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Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign disease of unknown etiology, characterized by abnormal vascular proliferation. ALHE usually presents with painful, itchy, or asymptomatic lesions in the neck region, particularly around the ears. Clinically, it is usually around the ear, at the border of the scalp. It can be seen as single or multiple nodules or papules lesions on the neck and neck. Medium-sized peripheral muscular artery involvement is rare. A 41-year-old male patient, presented to a rheumatology clinic for 1 year history of a soft painless swelling in his bilateral temporal region. He sustained no preceding trauma to the area and had no additional symptoms. On physical examination, temporal arteries were prominent, but there was no tenderness. The patient had no clinical signs of temporal arteritis. Temporal artery Doppler ultrasound was performed, which revealed an echogenic asymmetric vessel wall thickening in the bilateral superficial temporal arteries. Temporal artery biopsy yielded the final diagnosis of ALHE, a rare vascular involvement of unknown etiology. ALHE is a condition that should be kept in mind in the differential diagnosis of temporal arteritis.

OBJECTIVES This study aims to investigate the effect of radial extracorporeal shock wave therapy (rESWT) treatment in the prevention of epidural fibrosis after laminectomy in rats. MATERIALS AND METHODS Eighteen 16-month-old male Sprague-Dawley rats weighing 300 g were used in this experimental study between November 2019 and February 2020. The rats were randomly divided into two groups as the control group (L3-L4 total laminectomy without any treatment) and the study group (L3-L4 total laminectomy plus rESWT). The rats were sacrificed at the postoperative sixth week and the lumbar spine was excised en bloc, fixed, and decalcified. Sections were stained with hematoxylin-eosin to evaluate epidural fibrosis, acute inflammation, chronic inflammation, and vascular proliferation. RESULTS The median value and standard deviations were obtained based on histological examinations. Accordingly, epidural fibrosis decreased significantly in the study group compared to the control group. There was no statistically significant difference between the groups in terms of acute and chronic inflammation response and vascular proliferation. CONCLUSION The rESWT application immediately after surgery is effective in preventing epidural fibrosis after laminectomy in rats.

The epithelioid hemangioma, more commonly termed angiolymphoid hyperplasia with eosinophils, is a pathologic vascular proliferation characterized by a distinctive eosinophil-rich mixed inflammatory infiltrate. A nonspecific accompanying infiltrate has only rarely been reported, and may confound the diagnosis of this benign process with malignant mimics. We present such a case of angiolymphoid hyperplasia without eosinophils, and consider its diagnosis and pathogenesis within the spectrum of related entities.

Angiomatous polyps are an uncommon subtype of sinonasal polyps, characterized by extensive vascular proliferation and ectasia. The authors report the first case of angiomatous polyp originating from the inferior turbinate, which is a variant of the sinonasal polyp.

Rapid progress of the discovery of genetic loci associated with common, complex diseases has outpaced the elucidation of mechanisms pertinent to disease pathogenesis. To address relevant barriers for coronary artery disease (CAD), we combined genetic discovery analyses with downstream characterization of likely causal variants, genes, and biological pathways. Specifically, we conducted a genome-wide association study (GWAS) comprising 181,522 cases of CAD among 1,165,690 participants. We detected 241 associations, including 54 associations and 30 loci not previously linked to CAD. Next, we prioritized likely causal variants using functionally-informed fine-mapping, yielding 42 associations with fewer than five variants in the 95% credible set. Combining eight complementary predictors, we prioritized 185 candidate causal genes, including 94 genes supported by three or more predictors. Similarity-based clustering underscored a role for early developmental processes, cell cycle signaling, and vascular proliferation in the pathogenesis of CAD. Our analysis identifies and systematically characterizes risk loci for CAD to inform experimental interrogation of putative causal mechanisms for CAD.

