What are the characteristics of a hemangioma? What are the symptoms of hemangioma?

Pathologic features of hepatic hemangioma.

Hepatic hemangioma can occur alone, or it can occur to more than a dozen, and can occur in both left and right hepatic lobes, but the right hepatic lobe is more common, and a few are diffuse growth, which can occupy most of the liver or even the entire liver. Embryonal vascular hamarts originating from the liver are formed by causing tumor-like hyperplasia under the action of certain factors. The texture of the tumor is soft, the incision surface is honeycomb-shaped, filled with blood, compressible, and shaped like a sponge, so it is called hepatic cavernous hemangioma.

The tumor is purplish-red or blue-purple, with a clear border, smooth or irregular lobulation, filled with blood, and cystic sinuses of various sizes can be seen under the microscope, and the sinuses are lined with a layer of endothelial cells, and the sinuses are covered with red blood cells and sometimes thrombosis. The sinuses are separated by fibrous tissue, occasionally with compressed cell cords, and large fibrous septum with blood vessels and small bile ducts, and calcifications or phleboliths may occur in the fibrous septum and lumen.

1) Manifestations of simple capillary hemangioma: different sizes, different shapes, slightly higher than **, bright red or purple-red plaque-like masses, which do not fade or shrink after compression.

2) Yangmei hemangioma manifestations: protruding ** surface, strawberry-like, more common in the head and neck, usually not at birth, but within a few weeks after birth, increase within a few months, grow rapidly, even up to a few centimeters, mostly grow to the maximum within 1 year old, and then can degenerate on its own, and can completely or incompletely regress within a few years.

3) Bright red nevus, also known as telangiectasia nevus or port-wine nevus Clinical manifestations: one or several dark red or blue-red patches, with irregular edges, flattened, not prominent**, bright red or dark red into patches, which can fade after compression, generally more common in the head and neck, present at birth, and can increase as the human body grows up; Lesions that occur in the occipital region, frontal area, or bridge of the nose may resolve spontaneously, and larger or extensive lesions often persist uninterrupted throughout life.

4) Cavernous hemangioma manifestations: occur at birth or shortly after birth, mostly occur on the scalp and face, and can involve the oral cavity or pharyngeal mucosa; The appearance is purple-red, the peripheral superficial veins are increased, tortuous, distended, soft and elastic, can be reduced when squeezed, but quickly return to the original volume, a few surfaces can be combined with bright red nevi, after injury or vascular embolism, ulcer infection and degeneration can occur.

Hemangiomas have different symptoms depending on the structure and location of occurrence. In general, capillary hemangiomas on the surface are more common in infants, with red spots or small erythema on them, which gradually enlarge and protrude on the surface and appear red. Cavernous hemangioma can make a local raised lump, normal or purple in color, soft and elastic, with unclear borders and compressibility.

Cranoid hemangioma is a blood vessel with relatively large blood vessels with arteriovenous fistula, and a bruit can be heard; The early symptoms of visceral hemangioma are not obvious, and when it enlarges to a certain extent, it will cause symptoms of organs, and relatively large visceral hemangiomas will rupture and bleed, which may also be life-threatening.

Hemangioma grows in the maxillofacial area, because the maxillofacial physiological structure is complex, the face is thin and soft, containing more sebaceous glands and hair follicles, so it is easy to be infected. There are also nerves, blood vessels and parotid ducts passing through the superficial fascia, and the nerves and blood vessels are abundant, so there is a lot of bleeding after trauma, which is easy to damage the nerves and cause sequelae such as facial paralysis.

The typical symptoms of hemangioma are visible tumor protrusions, clear borders, sometimes palpable pulsations, and a small number of patients may be complicated by ulcers, thrombosis, bleeding and other manifestations. In severe cases, complications such as coagulation dysfunction and heart failure may occur.

Hemangioma is a common benign tumor, which can be divided into congenital and acquired hemangiomas, and hemangiomas should be classified according to the location, depth and age of hemangioma. Hemangiomas mainly include capillary hemangiomas, cavernous hemangiomas, and cranoid hemangiomas, and the causes of the disease are not yet clear, and may be related to genetics, congenital dysplasia in the embryonic period, hormones, drugs, trauma, and environmental factors, and are usually caused by changes in the local microenvironment in the blood vessels and abnormal transformation of endothelial cells. It can occur on the face, limbs and other parts**, and can also appear in organs such as the liver.

