Vascular

704 Pages·2015·19.34 MB·English

by  David L. Stockman

STOCKMAN
ii
David L. Stockman, MD, MS, FCAP
Director at Orthopath
Orthopedic and Sarcoma Pathology Associates, PC
Grand Rapids, Michigan
iii
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
DIAGNOSTIC PATHOLOGY: VASCULAR ISBN: 978-0-323-37674-7
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Notices

Knowledge and best practice in this field are constantly changing. As new research and
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Practitioners and researchers must always rely on their own experience and knowledge in
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Publisher Cataloging-in-Publication Data
Diagnostic pathology. Vascular / [edited by] David L. Stockman
pages ; cm
Vascular
Includes bibliographical references and index.
ISBN 978-0-323-37674-7 (hardback)
1. Blood-vessels--Diseases--Diagnosis--Handbooks, manuals, etc. 2. Peripheral vascular
diseases--Diagnosis--Handbooks, manuals, etc. I. Stockman, David L. II. Title: Vascular.
[DNLM: 1. Vascular Diseases--diagnosis--Atlases. 2. Vascular Diseases--pathology--Atlases. WG 505]
RC691.4.D515 2015
616.13--dc23
International Standard Book Number: 978-0-323-37674-7
Cover Designer: Tom M. Olson, BA
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Dedications
I would like to dedicate this book to my strong and loving wife, Jennifer, who every day
makes me a better husband and father to our son Brody, who gives my life purpose. To
my parents, Marvin and Barbara, and brother Manny, who have stood by me through
thick and thin. To my mentor in both pathology and life, Dr. Saul Suster, and to the other
(cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:7)(cid:6)(cid:8)(cid:9)(cid:10)(cid:4)(cid:10)(cid:11)(cid:12)(cid:5)(cid:6)(cid:11)(cid:5)(cid:3)(cid:13)(cid:14)(cid:11)(cid:15)(cid:3)(cid:16)(cid:14)(cid:11)(cid:3)(cid:11)(cid:16)(cid:17)(cid:3)(cid:15)(cid:3)(cid:4)(cid:9)(cid:18)(cid:11)(cid:16)(cid:9)(cid:19)(cid:14)(cid:17)(cid:14)(cid:20)(cid:18)(cid:14)(cid:11)(cid:9)(cid:20)(cid:11)(cid:4)(cid:5)(cid:14)(cid:11)(cid:12)(cid:3)(cid:21)(cid:11)(cid:22)(cid:11)(cid:3)(cid:2)(cid:2)(cid:17)(cid:6)(cid:3)(cid:18)(cid:5)(cid:11)(cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:7)(cid:6)(cid:8)(cid:21)(cid:23)(cid:11)(cid:24)(cid:17)(cid:10)(cid:25)(cid:11)
(cid:26)(cid:16)(cid:27)(cid:3)(cid:17)(cid:16)(cid:6)(cid:11)(cid:28)(cid:3)(cid:15)(cid:29)(cid:17)(cid:3)(cid:20)(cid:6)(cid:30)(cid:11)(cid:31)(cid:14)(cid:3)(cid:20)(cid:20)(cid:14)(cid:11)!(cid:14)(cid:9)(cid:10)(cid:30)(cid:11)"(cid:3)(cid:17)(cid:17)(cid:21)(cid:11)(cid:26)(cid:13)(cid:3)(cid:20)(cid:10)(cid:30)(cid:11)(cid:31)(cid:6)(cid:10)(cid:14)(cid:11)#(cid:7)(cid:3)$(cid:3)(cid:30)(cid:11)!(cid:9)(cid:18)(cid:5)(cid:3)(cid:14)(cid:7)(cid:11)%(cid:14)(cid:4)$(cid:7)(cid:3)(cid:19)(cid:30)(cid:11)&(cid:14)(cid:10)(cid:3)(cid:17)(cid:11)!(cid:6)(cid:17)(cid:3)(cid:20)(cid:30)(cid:11)
Aysegul Sahin, Victor Prieto, Wei-lien Wang, Steven Kroft, and Alexander Lazar.
DLS
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Contributing Authors
Wonwoo Shon, DO Munir R. Tanas, MD
Assistant Professor Assistant Professor
Department of Pathology, Immunology, Department of Pathology
and Laboratory Medicine University of Iowa
University of Florida College of Medicine Iowa City, Iowa
Gainesville, Florida
Paul M. Guzzetta, Jr., MD
Konstantinos Linos, MD, FCAP Interventional Radiologist
Assistant Professor of Bone, Soft Tissue Radiology Associates of Richmond
and Dermatopathology Richmond, Virginia
Geisel School of Medicine at Dartmouth
Department of Pathology Sujan Fernando, MD
Dartmouth-Hitchcock Medical Center Assistant Professor of Radiology
Lebanon, New Hampshire Musculoskeletal and General Radiology
Medical College of Wisconsin
Vickie Y. Jo, MD Milwaukee, Wisconsin
Assistant Professor of Pathology,
Harvard Medical School Jason Chih-Peng Chang, MD
Department of Pathology Instructor
Brigham & Women’s Hospital Department of Pathology
Boston, Massachusetts Memorial Sloan Kettering Cancer Center
New York, New York
Sean R. Williamson, MD
(cid:2)(cid:3)(cid:4)(cid:5)(cid:6)(cid:7)(cid:8)(cid:2)(cid:9)(cid:10)(cid:11)(cid:8)(cid:12)(cid:10)(cid:9)(cid:13)(cid:6)(cid:14)(cid:6)(cid:15)(cid:5)(cid:16)(cid:9) William A. Kanner, MD
Department of Pathology and Laboratory Medicine Clinical Assistant Professor, Pathology
Henry Ford Health System University of South Carolina
Clinical Assistant Professor of Pathology School of Medicine, Greenville
Department of Pathology Greenville, South Carolina
Wayne State University School of Medicine
Detroit, Michigan David S. Cassarino, MD, PhD
(cid:17)(cid:6)(cid:4)(cid:16)(cid:18)(cid:14)(cid:9)(cid:10)(cid:4)(cid:9)(cid:8)(cid:19)(cid:3)(cid:7)(cid:20)(cid:10)(cid:9)(cid:6)(cid:21)(cid:10)(cid:9)(cid:13)(cid:6)(cid:14)(cid:6)(cid:15)(cid:5)(cid:16)(cid:9)(cid:8)(cid:10)(cid:4)(cid:22)(cid:8)(cid:2)(cid:9)(cid:10)(cid:11)(cid:8)(cid:12)(cid:10)(cid:9)(cid:13)(cid:6)(cid:14)(cid:6)(cid:15)(cid:5)(cid:16)(cid:9)
Leona A. Doyle, MD
Southern California Permanente Medical Group
Assistant Professor of Pathology, Los Angeles, California
Harvard Medical School Clinical Professor
Associate Pathologist, Department of Pathology Department of Dermatology
Brigham and Women’s Hospital University of California, Irvine
Boston, Massachusetts Irvine, California

