Capillary hemangioma of the central nervous system: a comparative study with lobular capillary hemangioma of the skin

Abstract

Capillary hemangiomas have rarely been reported to develop in the brain or spinal cord. Here we report the histological and immunohistochemical features of ten cases of central nervous system capillary hemangiomas (CNSCH) and compare these to those of lobular capillary hemangioma (LCH) of the skin. CNSCH showed a lobular architecture with lobules that were separated by fibrous tissue septa in six cases. The lobules were composed of numerous, tightly packed, capillary-sized vessels. A highly cellular area was seen in six cases. A blood-filled cavernous space and fibroendothelial papillae that mimicked papillary endothelial hyperplasia were seen in four cases. Stromal edema was observed in nine cases. These features were not statistically different from those of LCH of the skin, although the highly cellular area was more prominent and more frequent in cases of CNSCH. Immunohistochemical studies demonstrated no positive staining of endothelial cells within either lesion for erythrocyte-type glucose transporter protein, which is a selective marker for capillary hemangioma of infancy. Vascular endothelial growth factor immunostaining demonstrated positive cells in the solid or immature-appearing areas without vessel lumen formation in both lesions. Some of the endothelial cells and stromal cells were positive for glucocorticoid receptor immunostaining. The MIB-1 index of CNSCH was variable (mean 5.6%) and the apoptotic index of CNSCH was significantly lower than that of LCH of the skin. CNSCH are benign lesions with histological and immunohistochemical features similar to those of LCH of the skin.

Rapid Regrowth of a Capillary Hemangioma of the Thoracic Spinal Cord

“…The MIB-1 index of the current patient was approximately 6%, which is not as high as reported for previous cases in the CNS, where the MIB-1 index ranged from 2.2% to 12.0%. 2) A case of capillary hemangioma in the conus medullaris showed no recurrence/regrowth despite an MIB-1 index of more than 10%. 5) Thus, the MIB-1 index is not a predictive factor for recurrence/regrowth in capillary hemangiomas.…”

“…10,11) A high proliferation index has also been described in cases of capillary hemangioma of the CNS. 2,5) Because the recurrence/regrowth of capillary hemangioma in the skin or soft tissues is not infrequent, 14,22) the surgical goal should be total excision of the lesion. However, pyogenic granuloma (capillary hemangioma) recurred despite surgical excision in 2 cases, which was initially thought to be sufficient.…”

“…13,14,22) Capillary hemangioma rarely involves the central 1,3,4,5,[7][8][9]16,18,19,21,[24][25][26]29) and peripheral 17,32) nervous systems. Its proliferative activity along the neuraxis has been shown to be high 2,5) similar to other lesions; however, recurrence/regrowth of the tumor in the central nervous system (CNS) has been extremely rare. 26) We report the case of an intradural capillary hemangioma of the thorax; this tumor showed a rapid regrowth 6 months after complete resection.…”

A Rare Case of Dumbbell-shaped Spinal Epidural Capillary Hemangioma

“…1 Hemangiomas of the spine are generally lesions of the vertebral bodies, but can occur in other locations. 2 It frequently occurs in the intradural extramedullary compartment.…”

Pyogenic granuloma, an impaired wound healing process, linked to vascular growth driven by FLT4 and the nitric oxide pathway

“…6 On rare occasions, it has been reported in organs such as liver 7 or central nervous system. 8 They have also been observed in the lumen of vessels 9 or in vascular lesions such as arteriovenous malformation 10 and capillary malformation. 11 Their pathogenesis is still poorly understood.…”