Histopathological reporting of paediatric cutaneous vascular anomalies in relation to proposed multidisciplinary classification system

J Clin Pathol. 2006 Dec;59(12):1278-82. doi: 10.1136/jcp.2006.038240. Epub 2006 Jun 2.

Abstract

Background: The terminology applied to vascular anomalies has been variable in previously published literature making interpretation suboptimal. The International Society for the Study of Vascular Anomalies (ISSVA) has proposed a revised classification based on clinical features and histopathological findings. This classification is increasingly being accepted as clinically useful and a platform for future studies.

Aims: To examine the extent to which the ISSVA classification can be practically applied to diagnostic histopathological specimens.

Methods: Cutaneous vascular lesions received in a single paediatric pathology unit during a 2-year period (2004-5) were reviewed, including glucose transporter protein 1 (GLUT1) immunostaining where required, and lesions were reclassified according to the ISSVA classification.

Results: 144 specimens were identified. Appropriate full clinical information was provided in only 17% of cases at submission. Infantile haemangiomas comprised 46% of cases, 18% of which were regressive type, initially inaccurately identified as vascular malformations before GLUT1 immunostaining. 30% of lymphatic malformations and all lymphovenous malformations were previously classified as vascular malformations, not otherwise specified.

Conclusions: The ISSVA classification of vascular anomalies provides a useful framework for histopathologists to classify vascular anomalies. However, meaningful and appropriate use of such a system is dependent on the adequacy of clinical information provided and routine use of immunohistochemical markers.

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Blood Vessels / abnormalities
  • Child
  • Child, Preschool
  • Glucose Transporter Type 1 / metabolism
  • Hemangioma / classification
  • Hemangioma / pathology*
  • Humans
  • Infant
  • Lymphatic Abnormalities / diagnosis
  • Skin / blood supply
  • Skin Diseases, Vascular / classification
  • Skin Diseases, Vascular / pathology
  • Skin Neoplasms / classification
  • Skin Neoplasms / pathology*

Substances

  • Biomarkers, Tumor
  • Glucose Transporter Type 1
  • SLC2A1 protein, human