Pyogenic granuloma is a benign growth characterized by active vascular proliferation and is prone to occurring during pregnancy. Given the complicated conditions of this special group of patients, it is controversial to perform removal therapy before delivery. Here, two giant pregnancy pyogenic granulomas of a patient at 34 weeks gestation were safely, completely and minimally invasively removed by water-cooled Nd: YAG laser without anesthetic agents, suturing or antibiotics. No recurrence was observed after 1 year. This removal therapy immediately relieved the problem of patient nutrition intake and greatly improved the quality of her prenatal preparation. Thus, this report highlights that complete excision of pyogenic granulomas during pregnancy can be performed before delivery when urgent circumstances are considered, and a water-cooled Nd: YAG laser can be applied as a powerful tool in this treatment.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular tumor which presents as a dermal papule or a nodule over the head-and-neck region. Histopathologically, there is vascular proliferation in the upper dermis and diffuse lymphocytic infiltrate with eosinophilia. Kimura's disease is the closest differential of ALHE, which presents as subcutaneous nodules. We report a case of ALHE presenting with a violaceous papule overlying a subcutaneous nodule, histopathologically; both lesions were diagnosed as ALHE.

Introduccion : El objetivo de este estudio fue analizar y comparar las caracteristicas de las membranas que se forman alrededor de espaciadores de cemento y aquellas que rodean a implantes de titanio y acero. Materiales y Metodos : Veinte conejos en 2 grupos de 10: grupo 1, espaciador de cemento con antibioticos en femur derecho y clavo de titanio (TEN) en femur izquierdo; grupo 2, espaciador de cemento con antibioticos mas corticoide en femur derecho y clavija de acero en femur izquierdo. A las 6 semanas se extrajeron las membranas. Se evaluaron sus caracteristicas macroscopicas, bioquimicas, histologicas y en las imagenes. Resultados : Macroscopia: la membrana del cemento con antibioticos era significativamente mas ancha y, en el cemento con corticoide y el TEN, era muy fina y adherente. Microscopia: menos inflamacion en el cemento con corticoide (p = 0,0502), sin diferencias con las clavijas (p = 0,322). La proliferacion epitelial era mayor en las clavijas (p = 0,026) y escasa en el cemento con corticoide (p = 0,071). Hubo una leve tendencia a la proliferacion vascular (p = 0,107), de menor actividad, en el grupo con corticoide vs. sin corticoide. No hubo diferencias entre clavija y TEN (p = 0,737). No hubo diferencias significativas en las radiografias y la tomografia (p = 0,988). En la resonancia magnetica, la mayoria de las respuestas en el grupo 2 indicaron sin osteointegracion, debido a distorsion de la imagen (metal). Conclusiones : Diferentes materiales y los diferentes agregados alteran macroscopica e histologicamente las membranas. El cemento con corticoide presento menor inflamacion y fibrosis, menos proliferacion vascular, y membranas mas finas y adherentes. Abstract Background : The objective of this study is to analyze and compare the characteristics of the membranes that form around cement spacers; as well as the one that develops around titanium and steel implants. Materials and Methods : 20 rabbits were divided into 2 groups of 10. In Group 1, an antibiotic-coated cement spacer was placed on the right femur, and a titanium elastic nail (TEN) on the left one. In Group 2, an antibiotic/steroid-coated cement spacer was placed on the right femur, and a steel peg on the left one. At 6 weeks, the membranes were removed and its macroscopic, imaging, biochemical and histological characteristics were evaluated. Results : Macroscopy: The membrane induced by the ATB-coated cement spacer was significantly wider, whereas the one induced by the steroid-coated cement spacer and the TEN was very thin and adherent. Microscopy: The membrane induced by the steroid-coated cement spacer showed less inflammation (p = 0.0502) and was similar to the one induced by the steel peg (p = 0.322). Steel pegs showed greater epithelial proliferation (p = 0.026), which was scarce on the membrane induced by the steroid-coated cement spacer (p = 0.071). There was a mild tendency towards less active vascular proliferation (p = 0.107) in the group of the steroid-coated cement spacer vs. the one without steroids. There were no differences between the steel peg and the TEN (p = 0.737). X-rays and CT showed no significant differences (p = 0.988). In MRIs, most of the responses indicated lack of osseointegration in the steel peg group due to metallic artifacts. Conclusions : Different materials (titanium, steel and cement) with different agents added to them (antibiotics and steroids), alter the membranes both macroscopically and histologically. The steroidcoated cement spacer showed less inflammation and fibrosis, less vascular proliferation, and thinner and adherent membranes.

