Tufted Angioma Workup
- Author: Mitchel P Goldman, MD; Chief Editor: Dirk M Elston, MD more...
No specific laboratory study is useful in the diagnosis or treatment of tufted angioma. Urinary levels of basic fibroblast growth factor are of no value in the diagnosis of this condition, unlike juvenile capillary angioma.
If the coexistence of Kasabach-Merritt syndrome is suspected, a CBC count with a determination of the platelet count, prothrombin time and/or activated partial thromboplastin time, and full disseminated intravascular coagulation profile is indicated.
MRI studies have been proven useful in the examination of patients with deep and/or extensive tufted angiomas. MRI has been successful in evaluating the depth of invasion and extent of growth of tufted angiomas that extend deep into the muscle and fascia.
No other tests are recommended for tufted angioma.
Other than biopsy for diagnosis and the surgical treatment described below, no other procedures are indicated for tufted angioma.
Tufted angiomas have a specific histologic pattern. They are characterized by the lobular arrangement of densely cellular capillaries, which appear similar to cannonballs, that are distributed throughout the dermis. The vascular tufts consist of tightly packed hypertrophic endothelial cells with scanty cytoplasm and nuclei that are round, ovoid, or fusiform.
Mitoses are abundant, but atypia and pleomorphism are rare. Occasionally, hemosiderin deposits may be observed within the endothelial cells. Capillary spaces are narrow and elongated, and they are more noticeable in the periphery of the lobules, where they have a characteristic half-moon shape.
The capillary lobules are present throughout the dermis and subcutaneous tissue; the epidermis is uninvolved in most cases. Rare cases with fascial and muscular involvement are reported. The surrounding appendageal structures of the dermis are unaffected, although hypertrophy of neighboring eccrine sweat glands is reported. No edema or inflammation surrounds the vascular lobules.
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