluder II was parked in hepatic vein, then gel foam and polyvinyl chloride particles were injected into infantile hepatic hemangioendothelioma. Cardiac failure resolved with marked regression of lesion. Discussion: Infantile hepatic hemangioendothelioma is a rare anomaly causing heart Case Study Vijayalakshmi et al.; CA, 2(4): 317-324, 2014; Article no. CA.2014.4.017 318 failure in neonate causing death in up to 70% of untreated infants without adequate regression of lesion. Therefore aggressive treatment is warranted. For the first time in the world, we report a case of infantile hepatic hemangioendothelioma in a neonate, with pump failure due to noncompaction of left ventricle and vegetations on all four valves, successfully treated by combination of transcatheter deployment of Amplatzer duct occluder II to occlude the venous end and hand injection of gel foam and polyvinly chloride particles from the aortic end to close the feeder artery. Conclusion: The combination of closure of hepatic vein by Amplatzer duct occluder II and injection of gel foam and polyvinyl chloride particles is safe and effective in infantile hepatic hemangioendothelioma in neonate with heart failure.

An unusual case of hemoptysis

An unusual case of hemoptysis

Angiomyxolipoma (Vascular Myxolipoma) of the Oral Cavity. Report of a Case and Review of the Literature

Angiomyxolipoma is a rare tumor characterized by a proliferation of adipose tissue associated with a myxoid stroma and multiple vascular channels. To date, ten cases of angiomyxolipoma located in subcutaneous tissue, spermatic cord and subungual area have been reported in the literature. We describe the clinical and histopathologic findings of the first case of intraoral angiomyxolipoma in a 12year-old male, as well as the utility of immunohistochemistry as a useful tool in differential diagnosis of this particular lesion with respect to other benign and malignant lesions derived from adipose tissue.

Hemangiomatous ameloblastoma: report of a case

Hemangiomatous ameloblastoma is a rare variant of ameloblastoma with only a few cases reported in the English literature. This is a report of a 42 year old man with a recurrent mandibular neoplasm who had r epeated surgical interventions. Clinical and radiographic examinations were not significantly different from other regular variants of ameloblastoma. Microscopic examination however revealed islands of cuboidal and columnar cells arranged in a pallisaded pattern with a central area of squamous metaplasia and stellate reticulum-like cells. There were multiple vascular channels containing red blood cells within the stellate reticulum-like areas. Surgical resection of the mandibular mass was done with immediate reconstruction. It may be concluded that repeated surgical interventions may be a possible etiology for the development of hemangiomatous ameleblastoma.

Aneurisma cirsoide renal: una rara causa de hematuria severa

Congenital arteriovenous fistulas are an exceptional clinical feature. Although they are frequently asymptomatic, their presentation as severe hematuria pose an excellent diagnostic exercise and often immediate therapeutic action. We report the case of a 75-year-old female patient presenting with severe hematuria producing anaemia, high blood pressure and congestive heart failure. Image tests revealed right ureteral-hydronephrosis with bladder blockage by blood clots. The endoscopic study (cystoscopy and ureterorenoscopy) alerted about the origin of the hematuria from the right kidney, finally requiring nephrectomy as definitive treatment. Pathology revealed the presence of a round formation with multiple vascular channels, arterial and venous, in the pyelocalicial submucosa, with focal epithelial erosion, compatible with congenital arteriovenous fistula. We review the diagnostic and therapeutic features in the literature. Renal congenital arteriovenous fistulas represent a diagnostic dilemma. They may present asymptomatic or condition clinical features derived from the shunt and high cardiac output (hypertensive cardiopathy and congestive heart failure) or from the erosion and acute hemorrhage into the urinary tract (severe renal hematuria). Treatment should be conservative with embolization or supraselective sclerosis. Nevertheless, in cases of big fistulas, post embolization revascularization, or hemodynamic instability nephrectomy is an excellent option.

Hepatic Infantile Hemangioendothelioma with Unusual Manifestations

Hepatic Infantile Hemangioendothelioma with Unusual Manifestations

Unusual computed tomography appearance of Castleman disease

A case is presented here of Castleman disease in an uncommon location. Ultrasonography demonstrated a large hypoechoic mass with multiple vascular channels. On computed tomography, the lesions with a nodular contour were located lateral to the carotid sheath on the right side, and demonstrated a variegated enhancement pattern.

Sonographic and Doppler features of infantile hepatic hemangiomas with pathologic correlation.

The sonograms of five patients with a diagnosis of infantile hepatic hemangioma were retrospectively reviewed to analyze their sonographic and Doppler characteristics. Three patients had single lesions, whereas two had multifocal involvement. All lesions except one were hypoechoic, well-circumscribed, and solid; the exception was hyperechoic. Findings of high flow, ie, large draining veins, an abrupt change in aortic caliber, and the presence of Doppler signal throughout the lesion were seen in three of five patients. The sonographic findings correlate well with the pathologic findings of multiple vascular channels separated by fibrous septa. The major differential diagnosis of infantile hepatic hemangioma includes hepatoblastoma and metastatic neuroblastoma. Although some of their sonographic features may simulate a hemangioma, large draining veins and changes in aortic caliber are not reportedly seen. Doppler flow was not seen in either of these malignant neoplasms in our study and, to date, has only been reported peripheral to three cases of hepatoblastoma and not at all in metastatic neuroblastoma. We propose an algorithmic approach dependent upon the sonographic-Doppler appearance.

A subacute exposure of beagle dogs to aflatoxin

Young adult beagle dogs, 2 females and 1 male per group, were orally dosed with an aflatoxin mixture (in %: B1, 37.5; B2, 5.4; G1, 17.1; G2, 1.0) at a daily dose (DR) of 1, 5, or 20 μg/kg body weight. The animals received the aflatoxin 5 days per wk for 10 wk. During these tests, 2 other dogs were dosed with 500 μg/kg day for 2 days; 1 dog died on the second day. Clinical signs attributable to aflatoxicosis were generally absent among the dogs in groups DR-5 and DR-1, and in the controls. Icterus, inappetance, yellow-orange urine, and an increase in prothrombin time were noted in dogs of the DR-20 group. Histopathologic examinations revealed no hepatic morphologic changes in groups DR-5 and DR-1 or in the controls. In livers of group DR-20, there was moderate bile duct proliferation, bile pigment accumulation in the portal areas, and multiple vascular channels around the central and portal veins.