Sara Szabo, MD, PhD Elizabeth Montgomery, MD
Associate Professor of Pediatric Pathology Professor of Pathology and Oncology,
Medical College of Wisconsin and Orthopedic Surgery
Children’s Hospital of Wisconsin Johns Hopkins University Medical Institutions
Milwaukee, Wisconsin Baltimore, Maryland

Andrea T. Deyrup, MD, PhD Jonathan B. McHugh, MD
Associate Professor Associate Professor of Pathology
Department of Pathology Clinical Associate Professor of Surgery,
Duke University School of Medicine Section of Oral Surgery
Durham, North Carolina University of Michigan Medical School
Ann Arbor, Michigan

vi
Steven D. Billings, MD David G. Hicks, MD
(cid:2)(cid:9)(cid:10)(cid:11)(cid:8)(cid:12)(cid:10)(cid:9)(cid:13)(cid:6)(cid:14)(cid:6)(cid:15)(cid:5)(cid:16)(cid:9)(cid:8)(cid:10)(cid:4)(cid:22)(cid:8)(cid:12)(cid:7)(cid:6)(cid:23)(cid:3)(cid:16)(cid:16)(cid:6)(cid:7)(cid:8)(cid:6)(cid:23)(cid:8)(cid:12)(cid:10)(cid:9)(cid:13)(cid:6)(cid:14)(cid:6)(cid:15)(cid:24) Professor
Cleveland Clinic Director, Surgical Pathology Unit
Cleveland, Ohio Department of Pathology and Laboratory Medicine
University of Rochester Medical Center
G. Petur Nielsen, MD Rochester, New York
Associate Pathologist, Department of Pathology
Massachusetts General Hospital Jeremy C. Wallentine, MD
Associate Professor Pathologist
Harvard Medical School Intermountain Healthcare and
Boston, Massachusetts Utah Pathology Services, Inc.
LDS Hospital
Andrew E. Rosenberg, MD Salt Lake City, Utah
Professor and Vice Chair
Director of Bone & Soft Tissue Pathology Brenda L. Nelson, DDS, MS
Miller School of Medicine, University of Miami Consultant Pathologist
University of Miami Hospital Naval Medical Center San Diego
Miami, Florida San Diego, California

