TY - JOUR
T1 - Lymphatic differentiation and microvascular proliferation in benign vascular lesions of skin and soft tissue
T2 - Diagnostic features following the International Society for The Study of Vascular Anomalies Classification—A retrospective study
AU - Utami, Amalia Mulia
AU - Lokhorst, Max M.
AU - Meijer-Jorna, Lorine B.
AU - Kruijt, Mara A.
AU - Horbach, Sophie E. R.
AU - de Boer, Onno J.
AU - van der Horst, Chantal M. A. M.
AU - van der Wal, Allard C.
N1 - Funding Information: Funding sources: This study was supported by the PhD Fellowship Grant for Amalia Mulia Utami from Indonesian Edowment Fund for Education (Lembaga Pengelola Dana Pendidikan - LPDP). Publisher Copyright: © 2023 American Academy of Dermatology, Inc.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Background: Discrepancies have been noted between the clinical and histologic diagnosis of vascular malformations. Objective: To evaluate the effectiveness of the International Society for Study of Vascular Anomalies (ISSVA) classification in diagnosing benign vascular anomalies based on clinical and (immuno) histologic parameters, focusing on lymphatic differentiation and vascular proliferation. Method: A retrospective study of 121 consecutive patients with benign skin and soft-tissue vascular anomalies located in the head and neck region (pyogenic granulomas and angioma senilis were excluded) by applying multiplex immunohistochemistry staining for lymph vessels (D2-40), endothelial blood vessels, and proliferating cells (Ki67). Clinical and histologic diagnosis was revised after the ISSVA classification. Results: Initially, 64 lesions were diagnosed as tumors and 57 as malformations. Revision diagnosis following the ISSVA classification revealed 27 tumors, 90 malformations (22.2% lymphatic), and 4 non-ISSVA. Immunostaining showed lymphatic differentiation in 24 (19.8%) of 121 cases, of which 20 were malformations. Proliferative activity (Ki67+) was found in 41 (33.8%) of 121 cases, of which 8 were arteriovenous malformations. Limitation: Quality and size of materials (biopsies vs resections) and clinical information. Conclusion: The diagnostic accuracy of combined histologic and clinical approaches for identifying vascular anomalies following the ISSVA classification can be substantially enhanced by incorporating additional immunostaining techniques to evaluate lymphatic differentiation and proliferative activity, particularly in identifying the occurrence of vascular malformations.
AB - Background: Discrepancies have been noted between the clinical and histologic diagnosis of vascular malformations. Objective: To evaluate the effectiveness of the International Society for Study of Vascular Anomalies (ISSVA) classification in diagnosing benign vascular anomalies based on clinical and (immuno) histologic parameters, focusing on lymphatic differentiation and vascular proliferation. Method: A retrospective study of 121 consecutive patients with benign skin and soft-tissue vascular anomalies located in the head and neck region (pyogenic granulomas and angioma senilis were excluded) by applying multiplex immunohistochemistry staining for lymph vessels (D2-40), endothelial blood vessels, and proliferating cells (Ki67). Clinical and histologic diagnosis was revised after the ISSVA classification. Results: Initially, 64 lesions were diagnosed as tumors and 57 as malformations. Revision diagnosis following the ISSVA classification revealed 27 tumors, 90 malformations (22.2% lymphatic), and 4 non-ISSVA. Immunostaining showed lymphatic differentiation in 24 (19.8%) of 121 cases, of which 20 were malformations. Proliferative activity (Ki67+) was found in 41 (33.8%) of 121 cases, of which 8 were arteriovenous malformations. Limitation: Quality and size of materials (biopsies vs resections) and clinical information. Conclusion: The diagnostic accuracy of combined histologic and clinical approaches for identifying vascular anomalies following the ISSVA classification can be substantially enhanced by incorporating additional immunostaining techniques to evaluate lymphatic differentiation and proliferative activity, particularly in identifying the occurrence of vascular malformations.
KW - ISSVA classification
KW - lymphatic vessels
KW - microvascular proliferation
KW - skin tumor
KW - soft-tissue tumor
KW - vascular anomalies
KW - vascular malformations
UR - http://www.scopus.com/inward/record.url?scp=85159226132&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jdin.2023.03.009
DO - https://doi.org/10.1016/j.jdin.2023.03.009
M3 - Article
C2 - 37228362
SN - 2666-3287
VL - 12
SP - 15
EP - 23
JO - JAAD International
JF - JAAD International
ER -