Benign tumors in the lungs. Classification: disease of the skin and internal organs of humans. Hemangioma: causes of occurrence

This is a rare benign tumor-like formation of the lungs, represented by a conglomerate of overgrown and anastomosing blood vessels. Symptoms of a tumor may include hemoptysis, chest pain, shortness of breath, cyanosis, weakness, and spontaneous pulmonary hemorrhage. The diagnosis of pulmonary hemangioma is based on data clinical picture, radiography and CT scan of the chest, angiography, bronchoscopy, ultrasound with Dopplerography of blood flow. Treatment of hemangioma is surgical, usually excision of the tumor, economical resection of the affected area of the lungs or bronchus, and lobectomy.

ICD-10

D18 D14.3

General information

Pulmonary hemangioma is an intrapulmonary or endobronchial vascular tumor of mesodermal origin with a benign course. Hemangiomas can develop in any organ, but are rarely detected in the lungs. In addition to hemangiomas, pulmonology also has to deal with other angiomas - hemangioendothelioma, hemangiopericytoma, lymphangioma, glomus tumor. Lung hemangiomas are characterized by clear demarcation from surrounding tissues, fairly slow growth and lack of tendency to malignancy. Vascular tumor of the lungs is more often detected in older children and adults, mainly males. Pulmonary hemangioma can be combined with another pathology of vascular development - telangiectasia of the skin and various organs.

Causes

Vascular formations are believed to be congenital vascular anomalies. The risk of developing pulmonary hemangioma in a newborn increases if the mother’s pregnancy was complicated by taking certain medications (hormones, etc.), viral or bacterial infections, unfavorable ecological environment. In adults, possible factors for the appearance of pulmonary hemangioma are hereditary predisposition, prolonged exposure to ultraviolet radiation, internal pathology, contributing to vascular disorders.

Pathogenesis

According to histogenesis, hemangioma is a dysontogenetic formation. The formation of pulmonary hemangioma is based on a congenital disorder of the development of vascular tissue (vasculogenesis), accompanied by its hyperplasia and the appearance of excess vascular buds. Cells vascular tumor begin their growth at the embryonic stage or shortly after the birth of the child. As part of a pulmonary hemangioma, atypically located elements of the vascular wall are detected, primarily, cells of the internal lining of blood vessels - endothelial cells, which have the ability to reproduce.

Hemangioma is a round tumor, surrounded by a connective tissue capsule, of dense or densely elastic consistency, which can have various shades of pink or red. The size of a hemangioma can vary from a few millimeters to 20 or more centimeters in diameter.

Classification

According to morphological criteria, hemangiomas can be capillary (simple or hypertrophic), cavernous (cavernous), combined and mixed.

Capillary hemangiomas(about 50% of all types of this tumor) are represented by proliferation and interweaving of dilated capillaries, usually with proliferation and hyperplasia of the endothelium, located in the form of concentric groups and elongated cords. More common in infants. Capillary hemangiomas are characterized by infiltrating growth, intensive new formation of small thin-walled vessels that even grow into the walls of arteries and veins.
Cavernous hemangiomas consist of many blood-filled arteriovenous cavities (sinusoidal areas) with thin connective tissue septa and endothelial lining. They are formed from larger blood vessels and can be significant in size.
Combined hemangiomas. Combined (capillary-cavernous) hemangiomas combine proliferating areas of immature capillary elements and cavernous sinuses, limited by mature endothelial cells.
Mixed hemangiomas are formed various types tissues (for example, angiokeratoma).

By localization, pulmonary hemangiomas are predominantly intrapulmonary, less often endobronchial; can be central or peripheral. Multiple hemangiomas affecting one or both lungs are common. There is a special sclerosing hemangioma of the lungs (pneumocystoma, fibroxanthoma, vascular endothelioma, alveolar angioblastoma) - a benign neuroendocrine pulmonary tumor, which contains hemangiomatous foci (angiomatous component). Pulmonary hemangioma is usually limited lung tissue and does not spread further; There are isolated cases of its invasion into the chest.

Symptoms of pulmonary hemangioma

The clinical picture of pulmonary hemangioma depends on the diameter, location and nature of the vascular formation. Due to slow growth over many years, the manifestations of a small hemangioma may be absent or quite sparse. Symptoms of pulmonary hemangioma usually develop when complications occur. With rapid growth, ulceration of the tumor is possible. Patients may be bothered by chest pain, hemoptysis, spontaneously occurring pulmonary hemorrhages (especially with cavernous hemangiomas).

With pulmonary hemangioma, which forms vascular (arteriovenous) fistulas between the pulmonary artery and vein, hemodynamic disorders occur. Chronic hypoxemia leads to shortness of breath, cyanosis and frequent dizziness; in children, growth and development may also be delayed. With vascular fistulas located at the level of segmental branches, the course of pulmonary hemangioma is asymptomatic. There is a gradual increase in polycythemia. Sometimes it is possible to detect noise in the vessels of the lung at the site of the tumor.

Complications

The danger of pulmonary hemangioma lies in the possible rupture of the tumor (with trauma or severe ulceration) with massive blood loss and risk of death. It is possible to develop compression syndrome of blood vessels and tissues, infection of the ulcerated hemangioma with the occurrence of a purulent process in the lungs and deterioration of the patient’s condition.

Diagnostics

The diagnosis of pulmonary hemangioma is established by a pulmonologist and is based on anamnesis and clinical picture (presence of episodes of hemoptysis or pulmonary hemorrhage), radiography, CT scan of the chest, ultrasound with Doppler ultrasound, pulmonary vascular angiography, bronchoscopy. Typically, pulmonary hemangiomas are discovered accidentally or already at the stage of complications. An indirect sign of a tumor can be the presence of telangiectasia in other organs and on the skin.

On a chest x-ray, hemangioma is visualized as a spherical or oval shape, having clear but usually irregular scalloped edges. Increased density is often detected lung root due to enlargement of the pulmonary vessels. It is possible to detect a direct connection of the hemangioma with the pulmonary vessels, establish the autonomous pulsation of the tumor, a decrease in its shadow during exhalation, an increase in size and darkening during inspiration.

Ultrasound with Doppler sonography is highly informative for vascular tumors, as it allows you to determine the volume of hemangioma, its structure and hemodynamic state. Confirmed using angiography vascular character tumor formation, its localization and prevalence, features of hemangioma (clear limitation, presence of areas with a lobular structure, peripheral or axial nature of the blood supply). With endobronchial growth of a vascular formation, bronchoscopy is advisable.

The morphological, endoscopic and clinical-radiological picture of pulmonary hemangioma corresponds to the signs of a benign tumor. Differential diagnosis of pulmonary hemangioma is carried out with congenital angiodysplasias, other benign and malignant tumors of this localization.