Background Angioma serpiginosum is a rare vascular anomaly whose pathogenesis is still unknown. It is characterized by the onset of vascular reddish macules and papules during childhood, lesions are usually monolateral with a linear serpiginous pattern. It is rarely associated with extracutaneous findings. This entity has not yet been included in the classification of the International Society for the Study of Vascular Anomalies. Case presentation We describe the first Italian report of angioma serpiginosum with a congenital symmetrical presentation. The patient had a further extension of macules during puberty involving both of the soles. No extracutaneous manifestations were present. Diagnosis was confirmed with dermoscopy and light microscopy that revealed the typical clusters of dilated, thickened and PAS+ capillaries in the upper dermis. Moreover, Immunohistochemistry showed positive WT-1 staining. Genetic analysis with next generation sequencing did not detected any mutation. Conclusions Our patient presented a peculiar symmetrical and planar extension with a serpiginous linear pattern. The proliferative nature of this condition has been widely discussed in literature. In our case immunohistochemistry was positive for Wilms tumor-1, a new endothelial marker expressed during angiogenesis in reparative processes and endothelial tumors. Clinical evolution, histological and immunohistochemical findings suggest that angioma serpiginosum should be considered as a vascular proliferation. For these reasons we think it should be included in the international classification as a tumor.

Cutaneous adverse events caused by aromatase inhibitors have been reported to be rare. We describe a rare case of a cutaneous adverse event that developed in a cancer-affected breast after aromatase inhibitor treatment. A 72-year-old postmenopausal female patient who was diagnosed with stage IA breast cancer received anastrozole as adjuvant treatment. Six months after the initiation of anastrozole, she developed an irregularly shaped purpuric plaque with several purpuric papules surrounding the postoperative scar on her left breast. Histological findings revealed capillary vessel proliferation and expansion, with hemorrhage in the superficial dermis. Immunohistochemistry of the skin biopsy specimen revealed hormone receptor expression limited to the vascular endothelial cells of the proliferating and expanding vessels. We believe that anastrozole induced a change in the local estrogen level, which affected the hormone receptor-positive endothelial cells in the dermis near the primary lesion of the breast cancer and caused a cutaneous adverse event only in the aforementioned area.

In this review, we systematically discuss the role of traditional Chinese medicine (TCM) in rheumatoid arthritis (RA) disease treatment. TCM classifies the subtypes of RA through its own theoretical method, which is beneficial for more accurate diagnosis and treatment with Chinese herbal medicines (CHMs) that are more suitable for different syndromes. TCM mainly uses a flexible combination of CHMs to play an important role in RA treatment. The main components of these extracts can be subdivided into alkaloids, flavonoids, triterpenes, saponins and other compounds. Using a platform of transgenic and induced arthritis models, we explore the potential mechanisms of TCM against RA with the help of omics analysis techniques and methods. These mechanisms are mainly CHM and its extracts can inhibit RA patients and experimental animal models, including synovitis, vascular proliferation and bone injury; this involves many biological signal exchange targets and pathways. In conclusion, the role of TCM in RA treatment mainly involves reducing the expression and secretion of pro-inflammatory factors, thus decreasing the degree of abnormal immune response.

Pyogenic granuloma (PG) is a common benign vascular proliferation that usually occurs on the skin and mucosa. Various treatment options exist in literature with no clear consensus. Our objective was to evaluate the efficacy and safety of sclerotherapy (sodium tetradecyl sulfate [STS]) in PG. This case series included 15 patients of PG, treated with intralesional injection of the STS (3%, 30 mg/ml) solution. All patients showed complete resolution of PG, without any major complication or recurrence during a 6-month follow-up period.

