Immunohistochemical Investigations of Orbital Infantile Hemangiomas and Adult Encapsulated Cavernous Venous Lesions (Malformation Versus Hemangioma)

Abstract

Immunophenotypic results for ECVL and IH demonstrated no overlapping staining patterns. Infantile hemangioma had the classical architecture of capillaries. Because of the constant presence of mural smooth muscle, it was concluded that ECVL is an accurate and descriptive term. However, desmin negativity in ECVL indicates myofibroblastic differentiation rather than full-fledged smooth muscle differentiation. Infantile hemangioma may display ectatic channels as the lesion ages but does not acquire multilaminar smooth muscle walls. Its pericytes lack cytoplasmic filaments and desmin reactivity but are SMA-positive because of the presence of poorly polymerized actin in the cytosol. In IH, Ki-67 positivity was observed in the endothelial cells of the solid and more ectatic regions. In contrast, the virtual absence of Ki-67 positivity in ECVL lends further support for the interpretation that it is more closely related to a malformation than a benign neoplasm.

Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature

“…Thrombosis with extensive fibrin can be seen infrequently, although lesser amounts of residual fibrin can be seen in multiple areas of earlier thrombosis. This had been noted previously22 23 and can be seen with the Movat stain (figure 3A,B).…”

“…The use of modern staining techniques as in this study and others,23 allow us to contextualise these findings in terms of natural processes occurring in slow flow venous systems, mainly thrombosis and recanalisation.…”

“…The cellular components are mature, do not tend towards dysplasia or hypercellularity, stain mostly negative for markers of cellular proliferation (such as Ki67), and are clearly differentiated from proliferating infantile haemangiomas in that they do not express GLUT-1 10 22 23. They are well encapsulated and do not infiltrate local tissues, although as we and others have demonstrated,24 they can infrequently incorporate local structures into the fibrous capsule.…”

Malignant rhabdoid transformation of a longstanding, aggressive, and recurrent orbital angiomyxoma

“…12,36,56,70 The myofibroblastic character of the cells is attributable in part to desmin-negativity, whereas this marker is strongly positive in true, fully differentiated smooth muscle cells. 36,50 On the other hand, calponin, which binds to actin, is positive in myofibroblasts, 70 as it was in the present lesion. Spotty and diffuse smooth muscle actin positivity has been identified in evaluations of orbital and non-orbital myxomas and angiomyxomas, 20,28 which in the present case was uniform and pronounced.…”

Vascular Malformations of the Orbit

“…[49][50][51] Histologically, they have noted that orbital cavernous VMs are similar to those in the liver and subcutaneous tissues, 49,50 where they also commonly occur. The authors wish to emphasize that so-called "cavernous hemangiomas" are not tumors but are VMs.…”