If it is a small intracutaneous capillary hemangioma, neonatal capillary hemangioma, intrahepatic hemangioma, etc., and the growth is slow, there are generally no symptoms and will not affect the human body, and may even disappear with age, so it usually does not need to be special**. However, if the hemangioma affects the patient's face or life, grows too fast, is too large, etc., it needs to be considered on a case-by-case basis**.

The main symptoms of hepatic hemangioma are:

1) Abdominal mass: the mass has a cyst**, no tenderness, smooth or not smooth surface, and conduction vascular bruits can sometimes be heard on auscultation at the mass site;

2) Gastrointestinal symptoms: vague pain and discomfort in the right upper quadrant, as well as loss of appetite, nausea, vomiting, belching, post-food distension and satiety, indigestion, etc.;

3) Compression symptoms: Huge hemangiomas can push and compress surrounding tissues and organs. compression of the lower end of the esophagus, which may cause dysphagia; compression of the extrahepatic biliary tract, which may cause obstructive jaundice and gallbladder effusion; compression of the portal venous system, which may cause splenomegaly and ascites; Compression of the lungs may cause dyspnea and atelectasis; compression of the stomach and duodenum, gastrointestinal symptoms may occur, etc.;

4) Hepatic hemangioma rupture and bleeding, which can cause severe pain in the upper abdomen, as well as symptoms of bleeding and shock, is one of the most serious complications, and is extremely rare for patients with large hepatic hemangiomas that grow below the costal arch due to external force causing rupture and bleeding;

5) Kasabach-Merritt syndrome, which is a hemangioma with thrombocytopenia and a large amount of coagulation factor depletion.

Capillary hemangioma symptoms: telangiectasia, congestion and rupture, so repeated cycle destruction, cannibalization of the affected area's ** and subcutaneous muscle tissue. More than 90% of capillary hemangiomas are congenital, and they are generally acquired shortly after birth or after local trauma, with the most occurring in the head and face, and can occur in any part.

The symptomatic incidence of strawberry hemangioma accounts for about 1% of newborns, mostly present at birth, with small red spots, which gradually increase later, often higher than **, bright red in color, lobulated, and shaped like strawberry or bayberry. The growth site is more common in the head, face, and trunk.

Symptoms of bright red nevi often appear at birth or shortly after birth, usually on the face, neck, and scalp, and are mostly unilateral and occasionally bilateral, sometimes involving mucous membranes. Lesions begin with several patches of pale red, dark red, or purplish-red patches of varying size, not rising above the skin surface, and have a smooth surface. With age, the color darkens, reddens, and purple, and in 65% of patients, the lesion will gradually expand, thickening and nodules may appear before the age of 40, and it is easy to bleed after trauma.

Cavernous hemangioma symptoms: Cavernous hemangioma can occur in any part of the body, either on the surface of the body or in various internal organs, especially in the limbs, trunk and parotid glands. The tumor** may be normal or dark blue, soft to the touch like a sponge, the lump can be compressed by pressing, and the patient complains of heaviness and soreness in the affected limb, which is obvious after activity.

Some cavernous hemangiomas may have capillary hemangiomas on the surface**, which is called mixed hemangiomas.

Symptoms of mixed hemangioma: At the beginning, most of them are small erythema of different surface sizes, which is no different from a simple strawberry-shaped hemangioma, but with the development of surface hemangioma, it invades the dermis and subcutaneous tissues at the same time, and the scope of invasion is sometimes very wide, so that the tissues and organs such as eyes, lips, nose or ears are covered by this expanding vascular tissue, which can cause dysfunction such as breathing, eating, vision and hearing.

Symptoms of cranoid hemangioma: Cranoid hemangioma is more common in the scalp, frontotemporal or extremities, some of which are more localized, but most of them are large, even reaching the entire limb, making the affected limb thicker and longer. The appearance can be seen as a local raised lump, or multiple subcutaneous bulging masses are connected, **flushed, the skin temperature is high, and purple-blue masses can be seen through**.

Tortuous vascular pulsations and peristalsis can be faintly felt, and cord-like soft enlarged blood vessels can be palpated, and vascular bruits can be heard on auscultation.

Symptoms of KM syndrome: large cavernous hemangiomas or mixed hemangiomas may be present.

Kasabach-Merrit syndrome. This syndrome refers to a hemangioma with thrombocytopenia syndrome. The incidence is about 1% of children with hemangiomas.

The pathogenesis is due to the large tumor body, slow blood flow, and surgical damage to the intima of blood vessels, so that the tumor retains and consumes a large number of platelets, fibrinogen, coagulation factors, and , and as a result, coagulation disorders occur. Symptoms and signs: In the first year of life, especially in infants around 6 months of age, the tumor at rest before the onset of the disease suddenly enlarges and has a purplish-red surface, accompanied by local and then generalized ecchymosis until the DIC manifestations.