Vascular proliferation is considered an important feature in psoriasis. Early psoriatic changes are characterized by vascular network expansion; healing of the lesions ultimately results in a decreasing size of the vascular network. Currently, the response of the vasculature in psoriatic lesions during treatment of adalimumab is still obscure.To investigate the response of the vasculature in psoriatic lesions during adalimumab treatment, using parameters such as endothelial cell proliferation, vascular network size and alternations in vessel diameter.The endothelial cell response (endothelial cell proliferation rate, vascular network size and vessel diameter) was studied, using an immunohistochemical double-staining of Ki67/CD31, in subsequent biopsies of psoriatic lesions from 10 patients treated with adalimumab at baseline, 10 days and 16 weeks after initiation of treatment.In active psoriatic skin the endothelial cell proliferation ratio is high and an increased vascular network size and vessel diameter is found. An evident decrease in all these parameters is found during 16 weeks treatment with adalimumab. Keratinocyte proliferation already decreased significantly and substantially after 10 days treatment.Adalimumab treatment of psoriasis causes an evident reduction in endothelial cell proliferation, vascular network size and vessel diameter, parallel to the clinical improvement. Vascular parameters do not capture early improvement to adalimumab treatment, however (non-)invasive measurement of vascular function parallels, the clinical improvement and may be a valuable marker for disease activity.

Tendinopathies are common causes of pain around the elbow resulting in significant functional impairment in athletes or the working-age population. Patients complain of a gradual onset pain with or without any specific trauma. Tissue histology shows chronic fibroblast and vascular proliferation, with a disorganized collagen pattern and absence of inflammatory mediators. Currently, numerous treatment options are described, but many of these are only supported by a heterogenous evidence base. Thus, management guidelines are difficult to define. Surgery is mostly indicated in selected cases that have failed non-operative management. This article reviews the pathophysiology and natural history of lateral and medial elbow tendinopathies, as well as distal biceps and triceps tendinopathies, and their current treatment options.

A fast growing, circumscribed, unilateral swelling of the right mandible of a juvenile horse was observed. Within few weeks, the continuously growing mass reached dimensions ranging from 7 to 10 cm in diameter and resulted in loss of the first deciduous premolar of the affected side. The animal was euthanized due to lesion progression. Histologically the mandibular swelling consisted of numerous variably sized vascular structures, partly filled with erythrocytes and embedded in a loosely arranged fibrous stroma within the medullary cavity of the mandible. Juvenile mandibular angiomatosis was diagnosed. To the authors' knowledge this is the first description of this rare entity in the mandible of a foal.

Background The human skin is an extremely sophisticated and evolved organ that covers the whole body. External agents or the patient’s own diseases can cause skin injuries that can challenge healthcare professionals and impose high social, economic and emotional costs. Objectives To evaluate the impact of topical nifedipine on skin wound healing, specifically on polymorphonuclear cells, vascular proliferation, and collagen. Methods We used three pigs, and created eight injuries in the dorsal region of each animal. We applied 1%, 10%, and 20% concentration nifedipine creams to four of the wounds in animals 1, 2, and 3 respectively and treated the other twelve wounds with saline solution 0.9% only. We analyzed the presence of polymorphonuclear cells, vascular proliferation, and collagen at six different times (days 1, 3, 7, 14, 21, and 28). Results The evaluation of polymorphonuclear levels showed mild cell activity at all times in the control group, while in the nifedipine groups, marked levels were more frequent at all times during the experiment. There was a 4.84-fold increase in the chance of marked vascular proliferation (p = 0.019) and, at the same time, a decrease in collagen formation (OR 0.02 / p = 0.005) in animal 3. Conclusions Topical NFD may have an impact on skin wound healing mechanisms. Our study showed that polymorphonuclear cells and vascular proliferation increased. We also demonstrated that collagen formation decreased. Therefore, topical NFD may have a positive impact on skin wound healing. Additional studies are needed to confirm our results. Resumo Contexto A pele humana é um órgão extremamente sofisticado e evoluído que cobre todo o corpo. As lesões cutâneas podem ser causadas por agentes externos ou pelas próprias doenças do paciente, e podem representar um desafio para os profissionais de saúde com altos custos sociais, econômicos e emocionais. Objetivos Avaliar o impacto da nifedipina tópica na cicatrização de feridas cutâneas, especialmente em relação a polimorfonucleares, proliferação vascular e colágeno. Métodos Utilizamos três porcos e realizamos oito ferimentos na região dorsal de cada animal. Aplicamos as concentrações de nifedipina creme a 1%, 10% e 20% para os animais 1, 2 e 3, respectivamente, sendo que, em quatro ferimentos, aplicamos o creme e, nos outros quatro ferimentos, apenas soro fisiológico a 0,9%. Analisamos a presença de polimorfonucleares, proliferação vascular e colágeno em seis momentos diferentes (dias 1, 3, 7, 14, 21 e 28). Resultados A avaliação dos níveis polimorfonucleares mostrou atividade celular discreta em todos os momentos no grupo controle, enquanto nos grupos nifedipina, os níveis marcados foram mais frequentes em todos os momentos do experimento. Houve aumento de 4,84 vezes na chance de uma produção marcada (p = 0,019) da proliferação vascular e, ao mesmo tempo, diminuição da formação do colágeno (odds ratio, OR 0,02; p = 0,005) no animal 3. Conclusões A nifedipina tópica pode ter impacto no mecanismo de cicatrização cutânea. Nosso estudo mostrou que há aumento dos polimorfonucleares e da proliferação vascular. Além disso, há diminuição da formação do colágeno. Assim, a nifedipina tópica pode ter impacto positivo na cicatrização das feridas cutâneas. Estudos adicionais são necessários para confirmar nossos resultados.