Rhonda K. Yantiss, MD Lester D.R. Thompson, MD
Professor of Pathology and Laboratory Medicine Consultant Pathologist
Chief, Gastrointestinal Pathology Southern California Permanente Medical Group
Weill Cornell Medical College Woodland Hills, California
New York, New York
Amitabh Srivastava, MD
Nicole C. Panarelli, MD Associate Professor of Pathology
Assistant Professor of Pathology Harvard Medical School
Albert Einstein College of Medicine Associate Director, Surgical Pathology
Bronx, New York Director, Surgical Pathology Fellowship Program
Brigham and Women’s Hospital
Keith Kay Tar Lai, MD Boston, Massachusetts
Assistant Professor of Pathology
University of Arkansas for Medical Sciences Thomas Mentzel, MD
Little Rock, Arkansas Dermatopathology Bodensee
Associated Professor
Nadine Aguilera, MD Department of Pathology
Associate Professor University of Freiburg, Germany
Department of Pathology Friedrichshafen, Germany
University of Virginia Health System
Charlottesville, Virginia Cyril Fisher, MD, DSc, FRCPath
Consultant Histopathologist
Saul Suster, MD Royal Marsden NHS Foundation Trust
Professor and Chairman Professor of Tumor Pathology
Department of Pathology & Laboratory Medicine Instititute of Cancer Research
Medical College of Wisconsin University of London
Milwaukee, Wisconsin London, United Kingdom

Cesar A. Moran, MD David Lucas, MD
Professor and Deputy Chair Professor of Pathology
Chief, Thoracic Pathology Department of Pathology
Department of Pathology University of Michigan Medical School
MD Anderson Cancer Center Ann Arbor, Michigan
Houston, Texas