The appearance resembles the manifestation of acute staining of soft tissues. Routine blood examination showed thrombocytopenia, which was life-threatening in severe cases. 【Shanghai Fuda hemangioma】

Hemangioma is a local vascular lesion formed by the abnormal growth of local blood vessels, and hemangioma is a benign disease, and its symptoms mainly include the following aspects:

1. Pain and pain: hemangioma will cause local pain, such as liver hemangioma, if the hemangioma is large, it will form local pain on the surface of the liver, and the pain can persist in severe cases, and many patients decide to undergo surgery or intervention because of this**;

2. Hemorrhage: Hemangioma itself is a vascular lesion, once there is trauma, the damaged hemangioma will easily cause uncontrollable bleeding, so when suffering from hemangioma, it is necessary to pay attention to avoid unnecessary accidental injury;

3. Affect aesthetics: In the case of hemangioma, if the hemangioma is located on the surface of the patient's body, which affects the patient's appearance, plastic surgery is sometimes required. At this time, a regular and experienced clinician should be selected to perform the operation, so as to ensure not only the surgical resection of the hemangioma, but also the local aesthetics after surgery.

Infantile hemangiomas are congenital benign tumors that are malformations of blood vessels that occur at or shortly after birth. It originates from residual embryonic vascular blasts. Hemangiomas are usually found at birth and can shrink on their own, with a rapid growth phase at 6 to 12 months after birth, and gradually shrinking over the next few years.

About 50% of infantile hemangiomas disappear within 5 years, and some can persist until about 10 years of age. Infantile hemangiomas generally resolve on their own, and after healing, the blood in the body will form antibodies to various blood diseases such as leukemia, hypertension, hemophilia, and anemia. People who have infantile hemangiomas as young adults will have healthier blood in adulthood.

On the contrary, people who have not suffered from infantile hemangioma in childhood may suffer from various blood diseases in adulthood Hemangioma has different symptoms due to the growth of different parts, which often occurs on the head, face and neck, affecting the appearance of the baby, especially the infantile hemangioma that occurs in the nose, ears and lips, which will cause tissue deformation after ulceration, so special attention should be paid to.

Cranoid hemangioma.

It is more common in the limbs, and there are many dendritic dilated blood vessels on the surface and around them, which are tortuous and vine-like, and the local ** is dark red or blue-purple, and sometimes the blood vessels can be felt or the vascular bruit can be heard. For this type of hemangioma, surgery should be performed as soon as possible, and the limb can also be bandaged with elastic bandages to relieve symptoms such as soreness in the limb.

2. Capillary hemangioma.

It is more common in **, with the occipital, head, face, limbs and back being the most, and many are longer than the lips and tongue. Capillary hemangiomas vary in size, from large ones that can occupy most of the face or limbs, to small ones that are only a few millimeters and slightly higher than **. Capillary hemangiomas are generally present after birth, grow rapidly within 6 months, and gradually stop growing after 1 or 2 years of age.

It is aesthetically pleasing and poses a risk of massive bleeding after breakage, so parents should pay close attention to it. If the hemangioma is small, slower-growing, and not in the exposed area, it can resolve on its own when it stops growing. If the hemangioma grows rapidly and seriously affects the aesthetics, it should be carried out immediately**, and isotope dressing and other methods can be used**.

3. Cavernous hemangioma.

It can occur in **, subcutaneous tissues, muscles, and even liver, kidneys, etc. The appearance is purple-red, surrounded by tortuous and distended small veins, which are soft and elastic, shrink when squeezed, and recover after decompression. This type of hemangioma grows in size as the baby gets older, sometimes very large and deep, severely damaging the appearance and destroying normal tissue.

Once the diagnosis is confirmed, it should be performed immediately**, with sclerotherapy injection or surgical excision.

4. Erythematous nevus. Also known as wine stains. Immediately after birth, it is a pale red or dark red plaque, which does not fade when pressed, does not rise above the ** surface, is located in the dermis, and is composed of a capillary network.

After birth, the erythematous nevus grows proportionally with the growth of the body, but the extent no longer expands. Erythema does not go away on its own. In addition to affecting the appearance, erythematous nevi generally have no other harm, and can be frozen if necessary**.

5 orange spots. Immediately after birth, the plaques vary in size, orange-red or light red, not higher than the ** surface, fade when lightly pressed, and darken when crying. Orange spots are more common on the forehead, upper eyelids, and occipital area and usually resolve spontaneously within a few months of life and do not need to be treated.