Fibro-adipose vascular anomaly and intramuscular venous malformation: a clinical and pathological comparative study
10.3760/cma.j.cn114453-20220318-00072
- VernacularTitle:纤维脂肪性血管性病变与肌肉内静脉畸形的临床病理比较研究
- Author:
Caijun JIN
1
;
Yong CHEN
;
Qian WANG
;
Min WANG
;
Siming YUAN
Author Information
1. 南京医科大学金陵临床医学院 解放军东部战区总医院烧伤整形科，南京 210000
- Keywords:
Vascular malformation;
Venous malformation;
Fibro-adipose vascular anomaly;
Pathology;
Magnetic resonance imaging
- From:
Chinese Journal of Plastic Surgery
2023;39(3):252-260
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical symptoms, imaging and histopathological features of fibroadipose vascular anomaly (FAVA), and to propose the differential diagnostic criteria for FAVA and intramuscular venous malformation (IMVM).Methods:Clinical data of FAVA and IMVM patients admitted to the Department of Burn and Plastic Surgery, Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into FAVA group and IMVM group, and the clinical symptoms, coagulation function and imaging results of the two groups were analyzed. The pathological characteristics of the surgically resected specimens were observed by HE staining, and the similarities and differences between FAVA and IMVM were summarized. Pearson chi-square test was used to investigate the occurrence of local intravascular coagulation (LIC) between the two groups, and P<0.05 was considered statistically significant. Results:Fourteen patients were included in FAVA group, including 4 males and 10 females. The age of treatment was (28.2 ± 13.2) years old and the age of onset was (20.5 ± 10.1) years old. A total of 39 patients were included in the IMVM group, including 16 males and 23 females. The age of treatment was (28.5 ± 14.1) years old and the age of onset was (18.8 ± 9.5) years old. The clinical symptoms of FAVA and IMVM patients were pain, swelling and paresthesia. MRI images of the FAVA group showed fat signal in muscle and varicose vascular shadow. The IMVM group showed large irregular vascular shadows in muscle without fat signal. Histopathological observation revealed fibroadipose hyperplasia accompanied by varicose veins in FAVA group. However, in IMVM group, the lesions showed a large number of malformed veins mixed with muscle, without fibroadipose hyperplasia. There were 2 cases of LIC in FAVA group and 21 cases of LIC in IMVM group, the difference was statistically significant ( χ2 =4.39, P=0.036). Conclusion:The clinical symptoms of FAVA and IMVM are similar. The differential diagnosis of FAVA and IMVM requires MRI and pathological examination. The main difference is that there is fibroadipose hyperplasia in FAVA lesion, while there is no fibroadipose hyperplasia in IMVM lesion.
