Benign lung tumors. Symptoms of pulmonary hemangioma. Lung hemangioma - Tumors and cysts of the chest cavity in children

Facts about hemangiomas:

They are often detected literally immediately after the baby is born or in the first weeks or months of life;
Hemangiomas are more often recorded in girls;
Hemangiomas can be of completely different sizes: from a small dot to a large spot.

Development of hemangioma in children

A characteristic sign of hemangioma is a change in its size. There are three stages in the development of hemangioma:

Period of intensive growth;
Period of growth cessation;
Period of reverse development.

It is quite difficult to predict how actively the hemangioma will increase in size. Sometimes the tumor grows even several centimeters per week. It is reliably known that premature babies hemangiomas grow much faster than in full-term babies. Hemangiomas actively grow in the first months of a baby’s life. Once the child reaches six months of age, the growth of the neoplasm slows down. This stage is called the stunting period and lasts several years.

The further development of hemangioma is difficult to predict. Reverse development (regression) of the neoplasm often occurs. The brightness of the spot gradually decreases, areas of white. After six to eight months, the hemangioma becomes pale pink and smooth. By the third or fourth year of a child’s life, only an area of depigmentation on the skin reminds of a neoplasm. It is worth noting that regression is only possible in the case of simple hemangiomas. Cavernous and combined hemangiomas never regress.

Types of hemangiomas

Hemangiomas are most often localized on the skin, but can also occur in internal organs. There are different types of hemangiomas::

Simple (capillary);
Cavernous (cavernous);
Mixed;
Combined.

Hemangioma on the skin

Hemangiomas have their own favorite places. Most often they occur in the face, scalp, neck, mouth, and hands. Much less often - on the external genitalia, legs.

Simple hemangiomas

In the structure of all hemangiomas, simple hemangiomas make up approximately 95%. A simple hemangioma is a layer of small, tightly adjacent capillary vessels. Sometimes the vessels gather into lobules. The lumen of the vessels is filled with blood. Simple hemangiomas are localized on the skin and do not penetrate into subcutaneous fat. The surface of capillary hemangiomas can be flat or nodular-lumpy.

A simple hemangioma looks like a raised red spot on the skin, which can be of varying sizes. If you press on the edge of the spot, you will notice how it gradually fades. This is due to compression of the vessel and expulsion of blood from it. But as soon as you let go of the skin, the spot immediately turns red. The stain has clear edges and is separated from the surrounding healthy tissue. There may be one or more of these growths on the skin.

Cavernous (cavernous) hemangiomas

Cavernous hemangioma consists of many cavities separated by septa. This type of hemangiomas is located in subcutaneous tissue. Cavernous hemangiomas account for about 3% of all hemangiomas.

Externally, cavernous hemangioma looks like extensive education, which rises noticeably above the skin. The surface of the formation is rough. The skin of cavernous hemangioma is not changed. But a tumor-like formation is visualized under the skin bluish color. It has a soft elastic consistency to the touch. If you press on it, the swelling decreases somewhat. But soon it regains its previous form. It is typical that when straining, crying, and even, the tumor briefly increases in size due to blood flow to it.

Mixed hemangiomas

Mixed hemangiomas are those that are combined with other neoplasms, such as lymphangioma or lipoma. Such hemangiomas are very rare, occurring in approximately 0.6% of all cases of hemangiomas.

Color, consistency, appearance tumor will depend on the tissues that make up the tumor.

Combined hemangiomas

In the structure of all hemangiomas, combined hemangiomas make up only 2%, but they are the ones that pose the greatest difficulty in treatment. Combined hemangiomas have supracutaneous and subcutaneous parts. External manifestations will depend on which component of the hemangioma predominates: capillary or cavernous.

