Morphological characterization of infantile hemangiomas: An Indian study

Context: Vascular tumors of infancy and childhood consist of a number of clinicopathologically distinct entities. Infantile hemangiomas (IH) constitute the bulk of these tumors. As they are seldom biopsied, we do not encounter an opportunity to study them, and this is evident from the paucity of reported cases in pathology literature from India. Clinicians and pathologists alike have traditionally tended to lump these tumors, under overly generic terms like capillary hemangioma which do little to guide proper clinical management. Aims: To delineate the morphological features that characterize IHs and outline the morphological changes seen in different phases of evolution of this tumor. Subjects and Methods: We characterized 21 cases of IHs over a period of 60-months. Mast cells were counted in 10 fi elds of high density, and mast cell density per square millimeter area was calculated. Results: Female to male ratio was 1:1.6. Head and neck were the most common region involved (71.4%). Morphological features were described. Mast cell density/square millimeter area ranged from 126.9 to 285.7. Spearman correlation coeffi cient was 0.681 (P = 0.676). Statistical Analysis: Spearman correlation coefficient was used to analyze the relationship between mast cell numbers and the age of the lesion. Conclusions: Morphological features seen on routine microscopy can easily help distinguish a lobular capillary hemangioma from an IH or a congenital hemangioma even in the absence of relevant clinical details, pointing to a need for looking beyond using a generic term of capillary hemangioma.