Published: 2019-07-25

Vascular malformations: a hospital based study

Komanapalli Sunilkumar, Karthik Aithal, Unmesh Kumar Jena, Uma Prasad, Bhagyalakshmi Atla, P. V. Sudhakar


Background: Vascular anomalies comprise a widely heterogeneous group of lesions. Diagnosis and management of these lesions present challenges to the surgeons, radiologists and histopathologists. Accurate classification of these lesions results in appropriate therapy. Aim of the study is to study the role of histopathology and histochemical stain in the diagnosis of vascular malformation

Methods: The present study is a hospital based observational study on vascular malformations over a period of three years from 2016 to 2018 done in department of Pathology and Plastic Surgery at tertiary care centre, Visakhapatnam.

Results: Out of 107 specimens of vascular anomalies received, 72 cases were vascular neoplasms, 35 were vascular malformations. Majority of the vascular malformations were seen in the cervicofacial region (43%) followed by extremities (37.1%). Most common malformation in the present study was arterio venous malformations (60%) followed by venous malformations (22.8%). Verhoeff’s VanGieson stain demonstrated discontinuity of internal elastic lamina in cases of arteriovenous malformation and helped in differentiating the lesions from capillary malformation and vascular tumors.

Conclusions: Histopathology, special histochemical stains along with imaging features can be used to reduce diagnostic difficulties and in helping proper management of vascular malformations.


Arteriovenous malformations, Histopathology, Vascular malformation, Verhoeff’s VanGieson stain

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Lee BB, Do YS, Yakes W, Kim DI, Mattassi R, Hyon WS. Management of arteriovenous malformations: a multidisciplinary approach. J Vascular Surg. 2004;39(3):590-600.

Joshua A.Cox, Erica Bartlett and Edward I. Lee. Vascular Malformations: A Review. Semin Plast Surg 2014;28(2):58-63.

Sadick M, Mueller-Wille R, Wildgruber M, Wohlgemuth WA. Vascular anomalies (part I): classification and diagnostics of vascular anomalies. InRöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 2018;190(9):825-835. ©Georg Thieme Verlag KG.

Greene AK, Orbach DB. Management of arteriovenous malformations. Clin Plast Surg. 2011;38(1):95-106.

Lee BB, Laredo J. Classification of congenital vascular malformations: the last challenge for congenital vascular malformations. Phlebol. 2012;27(6):267-9

Miller DD, Gupta A. Histopathology of vascular anomalies: update based on the revised 2014 ISSVA classification, 35, 3. 2016;35(3):137-46.

Wassef M, Blei F, Adams D, Alomari A, Baselga E, Berenstein A, Burrows P, Frieden IJ, Garzon MC, Lopez-Gutierrez JC, Lord DJ. Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatr. 2015;136(1):e203-14.

Adegboyega PA, Qiu S. Hemangioma versus vascular malformation: presence of nerve bundle is a diagnostic clue for vascular malformation. Arch Pathol Lab Med. 2005;129(6):772-5.

Meijer Jorna LB, Breugem CC, DeBoer OJ, Ploegmakers JP, Vander Horst CM, Vander Wal AC. Presence of a distinct neural component in congenital vascular malformations relates to the histological type and location of the lesion. Human Pathology. 2009; 40(10):1467-73.

Enjolras O. Ch 104: Vascular Malformations. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd Ed. China: Elsevier/Saunders; 2011: 1711-1728.

Gupta A, Kozakewich H. Histopathology of vascular anomalies. Clin Plastic Surg. 2011;38(1):31-44.

Mitakshara Sharma, Varuna Mallya, Nita Khurana, Praveen Kumar and Rajan Duggal. Lymphovascular Malformation-A Report of Two Cases. J Clin Diagn Res.2017;11(5): ED03-ED04

Makhija LK, Bhattacharya S. Management of vascular anomalies: Review of institutional management algorithm. Indian journal of plastic surgery: official publ Assoc Plastic Surg Ind. 2017;50(2):193.

Karmacharya RM, Shrestha BK, Shrestha B, Devbhandari M, Tuladhar SM. Vascular anomalies: Presentation and response to medical and surgical management, our experiences in the last 5 years. Ind J Vasc Endovasc Surg. 2019;6(1):10.

Pawane P, Gangane N. Hemangiomas versus arterio-venous malformations: Role of elastic stains and mast cell density. Ind J Pathol Microbiol. 2014;57(2):191.

Girard C, Graham JH, Johnson WC. Arteriovenous hemangioma (arteriovenous shunt). A clinicopathological and histochemical study. J Cutaneous Pathol. 1974;1(2):73-87.