Complications

Hemangioma grows quite quickly, and it is very difficult to predict its further effect on the body. Among the main complications of hemangiomas are:

Bleeding. Develops when tumor tissue is injured. Bleeding with liver hemangioma is especially dangerous, since the volume of blood loss can be very massive.
Ulceration. It develops mainly when hemangioma is localized in the area of the lips, perineum, and large folds of skin. Characterized by the development of an ulcer at the site of the tumor.
Blood clotting disorder. This is due to the fact that a hemangioma, roughly speaking, is perceived by the body as a damaged vessel, which is why platelets actively flow into this area. Over time, the number of platelets in the blood decreases, which can lead to poor clotting blood.
Inflammation and suppuration. Often associated with trauma to the tumor.
Dysfunction of organs affected by hemangioma(impaired vision with hemangioma of the eyelid, impaired hearing with hemangioma of the ear).

Hemangioma of internal organs

Hemangioma can form in internal organs: brain, uterus, lungs, kidneys. The most common type is liver hemangioma. The tumor is usually solitary and small in size. Hemangiomas of the liver are simple (capillary) and cavernous. Capillary hemangiomas are usually small and do not exceed a few centimeters. Cavernous reach ten centimeters.

It is noteworthy that often the tumor does not cause any discomfort. This is how a person lives with an illness for a long time. Approximately by the age of fifty, the size of the tumor increases and then symptoms of the disease appear: dull pain in the right hypochondrium, abnormal bowel movements, jaundice.

Bone hemangioma

Bone hemangioma is a slow-growing benign tumor. More often the tumor is located in the spine, somewhat less often in the bones of the skull and pelvis, and tubular bones.

Bone hemangiomas are usually asymptomatic and are therefore discovered by chance during a routine examination. Only in 1-1.5% of all cases, bone hemangioma is accompanied by pain. Bone hemangiomas do not always require active treatment, but constant monitoring by a doctor is necessary. The thing is that an expanding hemangioma of the spine, for example, pushes the bone elements apart, which can cause vertebral fractures.

Diagnostics

A doctor may suspect a hemangioma during an external examination of the tumor. Firstly, the presence of a raised red spot testifies in favor of a hemangioma. Secondly, with hemangioma, the spot turns pale when pressure is applied to it and restores its shape and color after the pressure stops.

To confirm the diagnosis, as well as clarify the extent of skin damage, certain studies can be carried out:

Ultrasound is performed to study cavernous hemangiomas, as well as neoplasms internal organs. This diagnostic method allows you to study the structure, depth, size of the hemangioma.

If hemangiomas of internal organs are suspected, computed tomography or magnetic resonance imaging is performed. These methods make it possible to detect tumors of the smallest size. In addition, only tomography can determine the presence of hemangiomas in the bones.

A clinical blood test is performed to determine complications and monitor the patient’s condition during the course of treatment. Characteristic changes in the blood with hemangiomas are a decrease in the number of platelets, and in addition to this, red blood cells with hemoglobin.

Treatment of hemangioma

Treatment issues must be approached individually, taking into account the specific course of the disease in specific child. You can often hear the opinion that hemangiomas do not need to be treated, because they can disappear on their own when the child grows up. However, this opinion is too frivolous. Indeed, simple hemangiomas can regress, but this does not happen in every case. In addition, cavernous and mixed hemangiomas are not at all capable of regressing. Thus, a wait-and-see strategy can only be applied in the case of simple uncomplicated hemangiomas with signs of regression.

There are certain indications according to which treatment of hemangioma should begin as soon as possible:

Hemangiomas located in the head and neck area, in the mouth, anogenital area;
Fast-growing tumors (its area doubles in a week);
Complicated hemangiomas.

Surgical treatment: removal of hemangiomas

Surgical excision of the skin of the tumor is a generally accepted treatment for hemangiomas. However, nowadays surgical intervention is rarely resorted to. First of all, due to the fact that surgical intervention must be carried out under general anesthesia. Surgical excision of the skin may be accompanied by blood loss, and a scar remains after the operation. However, surgical excision is preferred for deep hemangiomas, as well as for mature forms of the tumor. That is, when other treatment methods are impossible.

Removal of hemangiomas with laser, cryodestruction

Modern physical methods removal of hemangiomas (cryodestruction, laser removal) have many advantages compared to surgical treatment. Such manipulations are carried out on an outpatient basis, because the procedure lasts only 15-20 minutes, and there is no need to administer anesthesia to the child.