Treatment of pulmonary hemangioma

Treatment of pulmonary hemangioma is only surgical; depending on the affected area, it comes down to excision of the tumor within healthy tissue. For small tumors, this can be achieved by fenestrated or circular resection of the bronchus. In the presence of fistulas, they resort to economical resection of the lung, removal of the pulmonary lobe (lobectomy), and rarely - removal whole lung(pneumonectomy). Surgical interventions are performed by thoracic surgeons.

In the case of multiple pulmonary hemangiomas in both lungs, economical resection of the most affected areas is performed. It is advisable to remove hemangioma at an earlier date, while the size of the formation is small and there are no secondary irreversible changes in the lungs. When pulmonary hemorrhage develops with significant blood loss, blood transfusions, plasma and blood substitute transfusions are performed.

Watchful waiting can be used if peripheral location pulmonary hemangiomas and the absence of complications in elderly and senile patients. The prognosis of pulmonary hemangioma with timely surgical treatment is favorable.

- a rare benign tumor-like formation of the lungs, represented by a conglomerate of overgrown and anastomosing blood vessels. Symptoms of a tumor may include hemoptysis, chest pain, shortness of breath, cyanosis, weakness, and spontaneous pulmonary hemorrhage. The diagnosis of pulmonary hemangioma is based on the clinical picture, radiography and CT scan of the chest, angiography, bronchoscopy, ultrasound with Doppler ultrasound of blood flow. Treatment of hemangioma is surgical, usually excision of the tumor, economical resection of the affected area of the lungs or bronchus, and lobectomy.

Causes of pulmonary hemangioma

According to histogenesis, hemangioma is a dysontogenetic formation. The formation of pulmonary hemangioma is based on a congenital disorder of the development of vascular tissue (vasculogenesis), accompanied by its hyperplasia and the appearance of excess vascular buds. Vascular tumor cells begin their growth at the embryonic stage or shortly after the birth of the child. As part of a pulmonary hemangioma, atypically located elements of the vascular wall are detected, primarily, cells of the internal lining of blood vessels - endothelial cells, which have the ability to reproduce.

The risk of developing pulmonary hemangioma in a newborn increases if the mother’s pregnancy was complicated by taking certain medications (hormones, etc.), viral or bacterial infections, or an unfavorable environmental environment. In adults, possible factors for the appearance of pulmonary hemangioma are hereditary predisposition, prolonged exposure to ultraviolet radiation, and internal pathology that contributes to vascular disorders.

Classification of pulmonary hemangioma

According to morphological criteria, hemangiomas can be capillary (simple or hypertrophic), cavernous (cavernous), combined and mixed. Capillary hemangiomas (about 50% of all types of this tumor) are represented by the proliferation and interweaving of dilated capillaries, usually with proliferation and hyperplasia of the endothelium, located in the form of concentric groups and elongated strands. More common in infants. Capillary hemangiomas are characterized by infiltrating growth, intensive new formation of small thin-walled vessels that even grow into the walls of arteries and veins.

Cavernous hemangiomas consist of multiple blood-filled arteriovenous cavities (sinusoidal areas) with thin connective tissue septa and endothelial lining. They are formed from larger blood vessels and can be significant in size. Combined (capillary-cavernous) hemangiomas combine proliferating areas of immature capillary elements and cavernous sinuses, limited by mature endothelial cells. Mixed hemangiomas are formed by different types of tissue (for example, angiokeratoma).

By localization, pulmonary hemangiomas are predominantly intrapulmonary, less often endobronchial; can be central or peripheral. Multiple hemangiomas affecting one or both lungs are common. There is a special sclerosing hemangioma of the lungs (pneumocystoma, fibroxanthoma, vascular endothelioma, alveolar angioblastoma) - a benign neuroendocrine pulmonary tumor, which contains hemangiomatous foci (angiomatous component). Pulmonary hemangioma is usually limited to the lung tissue and does not spread further; There are isolated cases of its invasion into the chest.

Symptoms of pulmonary hemangioma

The danger of pulmonary hemangioma lies in the possible rupture of the tumor (due to injury or severe ulceration) with massive blood loss and the risk of death. It is possible to develop compression syndrome of blood vessels and tissues, infection of the ulcerated hemangioma with the occurrence of a purulent process in the lungs and deterioration of the patient’s condition.

Diagnosis of pulmonary hemangioma

The diagnosis of pulmonary hemangioma is established by a pulmonologist and is based on anamnesis and clinical picture (presence of episodes of hemoptysis or pulmonary hemorrhage), radiography, CT scan of the chest, ultrasound with Doppler, angiography of pulmonary vessels, bronchoscopy. Typically, pulmonary hemangiomas are discovered accidentally or already at the stage of complications. An indirect sign of a tumor can be the presence of telangiectasia in other organs and on the skin.

On a chest x-ray, a hemangioma is visualized as a spherical or oval-shaped formation with clear, but usually irregular, scalloped edges. An increased density of the lung root is often determined due to an increase in the pulmonary vessels. It is possible to detect a direct connection of the hemangioma with the pulmonary vessels, establish the autonomous pulsation of the tumor, a decrease in its shadow during exhalation, an increase in size and darkening during inspiration.

Ultrasound with Doppler sonography is highly informative for vascular tumors, as it allows you to determine the volume of hemangioma, its structure and hemodynamic state. Angiography confirms the vascular nature of the tumor formation, its localization and extent, and the characteristics of the hemangioma (clear limitation, presence of areas with a lobular structure, peripheral or axial nature of the blood supply). With endobronchial growth of a vascular formation, bronchoscopy is advisable.

Treatment of pulmonary hemangioma

Treatment of pulmonary hemangioma is only surgical; depending on the affected area, it is reduced to excision of the tumor within healthy tissue, fenestrated or circular resection of the bronchus, segmental or marginal resection of the lung, removal of the pulmonary lobe (lobectomy), and rarely, removal of the entire lung (pneumonectomy). Surgical interventions are performed by thoracic surgeons.

Watchful waiting can be used in case of peripheral location of pulmonary hemangioma and absence of complications in elderly and senile patients. The prognosis of pulmonary hemangioma with timely surgical treatment is favorable.

Pathology in the lung is a cluster of anastomosing blood vessels measuring 0.4-8.5 cm in diameter ( average- 2.8 cm). It is most often formed in children after 6-7 years of age and in adults. Men are more susceptible to the disease than women. A pathological formation in the lung is characterized by a slow increase and clear boundaries separating the tumor from healthy surrounding tissues. Diagnose the problem using x-rays, computed tomography and ultrasound. Treatment is primarily through surgical removal.

Pulmonary hemangioma is often genetically determined and rare disease non-malignant nature.