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Preface
Although our work is primarily intended for use by pathologists, dermatopathologists,
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purposeful and emphasized multidisciplinary approach taken in our book make it a useful
desktop reference for all radiologists, pediatricians, and surgeons.
Vascular tumors, malformations, and proliferations pose problems, as their often overlapping
clinical appearance fails to correlate with the broad spectrum of underlying lesions that possess
both morphological variations and widely disparate clinical courses, ranging from benign
malformations to aggressive sarcomas. To practicing pathologists and dermatopathologists
faced with making the diagnosis, these lesions may additionally pose compounding degrees
(cid:6)(cid:23)(cid:8)(cid:22)(cid:5)(cid:30)(cid:27)(cid:18)(cid:14)(cid:9)(cid:24)(cid:25)(cid:8)(cid:10)(cid:16)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)(cid:16)(cid:6)(cid:20)(cid:3)(cid:9)(cid:5)(cid:20)(cid:3)(cid:16)(cid:8)(cid:4)(cid:6)(cid:4)(cid:16)(cid:21)(cid:3)(cid:27)(cid:5)(cid:29)(cid:27)(cid:8)(cid:27)(cid:14)(cid:5)(cid:4)(cid:5)(cid:27)(cid:10)(cid:14)(cid:8)(cid:5)(cid:4)(cid:23)(cid:6)(cid:7)(cid:20)(cid:10)(cid:9)(cid:5)(cid:6)(cid:4)(cid:8)(cid:10)(cid:4)(cid:22)(cid:8)(cid:16)(cid:18)(cid:21)(cid:3)(cid:7)(cid:29)(cid:27)(cid:5)(cid:10)(cid:14)(cid:8)(cid:4)(cid:10)(cid:9)(cid:18)(cid:7)(cid:3)(cid:8)(cid:6)(cid:23)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)
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diagnostic pitfall. This occurrence is all too common as non-sampled, underlying, more
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work emphasizes the keys and subtle hints necessary for the practicing pathologist and
dermatopathologist to be aware of when making the diagnosis of any vascular lesion.
This book takes an anatomic approach to the diagnosis of these tumors, as all too often they
are cursorily covered in larger organ system-devoted pathology books. Appropriate clinical
information with regards to behavior is cited in a site-dependent manner as well as appropriate
(cid:16)(cid:5)(cid:9)(cid:3)"(cid:22)(cid:3)(cid:21)(cid:3)(cid:4)(cid:22)(cid:3)(cid:4)(cid:9)(cid:8)(cid:22)(cid:5)(cid:11)(cid:3)(cid:7)(cid:3)(cid:4)(cid:9)(cid:5)(cid:10)(cid:14)(cid:8)(cid:22)(cid:5)(cid:10)(cid:15)(cid:4)(cid:6)(cid:16)(cid:3)(cid:16)$(cid:8)’(cid:13)(cid:5)(cid:14)(cid:3)(cid:8)(cid:22)(cid:3)(cid:29)(cid:4)(cid:5)(cid:9)(cid:5)#(cid:3)(cid:8)(cid:27)(cid:7)(cid:5)(cid:9)(cid:3)(cid:7)(cid:5)(cid:10)(cid:8)(cid:9)(cid:6)(cid:8)(cid:20)(cid:10)!(cid:3)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)(cid:22)(cid:5)(cid:10)(cid:15)(cid:4)(cid:6)(cid:16)(cid:5)(cid:16)(cid:8)(cid:6)(cid:23)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)
multitude of vascular entities is largely absent from the literature, our book emphasizes that
only through a multidisciplinary approach, utilizing clinical information, radiology, and histologic
(cid:23)(cid:3)(cid:10)(cid:9)(cid:18)(cid:7)(cid:3)(cid:16)(cid:25)(cid:8)(cid:27)(cid:10)(cid:4)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)(cid:10)(cid:21)(cid:21)(cid:7)(cid:6)(cid:21)(cid:7)(cid:5)(cid:10)(cid:9)(cid:3)(cid:8)(cid:22)(cid:5)(cid:10)(cid:15)(cid:4)(cid:6)(cid:16)(cid:5)(cid:16)(cid:8)(cid:31)(cid:3)(cid:8)(cid:20)(cid:10)(cid:22)(cid:3)$(cid:8)’(cid:3)(cid:8)(cid:10)(cid:22)(cid:22)(cid:5)(cid:9)(cid:5)(cid:6)(cid:4)(cid:10)(cid:14)(cid:14)(cid:24)(cid:8)(cid:5)(cid:4)(cid:27)(cid:14)(cid:18)(cid:22)(cid:3)(cid:8)(cid:18)(cid:21)(cid:22)(cid:10)(cid:9)(cid:3)(cid:16)(cid:8)(cid:6)(cid:4)(cid:8)(cid:4)(cid:3)(cid:26)(cid:14)(cid:24)(cid:8)
designated entities such as pseudomyogenic hemangioendothelioma and the latest molecular
genetic information present in various problematic vascular tumors. Lastly, we include the
(cid:18)(cid:21)(cid:22)(cid:10)(cid:9)(cid:3)(cid:22)(cid:8)((cid:4)(cid:9)(cid:3)(cid:7)(cid:4)(cid:10)(cid:9)(cid:5)(cid:6)(cid:4)(cid:10)(cid:14)(cid:8)(cid:2)(cid:6)(cid:27)(cid:5)(cid:3)(cid:9)(cid:24)(cid:8)(cid:23)(cid:6)(cid:7)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)(cid:2)(cid:9)(cid:18)(cid:22)(cid:24)(cid:8)(cid:6)(cid:23)(cid:8))(cid:10)(cid:16)(cid:27)(cid:18)(cid:14)(cid:10)(cid:7)(cid:8)*(cid:4)(cid:6)(cid:20)(cid:10)(cid:14)(cid:5)(cid:3)(cid:16)(cid:8)(cid:27)(cid:14)(cid:10)(cid:16)(cid:16)(cid:5)(cid:29)(cid:27)(cid:10)(cid:9)(cid:5)(cid:6)(cid:4)(cid:8)(cid:16)(cid:27)(cid:13)(cid:3)(cid:20)(cid:10)(cid:8)
released in 2014, as important clinical implications and advances in the molecular genetics and
(cid:31)(cid:5)(cid:6)(cid:14)(cid:6)(cid:15)(cid:24)(cid:8)(cid:18)(cid:4)(cid:22)(cid:3)(cid:7)(cid:14)(cid:24)(cid:5)(cid:4)(cid:15)(cid:8)(cid:9)(cid:13)(cid:3)(cid:8)(cid:21)(cid:10)(cid:9)(cid:13)(cid:6)(cid:15)(cid:3)(cid:4)(cid:3)(cid:16)(cid:5)(cid:16)(cid:8)(cid:6)(cid:23)(cid:8)(cid:31)(cid:3)(cid:4)(cid:5)(cid:15)(cid:4)(cid:8)#(cid:10)(cid:16)(cid:27)(cid:18)(cid:14)(cid:10)(cid:7)(cid:8)(cid:14)(cid:3)(cid:16)(cid:5)(cid:6)(cid:4)(cid:16)(cid:8)(cid:6)(cid:30)(cid:27)(cid:5)(cid:10)(cid:14)(cid:14)(cid:24)(cid:8)(cid:22)(cid:5)#(cid:5)(cid:22)(cid:3)(cid:22)(cid:8)(cid:13)(cid:3)(cid:20)(cid:10)(cid:4)(cid:15)(cid:5)(cid:6)(cid:20)(cid:10)(cid:16)(cid:8)
and malformations.
This comprehensive textbook on vascular pathology is presented in an easy-to-access format
written with the busy practicing pathologist in mind. More importantly, it is an aid and decision-
making paradigm in how to use the latest appropriate immunohistochemical and molecular
tests to aid in diagnosis.
David L. Stockman, MD, MS, FCAP
(cid:19)(cid:5)(cid:7)(cid:3)(cid:27)(cid:9)(cid:6)(cid:7)(cid:8)(cid:10)(cid:9)(cid:8)%(cid:7)(cid:9)(cid:13)(cid:6)(cid:21)(cid:10)(cid:9)(cid:13)
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Grand Rapids, Michigan
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