Case Number : Case 558 - 30 July Posted By: Guest

Thought of spindle cell/kaposiform haemangioendothelioma. Intracytoplasmic lumina are present in the endothelial cells in the 2nd image.The multivacuolated cells are either pseudolipoblasts or multi vaculated endothelial cells !!. HHV8 is required to exclude kaposi sarcoma.

Vascular channels. Without clinical information is difficullt, though i´m thinking in Kaposi Sarcoma. Spindle cell hemangioendothelioma is a good differential diagnosis.

spindle cell hemangioma/haemangioendothelioma. HHV8 is necessary to rule out kaposi sarcoma

[color=#000000]Provisionally, a [/color][b][color=#231F20]spindle cell haemangioma. [/color][/b][color=#231F20]T[/color][color=#000000]hin-walled cavernous-like [b]c[b]ongested channels[/b] –[/b] [b]slit like spaces[/b] - [b]spindle cells[/b] – [b]“[/b][/color][b][color=#231F20]epithelioid” cells (lying in groups) with prominent vacuolation[/color][/b][color=#000000]. [/color][color=#231F20]Immunohistochemistry to [/color][color=#000000]check the endothelial nature of the cells and any [/color][color=#231F20]focal staining for actin. Also, testing for [/color][color=#000000]HHV-8. [/color]

spindle cell hemangioma

spindle cell hemangioma/haemangioendothelioma

Spindle cell hemangioma (hemangioendothelioma) vs. Kaposiform hemangioendothelioma. Would love to read a way of differentiating between them.

KS vs spindle cell hemangioendothelioma

Difficult case but the presence of so many endothelial cell lumina is very much in favor of spindle cell hemangioma. I don't know whether HHV-8 was done but assume that it was negative. Kaposiform hemangioendothelioma is another good differential diagnosis. My personal experience of this tumor is limited but msot importantly it is HHV-8 negative, often shows mixed growth pattern- KS-like areas, foci more in keeping with capillary hemangioma and sometimes areas resembling tufted hemagioma and even lymphangioma. It is commonly associated with the Kasabach-Merritt syndrome.

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Thank you.

Thanks Dr McKee :-)