General information

Varieties

Capillary hemangiomas, found in 50% of cases, are divided into simple and hypertrophic.
Cavernous (cavernous).
Capillary-cavernous - mixed hemangiomas of the lungs, differing in the most large sizes.

Intrapulmonary.
Endobronchial.
Central.
Peripheral.

Solid.
Papillary.
Hemorrhagic.
Alveolar.
Sclerotizing.

Capillary pulmonary hemangiomas occur in half of the cases of hemangiomas and consist of many small blood vessels. More often, this type of formation occurs in the lungs of children in the first 2 years of life. The tumor can grow deeper and penetrate the walls of important vessels and even the membranes of veins. Cavernous hemangiomas of the lungs are formed mainly from large vessels, and they are larger in size than capillary ones. Mixed type of pathology is the largest formation formed from different types tissues and vessels.

Doctors call UV rays, intrauterine developmental problems, and vascular pathologies as provocateurs of pulmonary hemangioma. Return to contents

Causes of pathology

According to histogenesis, pulmonary hemangioma is a dysontogenetic pathology, the basis of the formation of which is an intrauterine deviation in the formation of vascular tissues. This disorder is accompanied by the formation of an excess number of blood vessels. Due to the fact that the vascular lung tumor consists of endothelial cells (cells lining the internal vascular walls and characterized by the ability to reproduce quickly) sharp accelerations in growth are possible pathological neoplasms. Until the end, medicine does not know the exact reasons for the formation of hemangiomas, and the probable causes include:

excessive exposure to ultraviolet radiation;
hereditary tendency;
diseases of the vascular system;
transferred by the mother in the embryonic period of development infectious diseases during which medications were taken.

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How does the disease manifest itself?

The course of the pathology depends on morphological features, place of formation and type of structure. Because of pathological formation grows slowly in the lungs over several years, then primary symptoms tumors in 90% of cases are absent or blurred. Appearance clinical symptoms possible with a significant increase in pathology and with accelerated growth of a benign tumor. Fast growth Pulmonary neoplasm is characterized by the following symptoms:

Lung hemangioma can cause problems with breathing, blood circulation, and well-being.

pressing pain in the chest area;
pulmonary hemorrhage;
frequent coughing up blood;
formation of holes between pulmonary artery and vein;
shortness of breath and heavy breathing;
cyanosis;
dizziness associated with a lack of oxygen in the blood.

A dangerous complication of a vascular tumor in the lung is the probable rupture of the tumor, which occurs after a lung injury, especially resulting from strong prolonged pressure. The result of injury is profuse blood loss, which leads to fatal outcome. Abnormal growth of pathology in the lung causes compression of blood vessels and adjacent healthy tissue. It is possible to develop a lung abscess. Transition to a malignant course occurs no more than 1% of cases.

Diagnostic measures

Often, hemangioma in the lungs is discovered accidentally during scheduled inspection. Diagnosis of pulmonary pathology is made by a pulmonologist, who draws up a diagnostic history based on the patient’s symptoms. During the initial examination, while listening to the lungs with a stethoscope, noises are heard. Secondary symptom hemangiomas - expansion of small skin vessels and appearance spider veins that are not associated with inflammation (telangiectasia). Diagnostic methods:

Radiography. Visualizes a round or oval vascular formation, which is clearly limited from the surrounding tissues, and the border is often irregular in shape.
Computed tomography of the lungs. Determines the dilation of blood vessels in the respiratory system and increased density pulmonary root. There are pulsating movements of the tumor that are not associated with respiratory movements.
Ultrasound examination with Dopplerography. An informative way of diagnosing vascular disorders, allowing you to calculate the volume of the tumor and its structure.
Bronchoscopy. Carry out with endobronchial enlargement of pathology.
Angiography of blood vessels. A method confirming the vascular nature of the hemangioma, the characteristics of its formation and the nature of its spread.
Biopsy. Rarely done for differential analysis hemangiomas from a malignant tumor.

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Treatment of pulmonary hemangiomas

The main method of treating benign pulmonary tumors is surgical removal performed by a thoracic surgeon. The surgeon cuts out the pathological formation from healthy tissue. If there is more than one tumor in the lungs, then the doctor performs an economical resection of the areas of the lung with the greatest damage. It is better to remove the formation at an early stage of the disease, while the size is minimal, but since early stage Since the formation of the pathology is asymptomatic, people often learn about the disease when the size of the tumor is significantly increased. Depending on the affected area, the following types of pathology removal are distinguished:

fenestrated resection of the bronchus (circular removal);
segmental excision (marginal resection);
resection of the pulmonary lobe (lobectomy).

As a rule, surgical removal of pulmonary hemangioma provides an effective outcome from therapy.

Doctors very rarely resort to surgery complete removal lung or pneumonectomy. This method is chosen only in extreme cases when the lung cannot be saved. When the position of the hemangioma does not interfere with the organ’s ability to perform its work function and there is no tendency to grow, doctors choose a wait-and-see approach, especially for newborns and small children. Often a hemangioma forms unexpectedly and resolves on its own. Modern surgical methods and diagnostic procedures create favorable prognosis treatment of pulmonary hemangioma.

Lung hemangioma

Causes of pulmonary hemangioma

Symptoms of pulmonary hemangioma

Diagnosis of pulmonary hemangioma

Treatment of pulmonary hemangioma

Benign tumors in the lungs

There are such benign tumors in the lungs - adenoma, hamartoma, neurinoma, chondroma, fibroma, plasmacytoma, papilloma, hemangioma.

Symptoms

Benign tumors in the lungs are characterized by an asymptomatic onset, absence of intoxication symptoms, slow tumor growth, relative rarity of malignancy, and lack of positive dynamics with anti-inflammatory therapy. Most often, errors in the diagnosis of benign tumors in the lungs occur in the early period of their development. Currently, there is no clear definition of which tumor formations are classified as benign. This is especially true for bronchial adenomas and hamartomas. Often the difference between benign and malignant tumors in the lungs is very arbitrary. Some benign tumors initially have a tendency to malignancy, with the development of infiltrative growth and metastasis. However, the vast majority of authors believe that the existence of the concept of “benign tumors in the lungs” as a clinical and morphological group is completely justified.

Types of benign tumors in the lungs

Lung adenoma most often grows endobronchially, but can grow in the bronchial wall and extrabronchially. It is localized in the main, less often - in segmental bronchus. Bronchial adenoma grows slowly, moves away nearby tissues, but does not grow into them and does not metastasize. However, there is an opinion that an adenoma can turn into adenocarcinoma and recur, and therefore it is considered a malignant tumor. The tumor grows broadly, but can also be pedunculated. Its consistency is soft, less often dense, and has a lobed structure. The capsule contains many small vessels, and therefore patients may experience hemoptysis.

