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Capillary Hemangioma.

Capillary hemangiomas, the largest single type of vascular tumor, are most common in the skin, subcutaneous tissues, and mucous membranes of the oral cavities and lips, but they may

also occur in the liver, spleen, and kidneys. The "strawberry type" of capillary hemangioma (juvenile hemangioma) of the skin of newborns is extremely common (1 in 200 births), may be

multiple, grows rapidly in the first few months, begins to fade when the

Figure 11-30Hemangiomas. A, Hemangioma of the tongue. B, Histology of juvenile capillary hemangioma. C, Histology of cavernous hemangioma. D, Pyogenic granuloma of the lip. (A

and D, courtesy of John Sexton, M.D., Beth Israel Hospital, Boston; B, courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston; and C, courtesy of Thomas

Rogers, M.D., University of Texas Southwestern Medical School, Dallas, TX.)

Figure 11-31Bacillary angiomatosis. A, Photograph of a moist, erosive cutaneous lesion. B, Histologic appearance with acute neutrophilic inflammation and vascular (capillary)

proliferation. Inset, demonstration by modified silver (Warthin-Starry) stain of clusters of tangled bacilli (black). (A, courtesy of Richard Johnson, M.D. Beth Israel Deaconess Medical

Center, Boston, MA; B and inset, courtesy of Scott Granter, M.D., Brigham and Women's Hospital, Boston, MA.)

Figure 11-32Kaposi sarcoma. A, Gross photograph, illustrating coalescent red-purple macules and plaques of the skin. B, Histology of nodular form, demonstrating sheets of plump,

proliferating spindle cells. (B, courtesy of Christopher D.M. Fletcher, M.D., Brigham and Women's Hospital, Boston, MA.)

Figure 11-33Angiosarcoma. A, Gross photograph of angiosarcoma of the heart (right ventricle). B, Photomicrograph of moderately well-differentiated angiosarcoma with dense clumps of

irregular, moderate anaplastic cells and distinct vascular lumens. C, Positive immunohistochemical staining of angiosarcoma for the endothelial cell marker CD31, proving the endothelial

nature of the tumor cells.

Figure 11-34Balloon angioplasty and endovascular stents. A, Coronary artery with recent balloon angioplasty, in a low-power photomicrograph showing the split encompassing the intima

and media (arrow) and partial circumferential dissection. B, Gross photograph of restenosis following balloon angioplasty, demonstrating residual atherosclerotic plaque (left arrow) and a

new, glistening proliferative lesion (right arrow). C, Coronary arterial stent implanted long term, demonstrating thickened neointima separating the stent wires (black spot shown by arrow)

from the lumen (asterisk). (C, Reproduced from Schoen FJ, Edwards WD. Pathology of cardiovascular interventions, including endovascular therapies, revascularization, vascular

replacement, cardiac assist/replacement, arrhythmia control, and repaired congenital heart disease. In Silver MD, Gotlieb AI, Schoen FJ (eds): Cardiovascular Pathology, 3rd ed.



Philadelphia, Churchill Livingstone, 2001.)

Figure 11-35Anastomotic hyperplasia at the distal anastomosis of synthetic femoropopliteal graft. A, Angiogram demonstrating constriction (arrow). B, Photomicrograph demonstrating

Gore-Tex graft (arrow) with prominent intimal proliferation and very small residual lumen (asterisk). (A, courtesy of Anthony D. Whittemore, M.D., Brigham and Women's Hospital,

Boston, MA.)

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