Surgical Pathology Criteria

Hemangioma of the Breast

Differential Diagnosis

Angiosarcoma of the Breast Hemangioma of the Breast
Diffuse Circumscribed
Infiltrates and destroys lobules Adjacent to or surrounds lobules
Rarely <2 cm Rarely >2 cm
No fibrous septa Fibrous septa forming lobules of angioma
No feeder vessels May have feeder vessels
Complex anastomoses Few anastomoses, not complex
Intermediate and high grade tumors are cytologically atypical Focal atypia at most
Frequent papillae or tufting No papillae or tufting
May have hemorrhage and necrosis No hemorrhage or necrosis
No muscular walls Venous hemangioma may have muscular walls
Complete excision and examination are required to insure accurate diagnosis of an apparently benign vascular lesion in the breast

 

Hemangioma Pseudoangiomatous Stromal Hyperplasia
Endothelial lined spaces No true lining to spaces
CD31 positive CD31 negative
Red blood cells in some spaces No red blood cells in spaces

 

Angiomatosis Perilobular Hemangioma Hemangioma Venous Hemangioma
Mass lesion Microscopic, incidental lesion Mass lesion Mass lesion
Diffuse, infiltrating Localized Localized Localized
Cavernous Predominantly capillary Usually cavernous Cavernous
Complete excision and examination is required for the diagnosis of any benign vascular lesion in the breast

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