Inflammatory or allergic sinonasal polyps are characterized by extensive vascular growth and ectasia with deposition of pseudoamyloid in 5% of cases. Angiomatous nasal polyp (ANP) is a relatively rare benign lesion, which may be misdiagnosed as a benign or malignant tumor. The characteristic pathological features of ANP are expanded angiogenesis, accumulation of extracellular amorphous eosinophilic substance, and atypical stromal cells. This report aimed to outline the histological differential diagnosis of ANP. Through a full histopathological examination, we studied biopsies and resected specimens from five patients who were diagnosed with ANPs, including one with facial deformity. Gross findings showed that tumors were firm in consistency, lobulated on the surface, and lined by partially ulcerated mucous membrane. Light microscopy showed clusters of widened, thin-walled blood vessels among congo red-negative eosinophilic substance with an area of necrosis and irregular stromal spindle cells. Presence of endothelial cell myofibroblasts were confirmed by electron microscopy and immunohistochemistry. This is a report of four cases which showed extreme examples of ANPs that was completely resected by endoscopic sinus surgery for all patients. A full histopathological examination is recommended to confirm the possible differential diagnoses for a better management plan.

Objective: We aimed to evaluate and compare the effects of anti-adhesion materials,Seprafilm, Suprofilm, olive oil, and olive oil containing Vitamin E by measuring tensionforces.Methods: 60 male Wistar-Albino rats were divided into six groups. The front side of thececum and right abdominal parietal peritoneal wall were abrased. The rats wereeuthanized on the 14th postoperative day. Adhesions between intestines, omentum, otherabdominal organs, cecum, incisionsites, and abdominal anterior wall peritoneum were allevaluated. Adhesion strength was measured with dynamometer. Histopathologicalevaluations of the adhesion area was performed.Results: Stage-I (0.43Newton) in Group-I, stage-IV (1.0540N) in Group-II, stage-II(0.6370N) in Group-III, stage-II in Group-IV (0, 5230N), stage-III (0.7620N) in Group-V,stage-IV (1.3560N) in Group-VI, were detected. A significant difference was foundbetween these findings. P = 0.001, (p

Diffuse dermal angiomatosis of the breast can be a painful, irritating, and persistent inflammatory condition. It tends to present in middle age and is associated with a number of risk factors, mainly relating to tissue hypoxia. There are no standard treatment guidelines, and current treatment focuses on mitigating tissue hypoxia by addressing atherosclerosis through lifestyle changes and medical and/or surgical intervention. Herein, we present a case of diffuse dermal angiomatosis of the breast, describing the condition and current treatment approaches and the likelihood that this diagnosis is more common than previously believed.