During cryodestruction, the skin is affected liquid nitrogen having a low temperature. The method itself is quite simple, it does not require any special preparation and is carried out without anesthesia. Hemangiomas located on the skin are targeted with liquid nitrogen for 20-30 seconds, hemangiomas on the mucous membranes - for 7-15 seconds. On the third or fourth day, a crust forms on the treated area of skin; after a month, complete healing of the skin occurs. For large hemangiomas, treatment is carried out in several stages.

Laser removal is successfully used in the fight against hemangiomas. This method is used for tumors with a diameter of up to two centimeters. The laser causes thermal destruction of the tumor. The advantages of the method are that the possibility of bleeding is eliminated, since the laser beam cauterizes the vessels. A crust forms in the affected area, which disappears after two to three weeks. In its place a small scar is exposed.

Conservative treatment

Hemangiomas can be treated conservatively. One of the methods used in the fight against cavernous and combined hemangiomas is sclerosing therapy. A sclerosing agent - 70% alcohol - is injected into the tumor. This leads to an inflammatory reaction and thrombosis of the vessel, due to which the blood supply to the hemangioma stops. Soon the hemangioma can regress. Typically, several repetitions of procedures are required to achieve the desired result.

In the fight against extensive hemangiomas, hormonal therapy is also used. For this purpose, the child is prescribed Prednisolone. Towards the end hormone therapy the volume of the angioma decreases and growth stops; whitish areas appear on the surface of the hemangioma healthy skin. If necessary, the course of hormonal therapy can be continued after one to two months. However, with the help of such treatment it will not be possible to achieve the desired cosmetic effect, that is, the complete disappearance of the hemangioma. Therefore, you will have to resort to other methods of treatment.

The beta blocker Propranolol can also be used in the treatment of hemangiomas. The drug leads to a narrowing of tumor vessels, stimulating the replacement of the vascular wall with scar tissue.

For angiomas with complex localization, for example, in the orbital area or occupying a fairly large area, radiation therapy is used.

In any case, the decision on the need for dynamic observation or active treatment is made by pediatric surgeon. Therefore, if your baby has a hemangioma, you should consult a doctor and not wait for self-healing.

Grigorova Valeria, medical observer

... benign lung tumors, which are a large group of neoplasms of different origins, are among the rare diseases, accounting for 7 to 10% of all tumors of this localization (M. I. Perelman et al., 1981).

Benign lung tumors 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 lung tumors occur in early period 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 lungs can be very conditional. 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 lung tumors” as a clinical and morphological group is completely justified.

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 a lot 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. (1) In the first stage, there are no clinical signs. 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. (2) In the second stage, there is a more severe disruption of bronchial obstruction. Patients experience shortness of breath, cough, transient pulmonary atelectasis, pneumonia with possible abscess formation. (3) In the third stage, persistent atelectasis is formed, intoxication and pulmonary heart failure are observed.

Hamartoma, just like 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. According to A.I. Abrikosova (1953), 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. With intrabronchial localization, hamartomas form lung atelectasis, and a 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 cartilaginous tissue, while hamartochondroma is a heterogeneous tumor and, in addition to mesodermal elements, contains epithelial ones.

Chondroma, just 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.

Fibroma lungs. This type of benign tumor should be distinguished from neurofibroma, hamartochondroma and fibroangioma. The tumor can be solitary and multiple. 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 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, 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 are sometimes noted. Subsequently, the ESR increases, and the symptom “ drumsticks", amyloidosis of internal organs. A dense shadow is determined radiologically. After removal of the plasmacytoma, radiation therapy is indicated.

Papilloma lung refers to benign epithelial tumors, but 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, it occurs mainly in young people. It does not appear clinically for a long time. Then hemoptysis, symptoms of bronchial obstruction, bronchitis, and sometimes atelectasis may occur.

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.

Pulmonary neuroma. Let us dwell in more detail on the description of pulmonary neuroma, which is a rare tumor and for a long time remains unrecognized. 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.