With endobronchial growth, the lumen of the bronchus becomes clogged and atelectasis of the corresponding lung area. If the tumor grows extrabronchially or in the wall of the bronchus, then it puts pressure on the bronchus and ultimately bronchial patency is impaired, but atelectasis of the lung occurs much later.

There are three stages of bronchial adenomas.

In the first stage Clinical signs are missing. Patients may be bothered only by coughing or coughing, hemoptysis periodically occurs, and sometimes shortness of breath. The tumor is not always detected in a timely manner during a preventive x-ray examination. Since it is localized in the main and lobar bronchi, then on the radiograph pathological changes are not visible and only on a tomogram can changes in the bronchial wall be determined.
In the second stage there is more sharp violation bronchial patency. Patients experience shortness of breath, cough, transient pulmonary atelectasis, pneumonia with possible abscess formation.
In the third stage, persistent atelectasis is formed, intoxication and pulmonary heart failure are observed.

Pulmonary hamartoma, as well as teratoma, dermoid cysts are classified as malformations of the lungs. Among benign tumors, the frequency of hamartomas is 90%, but in the clinic of pulmonary pathology, pulmonary hamartomas are rare. Hamartoma occurs in 1 in 500 autopsies. Most other authors report that hamartoma is very rare and is discovered incidentally at autopsy. A more detailed study of it became possible after the introduction of resections into the practice of treating patients with lung diseases.

There are reports that hamartoma can be localized in the hilar region and simultaneously in both lungs. Hamartoma consists of cartilaginous plates, other elements of connective and epithelial tissue. The cartilage petrifies and ossifies, and therefore the tumor is elastic or dense, round or oblong shape, has a lobular structure, easily separated from the surrounding lung, although the capsule is absent. Diffuse hamartoma affecting the entire lobe of the lung is rare. The tumor is located extrabronchially and, less commonly, intrabronchially, grows very slowly and does not become malignant.

It is not difficult to differentiate hamartoma from tuberculosis, although mistakes do occur. Hamartomas are more common in men, are asymptomatic and are detected during X-ray examination. When intrabronchial localization, hamartomas form atelectasis of the lung, and the corresponding clinical symptoms(recurrent pneumonia, hemoptysis). The tumor itself is characterized by a shadow, intense in the center and less dense at the periphery. The edges of the tumor are sharply defined and can be smooth or lumpy. The presence of conglomerate calcification is pathognomonic. Hamartoma is localized in the anterior segment, most often in the right lung and, as a rule, is solitary. In addition to hamartoma, there is a chondroma, which consists of a capsule and cartilage tissue, while hamartochondroma is a heterogeneous tumor and, in addition to mesodermal elements, contains epithelial ones.

Chondroma, like hamartoma, is a dysontogenetic type of bronchial malformation. Chondroma is twice as common as hamartoma and grows peribronchially. The contours of her shadow are round and unclear. The intensity is moderate, but homogeneous. Chondroma may contain deposits of calcium salts. The course is asymptomatic.

Pulmonary fibroma. This type of benign tumor should be distinguished from neurofibroma, hamartochondroma and fibroangioma. The tumor can be solitary and multiple. It has the ability to grow and reaches large sizes. Occurs in young, middle and old age. At first it is asymptomatic. When enlarged, it can undergo decay and be complicated by hemoptysis. In addition, large tumors cause a feeling of heaviness and compression of the chest organs. Small and medium-sized pulmonary fibroids are asymptomatic.

Plasmacytoma of the lung occurs in men and women at any age. Morphologically, the tumor consists of mature plasma cells, but since after surgical treatment it recurs and can metastasize, it is considered malignant. It is presented in the lungs as a spherical nodular formation, delimited by a capsule; less often, there are several nodules that have a yellow-white color on the section. The tumor rarely disintegrates.

Clinical signs of plasmacytoma are nonspecific. At the onset of the disease, dry cough, chest pain, and shortness of breath are rarely bothered. As the tumor grows, there is sometimes a cough with a small amount of sputum and streaks of blood, increased body temperature, pain in the muscles, bones and joints, in the area of the spleen, liver and kidneys. Subsequently, the ESR increases, the symptom of “drumsticks” and amyloidosis of internal organs appear. A dense shadow is determined radiologically. After removal of the plasmacytoma, radiation therapy is indicated.

Pulmonary papilloma is a benign epithelial tumor, but it can also appear as a result of inflammation of the bronchial mucosa. It is a cluster connective tissue, covered with cubic and stratified epithelium. Localized in the trachea or large bronchi, found mainly in at a young age. It does not appear clinically for a long time. Then hemoptysis, symptoms of bronchial obstruction, bronchitis, and sometimes atelectasis may occur.

Lung hemangioma and other vascular tumors. All vascular tumors (hemangioendothelioma, hemangiopericytoma, capillary hemangioma, cavernous hemangioma, glomus tumor, tumors from lymphatic vessels- lymphangiomas) have a round shape, a dense or densely elastic consistency and a connective tissue capsule. The surface color varies from light pink to dark red. The size of the tumor can vary - from a few millimeters in diameter to very significant (20 cm or more). Vascular tumors small sizes are diagnosed, as a rule, when they are localized in large bronchi and the development of hemoptysis or pulmonary hemorrhage.

Hemangioendotheliomas and hemangiopericytomas have rapid, often infiltrative growth, a tendency to malignant degeneration, followed by rapid generalization of the tumor process. Many authors suggest classifying these vascular tumors as conditionally benign. In contrast, capillary and cavernous hemangiomas are not prone to malignancy, are characterized by limited growth, and grow slowly.

Neuroma of the lung. Let us dwell in more detail on the description of pulmonary neuroma, which is a rare tumor and remains unrecognized for a long time. Diagnosis of neuroma of the lung and pleura always causes great difficulties. Neuromas of the lungs and pleura are classified as peripheral mesodermal tumors; they are also called neurofibromas and schwannoma.

Neuroma chest cavity in 90% of cases it is localized in the posterior mediastinum, and only in rare cases is intrapulmonary localization noted. The course of neuroma is asymptomatic, as a result of which it is often detected by chance, when preventive examinations or examination for another disease. Intrapulmonary neuroma forms a round or ovoid shadow of a homogeneous structure with clear or smooth contours, without changes in the pulmonary pattern. Very rarely, with intrapulmonary neuroma, pain, cough, severe weight loss, arthralgia, increased body temperature up to 38 ° C, and shortness of breath are noted, which is explained by concomitant pneumonia.

If the boundaries of the tumor are unclear and its size is rapidly increasing, one should think about malignancy. Pleural neuromas are also asymptomatic; the tumor is rarely accompanied by effusion. This is a pedunculated neoplasm originating from the pleura or subpleural tissue of the chest wall, lung, diaphragm or mediastinum. Pleural neuroma on a radiograph is represented by a homogeneous shadow located parietally, with deep breathing she moves. Definite diagnostic value have the application of artificial pneumothorax, pleuroscopy and biopsy during thoracotomy.