The historical descriptions of glial tumors are often poorly understood and interpreted. The gross and histological depictions of glial tumors are often credited to Virchow, and while the first true histological description is truly his, gross descriptions can be traced back to the beginning of the 1800s, with their classification and histogenesis attributed to Percival Bailey and Harvey Cushing. Without any question, the most prominent and under-credited researcher in the field of glioma pathobiology was the German neuropathologist Hans Joachim Scherer. Despite the limited armamentarium available to him, his systematic approach led to conclusions, some of which have now been molecularly explained today while some are still being widely researched. Scherer defined pseudopalisadic necrosis as a pathognomonic feature of glioblastoma multiforme (GBM), as well as secondary features due to tumor growth, known collectively as secondary Scherer figures, for example, neuronal and vascular satellitosis, tract and subpial aggregation. All these features are key points in the modern histological diagnosis of glial tumors. Other contributions by Scherer include the definition of glomeruloid vascular proliferation and his conclusion that they are caused by vascular factors released by the tumor, decades before vascular endothelial growth factor and its receptors were discovered and their role in glioma evolution was established. Furthermore, he concluded that GBMs can arise de novo (primary) or from a preceding lower-grade glioma (secondary). All his contributions find their place in all modern aspects of glioma research, with some giving a simple explanation of the phenomena observed in glial tumors.

Pyogenic granuloma (PG) is a benign vascular proliferation of the skin and mucosae, that has been treated with different regimens with variable success and recurrence rates; however, the management of PG still remains a challenging issue, particularly in children and in adult cases with lesions localized at sites difficult to access. Imiquimod, a member of the imidazoquinoline family of immune response modifiers, is a topically applicable TLR-7/8 agonist that reveals potent antiviral, antitumor, immunoregulatory and antiangiogenic properties. In the present paper we report the case of a 9-year old boy with suborbital pyogenic granuloma, successfully treated with topical daily application of imiquimod 5% cream without occlusion. 8 weeks after onset of topical imiquimod treatment a complete resolution of the lesion without any scarring was observed. No systemic side effects were seen and the patient remained well throughout the course of therapy. He is presently completing a 15-month follow-up and has revealed no relapse. The findings of the present study suggest that topical imiquimod is a safe, effective and well-tolerated treatment for PG in children, even at difficult to treat areas like the suborbital region.

Intravascular papillary endothelial hyperplasia or Masson’s hemangioma is a rare vascular tumor. The reactive proliferation of endothelial cells in this disease mimics other benign or malignant vascular proliferation such as angiosarcoma or Kaposi’s sarcoma. It is important to make an accurate distinction to avoid confusion with these malignant tumors. This would facilitate a proper diagnosis, which is essential so that the patient is not subjected to unnecessarily aggressive or inappropriate treatment.

Intravascular papillary endothelial hyperplasia (IPEH) or Masson’s tumour is a benign vascular proliferation that mimics other malignant vascular tumour. To date, this is the fourth case of Masson’s tumour at urethra being reported in the literature. A 65-year-old female Para 2, presented with post-menopausal bleeding. Examination revealed a 4x3x3 cm growth surrounding the urethral meatus. She underwent examination under anaesthesia and excision of the periurethral mass. Histopathological examination confirmed Masson’s tumour. Diagnosis and management of this uncommon tumour at a rare location was discussed.

Acquired elastotic hemangioma is a hemangioma variant first described in 2002. It is characterized by being a benign, solitary, slow-growing lesion, that appears in adulthood and is associated with solar exposure. It is a rare hemangioma variant with few cases reported in the literature. We present a case of acquired elastotic hemangioma on the back of the right hand and forearm in a male adult. Acquired elastotic hemangioma is a benign vascular proliferation associated with solar exposure, usually assymptomatic. It affects adults between 59 and 65 years of age. Histopatologically it is characterized by proliferation of small vessels in the upper dermis that are disposed parallel to the epidermis, and significant solar elastosis. The treatment is surgical, with no relapses reported.