Thoracic neuroma in 90% of cases 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. According to E.S. Lushnikov and V.V. Golovteeva (1970), pulmonary neuroma is not only potentially malignant, but also presents great difficulties in differential diagnosis with peripheral lung cancer. According to A.P. Avtsyn (1961), the cause of neuroma recurrence is not its malignant degeneration, but the growth of a non-radically removed tumor.

Pleural neuromas are also asymptomatic. According to A.Ya. Tsigelnik and G.I. Chernetsky (1964), the tumor is rarely accompanied by effusion. This is a pedunculated neoplasm originating from the pleura or subpleural tissue 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(lipoma, lymphoma, leiomyoma, xanthoma) are extremely rare. For example, only about 20-30 cases of lipoma and leiomyoma are 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 benign lung tumors 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.

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 genetically determined and rare disease 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 the vascular lung tumor consists of endothelial cells (cells lining the internal vascular walls and characterized by the ability to multiply 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.

How does the disease manifest itself?

The course of the pathology depends on morphological characteristics, 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. 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 lung injuries, 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 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 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. Method confirming vascular character hemangiomas, features of formation and nature of spread.
Biopsy. Rarely done for differential analysis hemangiomas from a malignant tumor.

Hemangioma

Hemangioma is the most common vascular tumor in childhood. It appears as red spots on various parts of the body, including the face. According to statistics, one child in a hundred is born with a hemangioma, and it attracts attention only with its color, increasing moderately in proportion to the child’s height, without causing him any unpleasant sensations.

However, its activity is very dangerous and destructive, since, having formed on the surface of the skin, it actively grows inside. And if a hemangioma in a child forms near one of the organs, then it can disrupt its functioning. So, if its location is near the ear, the hemangioma can destroy eardrum, and the child will lose hearing. For this reason, it must be neutralized as early as possible.

So, hemangiomas are simple (located on the surface of the skin), cavernous (located under the skin), combined (consisting of the skin and subcutaneous parts) and mixed (consisting of the hemangioma itself and other tissues - muscle or nervous), of which simple hemangiomas are found in 70–80% of cases.

The definitive cause of the appearance of hemangiomas is currently unclear, but there are several assumptions:

Bad ecology.

ARI that the mother suffered from in the first 3–6 weeks of pregnancy, when the formation of the fetal vascular system is underway.

Consequences of the mother taking various medications and drugs during pregnancy.

Hormonal characteristics of the child, especially those children who were born prematurely.

In 97% of cases, hemangiomas are detected at birth. But sometimes they appear in children in the first month of life and grow until six months of age, after which their growth usually slows down.

Simple hemangioma has a red or blue-purple color and is located superficially. This hemangioma is clearly demarcated, has a smooth surface and sometimes is somewhat protruding. A simple hemangioma affects the skin and a few millimeters of the subcutaneous fat layer. When pressed, it turns pale, but then regains its color. It grows mainly to the sides.

Cavernous hemangioma located under the skin in the form of a limited node. It looks like a tumor-like formation, covered with unchanged or bluish skin at the top. When pressed, the hemangioma collapses and turns pale, which occurs due to the outflow of blood.

Combined hemangioma are a combination of superficial and subcutaneous hemangioma (simple and cavernous).

Mixed hemangioma consists of tumor cells originating from blood vessels and other tissues. The appearance, color and consistency are determined by the tissues that make up the vascular tumor.

IN Lately Cases have become more frequent when children are diagnosed with multiple hemangeomatosis. There is a known case when one baby had to remove more than a hundred tumors. However, this is the exception rather than the rule.

Treatment. In the treatment of hemangioma, cryotherapy, administration of sclerosing drugs and electrocoagulation are used. However, the most effective and gentle method is laser photothermolysis, i.e. laser radiation that is selectively absorbed by hemangioma tissue and blood, causing damage without damaging surrounding tissue. Surgical treatment consists of excision of deeply located hemangiomas in closed areas of the body and limbs. However, their removal is associated with the risk of massive bleeding, so for preventive purposes preliminary ligation of the arteries feeding the tumor, suturing and suturing of hemangiomas are justified.

