Vascular transformation of lymph node sinuses

Abstract

Vascular transformation of lymph node sinuses is an uncommon condition and only isolated cases have been reported. It is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. Venous or lymphatic obstruction is thought to be the underlying mechanism, and in most cases factors that may contribute to lymphovascular obstruction can be identified such as tumour in the vicinity, vascular thrombosis, heart failure, previous surgery or radiotherapy. Most cases involve abdominal lymph nodes, and head and neck involvement is rare. We present two cases of vascular transformation of lymph node sinuses presenting only as cervical lymphadenopathy, without an obvious cause of lymphovascular obstruction.

Vascular Transformation of Bilateral Cervical Lymph Node Sinuses: A Rare Entity Masquerading as Tumor Recurrence

“…VTS itself is a rare lesion and cervical lymph node is a very unusual site for VTS. To the best of our knowledge, only 15 cases have been reported in cervical lymph nodes till date [4,[6][7][8]. Further, associated angiolipomatous or angiomyomatous hamartoma-like area was noted only in two cases of cervical lymph node VTS [6,8].…”

Diagnostic Exercise

“…4,6 In many but not all cases of vascular transformation of lymph nodes, a causative obstructive process is identified. 4,18 In people, vascular transformation of lymph nodes is believed to be secondary to obstruction of the efferent hilar lymphatics. The lesion was reproduced experimentally by ligation of the efferent lymphatics or partial ligation of the nodal veins and lymphatics of rabbits.…”

Human safety risk assessment of lymph node angiomas observed in 2-year carcinogenicity studies in rats

“…Several proposed etiologies and conditions for mesenteric lymph node angiomas or ''angioma-like'' masses in rats may include: (1) genetic drift (Tennekes et al, 2004), (2) congenital/ developmental malformation (Zadvinskis et al, 1992), (3) vascular transformation/venous obstruction of outflow (Chan et al, 1991;Haferkamp et al, 1971;Samet et al, 2001), (4) ''inflammatory'' pseudo-tumors (Mancardi et al, 1999), and/or (5) defects of endothelial lymphatic vascular secretion/permeability (Ohtani and Ohtani, 2008).Tumor drift that is caused primarily by genetic drift (i.e., variation of tumor incidence over time related to changes in genetically determined factors) occurred far more often in outbred rats (Wistar and Sprague-Dawley) than in inbred F344 rats. Genetic factors have been proposed as a cause for predisposition of Wistar Han and Sprague-Dawley males and BASF Wistar females to develop mesenteric lymph node hemangioma (Tennekes et al, 2004).…”

“…Lymph node sinus vascular transformation is an uncommon condition that has been reported in association with lymphatic or venous obstruction and/or congestion (Chan et al, 1991;Haferkamp et al, 1971;Samet et al, 2001). Factors that may contribute to lymphovascular obstruction include neoplasia, vascular thrombosis, heart failure, previous surgery or radiotherapy (Samet et al, 2001).…”

“…Factors that may contribute to lymphovascular obstruction include neoplasia, vascular thrombosis, heart failure, previous surgery or radiotherapy (Samet et al, 2001). Vascular transformation of lymph node sinuses (VTS) is a reactive condition characterized by conversion of nodal sinuses into complex, capillary-like, endothelium-lined, well-formed, irregular vascular channels, commonly accompanied by expansion or fibrosis/sclerosis of the sinuses with sparing of the capsule (Haferkamp et al, 1971;Chan et al, 1991).…”