Other benign tumors in the lungs (lipoma, lymphoma, leiomyoma, xanthoma) are extremely rare. For example, only about a few cases of lipoma and leiomyoma have been described in the literature. Their course is asymptomatic. It is detected by chance or during a medical examination in the form of a spherical formation. Tumors are diagnosed by morphological examination of the resected lung or posthumously, during an autopsy.

Treatment

Treatment of benign tumors in the lungs is surgical. The operation should be performed as early as possible, as this avoids the development of secondary irreversible changes in the lungs, prevents the possibility of malignancy and removes the tumor in the most economical manner. A wait-and-see approach may be justified for peripheral tumors in elderly and senile patients with low functional reserves of the body, in the absence of complications of the disease and clinical, radiological, endoscopic and laboratory data indicating the presence of malignant growth.

Lung hemangioma - Tumors and cysts of the chest cavity in children

Lung hemangiomas, or vascular formations, consist of countless anastomosing arteriovenous vessels and cavities filled with blood. Lung hemangiomas are described in the literature under other names that characterize this type tumors as a developmental defect: pulmonary arteriovenous aneurysms, varicose veins of the lung. Despite the fact that these formations are a developmental defect, they are detected more often in older children or adults. Thus, Muré (1953) notes that out of 73 patients described in the literature, 11 were children under 15 years of age. MikuJas et al. (1972) describe 2 patients with arteriovenous fistulas, one of them was a 7-year-old child.

The localization of hemangiomas in the lung varies; most often they are located in the lung parenchyma itself. Typically, hemangiomas are limited to the lung tissue, but in the literature there are descriptions of its growth from the lung into the chest. Lung hemangiomas are often multiple, affecting even both lungs. Sometimes they are combined with a malformation of blood vessels in the area of other organs and skin (telangiectasia). These manifestations are an indirect sign that facilitates the recognition of pulmonary hemangiomas.

Clinical manifestations depend on the size and location of hemangiomatous formations, as well as on the nature of arteriovenous fistulas. With hemangioma with fistulas between the pulmonary artery and pulmonary vein, i.e. directly between the great vessels, hemodynamic disorder comes first. A child with such a hemangioma experiences cyanosis, shortness of breath, weakness, frequent dizziness, and sometimes hemoptysis.

Depending on the location of the tumor in the lung, a vascular murmur can sometimes be heard.

Hemangiomas that form vascular fistulas within segmental arteries and veins have little clinical manifestation. Most constant sign is a gradual increase in polycythemia over many years.

Percussion and auscultation data do not allow us to determine the nature of the disease. No malignant degeneration is observed. In some cases, small hemangiomas in the lungs are discovered by chance. Thus, I. G. Klimkovich and co-authors (1967) provide a description of a pulmonary hemangioma that was asymptomatic in a 4-year-old child.

The X-ray picture depends on the size of the hemangioma and the presence of an arteriovenous connection. Typically the tumor is ovoid or spherical in shape, often with irregular scalloped but fairly distinct edges. As a rule, an increased density of the lung root is determined, apparently due to an increase in the pulmonary artery and vein. Sometimes there is a direct connection between the formation and the vessels of the lung root. With transillumination and x-ray kymograms, it is possible to see the pulsation of the tumor, which is independent and not transmitted (from the heart) in nature. During exhalation, the shadow of the hemangioma decreases, during inhalation it increases and becomes more intense.

Angiography often determines the extent of the lesion and makes it possible to detect small hemangiomas that are not detected by plain fluoroscopy (E. N. Meshalkin, E. A. Damir, 1956).

Lung hemangioma

Pulmonary hemangioma is a rare benign tumor-like formation of the lungs, represented by a conglomerate of overgrown and anastomosing blood vessels. Symptoms of a tumor may include hemoptysis, chest pain, shortness of breath, cyanosis, weakness, and spontaneous pulmonary hemorrhage. The diagnosis of pulmonary hemangioma is based on the clinical picture, radiography and CT scan of the chest, angiography, bronchoscopy, ultrasound with Doppler ultrasound of blood flow. Treatment of hemangioma is surgical, usually excision of the tumor, economical resection of the affected area of the lungs or bronchus, and lobectomy.

Lung hemangioma

Causes of pulmonary hemangioma

According to histogenesis, hemangioma is a dysontogenetic formation. The formation of pulmonary hemangioma is based on a congenital disorder of the development of vascular tissue (vasculogenesis), accompanied by its hyperplasia and the appearance of excess vascular buds. Vascular tumor cells begin their growth at the embryonic stage or shortly after the birth of the child. As part of a pulmonary hemangioma, atypically located elements of the vascular wall are detected, primarily, cells of the internal lining of blood vessels - endothelial cells, which have the ability to reproduce.

Classification of pulmonary hemangioma

According to the localization of pulmonary hemangiomas, they are predominantly intrapulmonary, less often endobronchial; can be central or peripheral. Multiple hemangiomas affecting one or both lungs are common. There is a special sclerosing hemangioma of the lungs (pneumocystoma, fibroxanthoma, vascular endothelioma, alveolar angioblastoma) - a benign neuroendocrine pulmonary tumor, which contains hemangiomatous foci (angiomatous component). Pulmonary hemangioma is usually limited to the lung tissue and does not spread further; There are isolated cases of its invasion into the chest.

Symptoms of pulmonary hemangioma

Diagnosis of pulmonary hemangioma

The diagnosis of pulmonary hemangioma is established by a pulmonologist and is based on anamnesis and clinical picture (presence of episodes of hemoptysis or pulmonary hemorrhage), radiography, CT scan of the chest, ultrasound with Doppler, angiography of pulmonary vessels, bronchoscopy. Typically, pulmonary hemangiomas are discovered accidentally or already at the stage of complications. An indirect sign of a tumor can be the presence of telangiectasia in other organs and on the skin.

Treatment of pulmonary hemangioma

Lung hemangiomas

Pulmonary hemangioma (first described in 1956) is an uncommon lung tumor. This hemangioma usually develops in middle-aged people, with a preponderance of females (5 women: 1.5 men). However, these tumors have also been diagnosed in young patients aged 10 to 19 years with lymph node metastases. Most patients with these tumors do not experience any symptoms. Most often, pulmonary hemangiomas are diagnosed accidentally during a chest x-ray for other reasons. In rare cases, patients may complain of hemoptysis, chronic cough or chest pain.

Lung hemangiomas appear as well-demarcated, firm, yellow-brown masses. In most cases, these hemangiomas are single and their size ranges from 0.3 to 7 cm. In rare cases, hemangiomas can be multiple, unilateral or bilateral.