Treatment of hemangiomas located on the face, in the parotid region or on the neck is complicated due to the abundant blood supply to these parts of the body. But, fortunately, such tumors occur only in 0.5 % cases.

It is also very difficult to treat hemangiomas that are located in the area mammary gland in girls, on the hands and feet and in the perineum. Hemangiomas are especially dangerous for premature babies: they grow 2-3 times faster than in babies born at term.

However, about 7% of hemangiomas can disappear on their own as the child grows, which distinguishes them from other tumors. But, as a rule, the most harmless ones disappear - simple ones and located in closed areas of the body.

70% of hemangiomas are treated with the cryogenic method, using liquid nitrogen at a temperature of 196 °C. Healing occurs without a scar, which is very important for children. The number of cryotherapy sessions depends on the size of the hemangioma. A tumor up to 10 cm 2 in size can be removed at a time. Treatment is carried out on an outpatient basis, without anesthesia. As a rule, there are no complications. After completion of the procedures, no special therapy is required. It is enough for parents to treat the area where the hemangioma was with brilliant green and then with baby cream.

For deep cavernous hemangiomas (including on the face), the method of microwave cryodestruction is used. In this case, the hemangioma is irradiated with a microwave field and then subjected to cryotherapy.

Children in the first six months of life (with hemangiomas with a total area of more than 100 cm2 or occupying half of the child’s body) benefit greatly from hormone therapy using prednisolone tablets. For hemangiomas of the eye orbit and periorbital region, it is recommended radiation treatment. For tumors in the parotid region, on the face, and neck, a technique of angiography and embolization (that is, narrowing of blood vessels and blocking the blood flow to the tumor) has been developed.

The effectiveness of treatment of simple hemangiomas is 99.9%, complex - 98.6%. The goal of treatment is to eliminate the tumor process and obtain the best functional and cosmetic result. And the right method, as well as timely treatment, can make your child not only healthy, but also beautiful.

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 hemangiomas, found in 50% of cases, are divided into simple and hypertrophic.
Cavernous (cavernous).
Capillary-cavernous - mixed hemangiomas of the lungs, characterized by the largest size.

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. 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. 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 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.

Return to contents

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.

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Treatment of pulmonary hemangiomas

The main treatment method for benign pulmonary tumors is surgical removal 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 a favorable prognosis for the treatment of pulmonary hemangioma.

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Hemangioma: symptoms, diagnosis, treatment in children

Benign neoplasms are quite common in childhood. Every tenth child under the age of one year is diagnosed with hemangioma. This is a benign tumor that originates from blood vessels. And although the process is benign, it is necessary to closely monitor the progression of hemangioma and begin treatment in a timely manner. IN otherwise one should be wary of the development of complications.

Hemangioma: causes of occurrence

To the question of why hemangioma develops, scientists still cannot give a definite answer. Probable cause are the effects of adverse factors during pregnancy during the development of mesenchymal tissue of the fetus. Blood vessels are formed from this tissue. Most aggressive unfavorable factor are infectious diseases of pregnant women, in particular ARVI.

They are often detected literally immediately after the baby is born or in the first weeks or months of life;
Hemangiomas are more often recorded in girls;
Hemangiomas can be of completely different sizes: from a small dot to a large spot.

Development of hemangioma in children

A characteristic sign of hemangioma is a change in its size. There are three stages in the development of hemangioma:

Period of intensive growth;
Period of growth cessation;
Period of reverse development.

It is quite difficult to predict how actively the hemangioma will increase in size. Sometimes the tumor grows even several centimeters per week. It is reliably known that in premature infants, hemangiomas grow much faster than in full-term infants. Hemangiomas actively grow in the first months of a baby’s life. Once the child reaches six months of age, the growth of the neoplasm slows down. This stage is called the stunting period and lasts several years.

The further development of hemangioma is difficult to predict. Reverse development (regression) of the neoplasm often occurs. The brightness of the spot gradually decreases, and areas of white color are visible on it. After six to eight months, the hemangioma becomes pale pink and smooth. By the third or fourth year of a child’s life, only an area of depigmentation on the skin reminds of a neoplasm. It is worth noting that regression is only possible in the case of simple hemangiomas. Cavernous and combined hemangiomas never regress.

Types of hemangiomas

Hemangiomas are most often localized on the skin, but can also occur in internal organs. There are the following types of hemangiomas:

Hemangioma on the skin

Hemangiomas have their favorite places. Most often they occur in the face, scalp, neck, mouth, and hands. Much less often - on the external genitalia, legs.

Simple hemangiomas

In the structure of all hemangiomas, simple hemangiomas make up approximately 95%. A simple hemangioma is a layer of small, tightly adjacent capillary vessels. Sometimes the vessels gather into lobules. The lumen of the vessels is filled with blood. Simple hemangiomas are localized on the skin and do not penetrate the subcutaneous fat. The surface of capillary hemangiomas can be flat or nodular-lumpy.

A simple hemangioma looks like a raised red spot on the skin, which can be of varying sizes. If you press on the edge of the spot, you will notice how it gradually fades. This is due to compression of the vessel and expulsion of blood from it. But as soon as you let go of the skin, the spot immediately turns red. The spot has clear edges and is demarcated from the surrounding healthy tissue. There may be one or more of these growths on the skin.

Cavernous (cavernous) hemangiomas

Cavernous hemangioma consists of many cavities separated by septa. This type of hemangiomas is located in the subcutaneous tissue. Cavernous hemangiomas account for about 3% of all hemangiomas.

Externally, cavernous hemangioma looks like a volumetric formation that noticeably rises above the skin. The surface of the formation is rough. The skin of cavernous hemangioma is not changed. But a bluish tumor-like formation is visualized under the skin. It has a soft elastic consistency to the touch. If you press on it, the swelling decreases somewhat. But soon it regains its previous form. It is typical that when a child strains, cries, or even coughs, the tumor briefly increases in size due to blood flow to it.

Mixed hemangiomas

Mixed hemangiomas are those that are combined with other neoplasms, such as lymphangioma or lipoma. Such hemangiomas are very rare, occurring in approximately 0.6% of all cases of hemangiomas.

The color, consistency, and appearance of the tumor will depend on the tissues that make up the tumor.

Combined hemangiomas

Complications

Hemangioma grows quite quickly, and it is very difficult to predict its further effect on the body. Among the main complications of hemangiomas are:

Bleeding. Develops when tumor tissue is injured. Bleeding with liver hemangioma is especially dangerous, since the volume of blood loss can be very massive.
Ulceration. It develops mainly when hemangioma is localized in the area of the lips, perineum, and large folds of skin. Characterized by the development of an ulcer at the site of the tumor.
Blood clotting disorder. This is due to the fact that a hemangioma, roughly speaking, is perceived by the body as a damaged vessel, which is why platelets actively flow into this area. Over time, the number of platelets in the blood decreases, which can lead to poor blood clotting.
Inflammation and suppuration. Often associated with trauma to the tumor.
Dysfunction of organs affected by hemangioma(impaired vision with hemangioma of the eyelid, impaired hearing with hemangioma of the ear).

Hemangioma of internal organs

Bone hemangioma

Bone hemangioma is a slow-growing benign tumor. More often the tumor is located in the spine, somewhat less often in the bones of the skull and pelvis, and tubular bones.

Diagnostics

To confirm the diagnosis, as well as clarify the extent of skin damage, certain studies can be carried out:

Ultrasound is performed to study cavernous hemangiomas, as well as neoplasms of internal organs. This diagnostic method allows you to study the structure, depth, and size of the hemangioma.

Treatment of hemangioma

Treatment issues must be approached individually, taking into account the characteristics of the disease in a particular child. You can often hear the opinion that hemangiomas do not need to be treated, because they can disappear on their own when the child grows up. However, this opinion is too frivolous. Indeed, simple hemangiomas can regress, but this does not happen in every case. In addition, cavernous and mixed hemangiomas are not at all capable of regressing. Thus, a wait-and-see strategy can only be applied in the case of simple uncomplicated hemangiomas with signs of regression.