Since pulmonary hemangiomas are considered benign tumors, surgical excision alone will be sufficient. In very rare cases, these tumors can metastasize to regional lymph nodes. But these metastases do not appear to affect the patient's prognosis.

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Hemangioma. Causes, symptoms, signs, diagnosis and treatment of pathology

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor.

The number of hemangiomas in a child can vary from one or two to several hundred.
There are both small hemangiomas (2–3 mm) and huge ones (up to several meters in diameter).
Hemangiomas in adults are detected extremely rarely and are a consequence of their incomplete cure in childhood.
Small hemangiomas may disappear on their own by the age of five.
Hemangioma is characterized by the most aggressive growth among all benign tumors.

Causes of hemangioma

Formation of fetal vessels

It is characterized by the formation of primary capillaries (the smallest and thinnest blood vessels) directly from the mesenchyme. This type of vessel formation is characteristic only for early period embryonic development. Primary capillaries do not contain blood and are a single layer of endothelial cells (in the adult body, endothelial cells line the inner surface of the vessels).

It is characterized by the growth of new vessels from already formed ones. This process is determined genetically and is also controlled by local regulatory factors.

Theories of hemangioma occurrence

stray cell theory;
fissural (slit) theory;
placental theory.

Lost Cell Theory

The most modern and scientifically substantiated theory, according to which hemangioma occurs as a result of a violation of the development of capillaries from the mesenchyme. During embryogenesis, accumulations of immature blood vessels (capillaries) are formed in organs, which then turn into veins and arteries. After the formation of an organ, a certain amount of unused immature vascular tissue may remain in it, disappearing over time.

At the initial stages of embryo development, the so-called embryonic fissures are distinguished in the area of the skull - the future location of the sensory organs (eyes, ears, nose) and the oral opening. At week 7, blood vessels and nerves that take part in the formation of organs grow into these gaps.

It is assumed that endothelial cells of the placenta enter the bloodstream of the fetus and are retained in its organs and tissues. During intrauterine development maternal factors inhibition of angiogenesis does not allow vascular tissue to actively grow, however, after birth, their effect ceases and intensive growth of hemangioma begins.

Mechanism of occurrence of hemangioma

Multiple pregnancy. When two or more fetuses develop in the uterus, the likelihood of having children with hemangioma is increased.

Fetoplacental insufficiency. Characterized by insufficient delivery of oxygen (and other substances) to the fetus due to a violation of the structure or function of the placenta.

Trauma during childbirth. When a child passes through the birth canal, the tissues of the head are compressed quite strongly, which disrupts the normal blood circulation in them. Long (or, conversely, too fast) labor, narrow birth canal or big size the fetus can provoke the development of local hypoxia with the subsequent formation of hemangioma in the scalp and face.

Eclampsia. This condition develops during pregnancy or childbirth and is characterized by a pronounced increase in maternal blood pressure with possible loss consciousness and convulsions, as a result of which the delivery of oxygen through the placenta to the fetus is disrupted.

Smoking during pregnancy. When you smoke, part of your lungs fills up tobacco smoke, as a result of which the amount of oxygen entering the body decreases. If the maternal body is able to tolerate this condition relatively easily, then in the fetal body hypoxia can cause increased growth of capillary tissue and the development of hemangioma.

Intoxication. Exposure to various occupational hazards, as well as alcohol abuse during pregnancy, increases the risk of having a child with hemangioma.

Mother's age. It has been scientifically proven that childbirth after 40 years is associated with increased risk the presence of various developmental anomalies in the fetus, including vascular neoplasms.

Prematurity. Starting from 20 - 24 weeks of pregnancy, surfactant is produced in the fetal lungs - a special substance without which it is impossible pulmonary respiration. A sufficient amount of it accumulates only by the 36th week of pregnancy, so the respiratory processes in premature babies are disrupted, which leads to tissue hypoxia.

Development of hemangioma

A period of intense growth. It is typical for the first weeks or months after the onset of hemangioma and, as a rule, stops by the end of the first year of life (exceptions are possible). Externally, the tumor is bright red in color, constantly increasing in diameter, as well as in height and depth. The growth rate varies within different limits - from insignificant to very pronounced (several millimeters per day). This period is the most dangerous from the point of view of the development of complications (tumor ulceration, germination into neighboring organs and their destruction).

Period of growth cessation. In most cases, by the end of the first year of life, the growth of the vascular neoplasm stops, and until the age of 5–6 years it increases slightly, corresponding to the growth of the child.

Period of reverse development. In approximately 2% of cases, complete spontaneous disappearance of the hemangioma is observed. Some time after growth stops (months or years), the surface of the tumor becomes less bright and may ulcerate. The capillary network gradually disappears, which is replaced either normal skin(for small, superficially located hemangiomas), or scar tissue (in the case of volumetric formations germinating into the deep layers of the skin and subcutaneous tissues).

Types of hemangiomas

Capillary (simple) hemangiomas. They occur in 96% of cases and represent a dense capillary network of bright red or dark crimson color, rising above the surface and growing into the deep layers of the skin. This form counts initial stage development of the disease and is characterized by the intensive formation of new capillaries, prone to sprouting into the surrounding tissues and destroying the latter.

Cavernous hemangiomas. Are the result further development capillary hemangiomas. In the process of growth and increase in size, as a result of capillaries overflowing with blood, some of them expand and rupture, followed by hemorrhage into the hemangioma tissue. The consequence of this process is the formation of small, blood-filled cavities (cavities), the inner surface of which is lined with endothelial tissue.

Combined hemangiomas. Combined hemangioma is classified as a transitional stage from capillary to cavernous form. It is a tumor in which there is an alternation of immature capillary tissue with cavities filled with blood (cavities). The increase in tumor size occurs mainly due to the formation of new capillaries, which subsequently also undergo transformation into cavities, up to complete replacement of the hemangioma.

Depending on the location there are:

Skin hemangiomas. Occurs in 90% of cases. They can be single or multiple, capillary or cavernous type.

Hemangiomas of internal organs. Almost always accompanied by multiple hemangiomas of the skin. May vary depending on structure and shape. The most common and dangerous are damage to the liver, spine, bones and muscles.

What is hemangioma: causes and classification of the disease

One of the most common benign tumors of the human body is hemangioma. It develops from vascular tissue and is a pink or purple tissue defect that is noticeable in appearance, if localized on the skin. Moreover, the pathology does not provoke obvious disorders, although when localized in the area parenchymal organs(liver, kidneys and others), as well as in the area auricle, organ of vision, in the brain and lungs can cause loss of functional activity. This occurs due to the fact that the hemangioma mechanically compresses the organs, the cells of which atrophy and lose their functional activity.