There are certain indications according to which treatment of hemangioma should begin as soon as possible:

Hemangiomas located in the head and neck area, in the mouth, anogenital area;
Fast-growing tumors (its area doubles in a week);
Complicated hemangiomas.

Surgical treatment: removal of hemangiomas

Surgical excision of the skin of the tumor is a generally accepted treatment for hemangiomas. However, nowadays surgical intervention is rarely resorted to. First of all, due to the fact that surgery must be performed under general anesthesia. Surgical excision of the skin may be accompanied by blood loss, and a scar remains after the operation. However, surgical excision is preferred for deep hemangiomas, as well as for mature forms of the tumor. That is, when other treatment methods are impossible.

Removal of hemangiomas with laser, cryodestruction

Modern physical methods for removing hemangiomas (cryosurgery, laser removal) have many advantages compared to surgical treatment. Such manipulations are carried out on an outpatient basis, because the procedure lasts only minutes, and there is no need to administer anesthesia to the child.

During cryodestruction, the skin is exposed to liquid nitrogen at a low temperature. The method itself is quite simple, it does not require any special preparation and is carried out without anesthesia. Hemangiomas located on the skin are targeted with liquid nitrogen within seconds, hemangiomas on the mucous membranes - within 7-15 seconds. On the third or fourth day, a crust forms on the treated area of skin; after a month, complete healing of the skin occurs. For large hemangiomas, treatment is carried out in several stages.

Conservative treatment

In the fight against extensive hemangiomas, hormonal therapy is also used. For this purpose, the child is prescribed Prednisolone. By the end of hormonal therapy, the volume of the angioma decreases and growth stops; whitish areas of healthy skin appear on the surface of the hemangioma. If necessary, the course of hormonal therapy can be continued after one to two months. However, with the help of such treatment it will not be possible to achieve the desired cosmetic effect, that is, the complete disappearance of the hemangioma. Therefore, you will have to resort to other methods of treatment.

The beta blocker Propranolol can also be used in the treatment of hemangiomas. The drug leads to a narrowing of tumor vessels, stimulating the replacement of the vascular wall with scar tissue.

For angiomas with complex localization, for example, in the orbital area or occupying a fairly large area, radiation therapy is used.

In any case, the decision on the need for dynamic observation or active treatment is made by the pediatric surgeon. Therefore, if your baby has a hemangioma, you should consult a doctor and not wait for self-healing.

Grigorova Valeria, medical observer

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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 of tumor 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. Hemangiomas are usually limited to lung tissue, however, 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. For hemangioma with fistulas between the pulmonary artery and pulmonary vein, i.e. directly between main 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. The most consistent feature 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 lung hemangiomas, which 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, it is determined increased density lung root, apparently due to the enlargement of 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 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.

Lung hemangioma

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 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, unfavorable ecological environment. In adults possible factors the appearance of pulmonary hemangioma are hereditary predisposition, prolonged exposure to ultraviolet radiation, internal pathology, contributing to vascular disorders.

Classification of pulmonary hemangioma

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.

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 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 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).

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

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 forming vascular (arteriovenous) fistulas between pulmonary artery and vein, hemodynamic disorders occur. Chronic hypoxemia leads to shortness of breath, cyanosis and frequent dizziness, children may also experience delays in growth and development. 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 you can detect noise in lung vessels at the site of the tumor.

The danger of pulmonary hemangioma is possible rupture tumors (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.

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. Indirect sign The tumor may be caused by the presence of telangiectasias 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. 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 in vascular tumors, as it allows you to determine the volume of the 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.

The morphological, endoscopic and clinical-radiological picture of pulmonary hemangioma corresponds to the signs of a benign tumor. Differential diagnosis pulmonary hemangiomas are 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, fenestrated or circular resection of the bronchus, segmental or marginal resection of the lung, removal of the pulmonary lobe (lobectomy), and rarely - removal whole lung(pneumonectomy). Surgical interventions 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 the hemangioma in a more early dates, 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 in case of peripheral location of pulmonary hemangioma and absence of complications in elderly and senile patients. Prognosis of pulmonary hemangioma with timely diagnosis surgical treatment– favorable.