What is hemangioma

For a tumor such as hemangioma, the causes have not yet been sufficiently studied, although clear data on its development were obtained from autopsies of children who died before childbirth. Some changes in vascular tissue were found in their bodies, which suggests that the defect is congenital. Moreover, the opinion of modern doctors is that all children experience this disorder; it’s just that not every child has a hemangioma located on the skin. Therefore, it is not visible, although its size can vary greatly.

The specifics of the development of the disease have also not yet been identified; today, the results of statistical studies have been received confirming that girls develop hemangiomas 6-7 times more often. Moreover, this dependence is still difficult to explain, which is associated with the intrauterine development of the child. Because on this moment The opinion of doctors is that hemangioma is an intrauterine disease, or, more precisely, a disorder of the development of vascular tissue in a certain location. This doesn't always lead to various disorders, although it is a tumor of vascular tissue.

Causes of the disease

As described earlier, the disease has unspecified causes of development. Modern opinion Experts conclude that this tumor develops due to impaired growth of vascular tissue during intrauterine development. They also comment on the growth process hormonal disorders. However, in utero the fetus does not synthesize specific hormones that have a long-term effect. Moreover, their endocrine glands practically do not function, and therefore this theory is called into question.

It is worth highlighting the failure of the growth processes of body parts and vascular tissue. It is at this level that dysregulation may occur. This theory is somewhat simpler to explain: during the period of organ formation, vascular tissue penetrates parts of the body along a chain of pericytic cells. They are “conductors” and obey humoral (protein molecules) mechanisms. If the tissue experiences hypoxia at the local level, then special proteins are synthesized that attract pericytes. They pave new blood supply pathways, which eliminates hypoxia. In some cases, the release of proteins does not stop as the vascular tissue develops, and therefore it develops and becomes a voluminous tumor-like formation.

The second name of the disease is vascular hyperplasia. This means that the cause of tumor development is a disruption of the growth processes of vascular tissue associated with an increase in its quantity. A clear definition of the process is not given, since for clarification it is necessary to monitor the patterns of intrauterine development. This is currently impossible due to the lack of necessary equipment. Therefore, the only substrate for research is the corpses of newborns, as well as fetuses that could not be born. Fetuses removed as a result of abortions can also be used.

Classification: disease of the skin and internal organs of humans

There is a division of hemangiomas into several types depending on where in the body they are located. In this regard, it is worth highlighting:

Cutaneous (integumentary hemangiomas): they are located in top layer skin. Such tumors are the least dangerous, and therefore they do not need to be removed. The exception is hemangioma in the area of the ear canal, organ of vision, as well as on the face and genital area.
Hemangiomas of parenchymal organs (liver, kidneys, brain, gonads and glands internal secretion): they need treatment as they are identified, and initially conservative pharmacological techniques that can affect the course of tumor development should be taken.
Hemangiomas of the musculoskeletal system: these tumors are less dangerous than parenchymal ones, although they can lead to impaired skeletal development, since they grow much faster than the child’s bones.

With a pathology such as hemangioma, the causes do not always reflect the degree of complexity of the disease. They also do not affect the type of tumor according to the structure of the organ tissue. According to this feature, three types of hemangiomas are distinguished:

Capillary hemangioma: a violation of the development of vascular tissue manifests itself at the level of the capillary part of the vascular bed. A tumor of this type is represented by vascular tissue, which is made of single-layer epithelium. It most often manifests itself in the skin and musculoskeletal system in the metaphyseal zone of bones.
Cavernous hemangioma: this type of tumor develops from larger areas of blood vessels, which manifests itself in larger sizes than in the case of capillary hemangioma. As a rule, such tumors are most often found in organs with a massive blood supply: kidneys, liver, brain. At the same time, the development of cavernous hemangiomas in the structures of the musculoskeletal system is a rare finding during operations. This also contains the answer to the question of why hemangioma is dangerous: a tumor of this type is most prone to rapid growth or involution (reduction in size), which can provoke severe bleeding during blunt trauma or dissection of the tumor.
Mixed capillary-cavernous hemangioma: this pathology develops at the level of distal (closer to the organ) areas, and therefore originates from both arterioles and capillaries. This allows this type of tumor to develop both in the skin and in the area of bones and parenchymal organs. This has led to the fact that mixed hemangioma is the most common tumor that also occurs in adults.

Known patterns of disease development

Vascular hemangioma can develop next to any tissue of the body. And here there is a growth disorder at the local level. The dependence of where the hemangioma will develop has not been identified, although there is evidence that organs such as bones, skin, liver, lungs and kidneys are most often involved in this process. Therefore, with such a pathology as spinal hemangioma, the reasons lie in the need for abundant blood supply. In the prenatal period, all bones are hematopoietic organs, and therefore, for this purpose, a wide-loop network of blood supply develops in them.

Its formation can proceed according to the same principles as the development of hemangioma. However, in this regard, it is difficult to say why the tumor most often develops on the skin. Based on this, for such a pathology as spinal hemangioma, the causes of its occurrence cannot be definitively identified, as well as for the skin form. The only regularity is that the tumor develops in a place where the organs need an abundant blood supply, which implies the formation of a looped network of capillaries.

There are 2 such networks in the dermis of the skin, one of them is superficial, and the other is deep. There is also an arterial network in the vertebral area, although it is located inside the spinal canal and outside the spinal column. Tumors also develop in the liver, kidneys, lungs and brain. And the location of the disease is important to assess its health hazard.

What is dangerous for adults and children

In the question of whether this disease is dangerous, a lot depends on its location and size. If it is large, but built of capillary tissue, then it will not pose a danger. If it is located in an area of highly vascularized tissue, then its damage may be accompanied by heavy bleeding. This is most often typical for tumors located in the liver, since this organ often experiences mechanical damage.

It is noteworthy that hemangioma in newborns is usually harmless. This tumor is located on the surface of the skin and is very often found. But hemangioma in adults, if it is not located on the skin, but is located in the area of parenchymal organs, can be accompanied by serious disorders.

Since hemangioma is a tumor, there is a certain risk of developing secondary changes at the site of its localization. It can grow and inhibit the functioning of other organs, which is most dangerous in the area of the brain, the organ of vision and in ear canal. Moreover, then the growth of the tumor will be infiltrative, that is, it will grow into the surrounding tissues, pushing their cells to the sides. This may also be accompanied by bleeding and dysfunction.

In terms of malignancy, hemangioma is practically harmless. It rarely malignizes, because it grows expansively from newborn to 4-5 years. At about the age of 5 years, its growth processes are inhibited, and it gradually collapses. Therefore, there is a possibility that the tumor itself will disappear from the body, compensating for its violations.

Of the vascular formations of the lungs, the most common are hemangiomas - tumors consisting of anastomosing arteriovenous sinuses and cavities filled with blood. Lung hemangiomas are also described in the literature under other names that characterize this type of tumor as a developmental defect: “pulmonary arteriovenous aneurysms”, “pulmonary varicose veins”. Despite the fact that these diseases are developmental defects, they are detected more often in older children or adults. Thus, J. Muri notes that out of 73 patients described in the literature, 11 were children under 15 years of age; 32 patients were older than this age; the ages of the others are not specified. Most observations relate to the male gender.

The localization of hemangiomas in the lung varies; most often they are located in the lung parenchyma itself. Typically, hemangiomas are limited to the lung tissue, but in the literature there are descriptions of its growth from the lung into the chest wall. Lung hemangiomas are often multiple, affecting even both lungs. Sometimes they are combined with a malformation of blood vessels in the area of other organs and skin (telangiectasia). These manifestations are indirect sign, facilitating the recognition of pulmonary hemangiomas.

Symptoms of hemangioma. Clinical manifestations depend on the size and location of hemangiomatous formations, as well as on the nature of arteriovenous fistulas. With a hemangioma that forms fistulas between the pulmonary artery and the pulmonary vein, i.e. directly between the great vessels, a hemodynamic disorder comes to the fore. A child with such a hemangioma has cyanosis, shortness of breath, weakness, frequent dizziness, sometimes hemoptysis. Due to constant hypoxemia, the child is delayed in growth and development. Polycythemia gradually develops. Depending on the location of the tumor in the lung, it is sometimes possible to hear a murmur in the vessels of the lung.

Hemangiomas that form vascular fistulas within segmental arteries and veins have little clinical manifestation; the most constant sign is a gradual increase in polycythemia over many years. Percussion and auscultation data do not allow us to determine the nature of the disease. No malignant degeneration is observed.

The X-ray picture depends on the size and presence of arteriovenous connection. Typically the tumor is ovoid or spherical in shape, often with irregular scalloped but fairly distinct edges. As a rule, an increased density of the lung root is determined, apparently due to an increase in the pulmonary artery and vein. Sometimes there is a direct connection between the formation and the large vessels of the root of the lung. When X-rayed, you can often see the pulsation of the tumor, which is independent and not transmitted (from the heart) in nature. During exhalation, the shadow of the hemangioma decreases, during inhalation it increases and becomes more intense. Angiography often determines the extent of the lesion and can detect small hemangiomas that are not detected by plain fluoroscopy.

Treatment only operational. It consists of removing the affected part of the lung; most often it is necessary to perform a lobectomy and even removal of the entire lung. For multiple hemangiomas localized in both lungs, resection should be economical; the most affected areas are removed.

Hemangioma is a common vascular formation in the main respiratory organ. Lung hemangioma is a rare formation in the form of a tumor, which in 99% of cases is benign and more often affects lower sections organ. Pathology in the lung is a cluster of anastomosing blood vessels measuring 0.4-8.5 cm in diameter (average - 2.8 cm). It is most often formed in children after 6-7 years of age and in adults. Men are more susceptible to the disease than women. A pathological formation in the lung is characterized by a slow increase and clear boundaries separating the tumor from healthy surrounding tissues. The problem is diagnosed using X-rays, computed tomography and ultrasound. Treatment is primarily through surgical removal.

Pulmonary hemangioma is often a genetically determined and rare disease of a non-malignant nature.

General information

Varieties

Capillary pulmonary hemangiomas occur in half of the cases of hemangiomas and consist of many small blood vessels. More often, this type of formation occurs in the lungs of children in the first 2 years of life. The tumor can grow deeper and penetrate the walls of important vessels and even the membranes of veins. Cavernous hemangiomas of the lungs are formed mainly from large vessels, and they are larger in size than capillary ones. The mixed type of pathology is the largest formation, formed from different types of tissues and vessels.

Doctors call UV rays, intrauterine developmental problems, and vascular pathologies as provocateurs of pulmonary hemangioma.

Causes of pathology

According to histogenesis, pulmonary hemangioma is a dysontogenetic pathology, the basis of the formation of which is an intrauterine deviation in the formation of vascular tissues. This disorder is accompanied by the formation of an excess number of blood vessels. Due to the fact that a vascular lung tumor consists of endothelial cells (cells lining the internal vascular walls and characterized by the ability to multiply rapidly), sharp accelerations in the growth of pathological neoplasms are possible. Until the end, medicine does not know the exact reasons for the formation of hemangiomas, and the probable causes include:

excessive exposure to ultraviolet radiation;
hereditary tendency;
diseases of the vascular system;
infectious diseases suffered by the mother during the embryonic period of development, during which medications were taken.

How does the disease manifest itself?

The course of the pathology depends on the morphological characteristics, place of formation and type of structure. Due to the fact that the pathological formation in the lungs grows slowly over several years, the primary symptoms of the tumor in 90% of cases are absent or vague. The appearance of clinical symptoms is possible with a significant increase in pathology and with accelerated growth of a benign tumor. The rapid growth of a pulmonary tumor is characterized by the following signs:

Lung hemangioma can cause problems with breathing, blood circulation, and well-being.

pressing pain in the chest area;
pulmonary hemorrhage;
frequent coughing up blood;
the formation of holes between the pulmonary artery and vein;
shortness of breath and heavy breathing;
cyanosis;
dizziness associated with a lack of oxygen in the blood.

A dangerous complication of a vascular tumor in the lung is the probable rupture of the tumor, which occurs after a lung injury, especially resulting from strong prolonged pressure. The result of injury is profuse blood loss, which leads to death. Abnormal growth of pathology in the lung causes compression of blood vessels and adjacent healthy tissue. It is possible to develop a lung abscess. Transition to a malignant course occurs no more than 1% of cases.

Diagnostic measures

Often, hemangioma in the lungs is discovered by chance during a routine examination. Diagnosis of pulmonary pathology is made by a pulmonologist, who draws up a diagnostic history based on the patient’s symptoms. During the initial examination, while listening to the lungs with a stethoscope, noises are heard. A secondary sign of hemangioma is dilation of small skin vessels and the appearance of spider veins that are not associated with inflammation (telangiectasia). Diagnostic methods:

Radiography. Visualizes a round or oval vascular formation, which is clearly limited from the surrounding tissues, and the border is often irregular in shape.
Computed tomography of the lungs. Determines the dilation of the vessels of the respiratory organ and the increased density of the pulmonary root. There are pulsating movements of the tumor that are not associated with respiratory movements.
Ultrasound examination with Dopplerography. An informative method for diagnosing vascular disorders, allowing one to calculate the volume of a neoplasm and its structure.
Bronchoscopy. Carry out with endobronchial enlargement of pathology.
Angiography of blood vessels. A method confirming the vascular nature of the hemangioma, the characteristics of its formation and the nature of its spread.
Biopsy. It is rarely performed to differentiate a hemangioma from a malignant tumor.