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Glomusangioma

Glomusangioma — the benign tumor proceeding from an arteriovenous anastomosis.

Epidemiology

It is observed at various age, without distinction as to sex. Multiple glomusangiomas can be inherited on autosomal dominantly type.

Classification

Allocate 2 forms:
• isolated;
• the multiple disseminated glomusangioma.

 Etiology and pathogeny

The tumor of organoid type, develops from walls of the channel the Bough — Goyera, being functional part of a klubochkovidny arteriovenous anastomosis.
It has a narrow gleam, is covered by endotheliocytes and surrounded several rows of glomal cells which are considered as the modified smooth muscle cells changing an anastomosis gleam. Balls are richly innervated.

Clinical signs and symptoms of a glomusangioma

Preferential localization — fingers of brushes and feet, in a zone of a nail bed, is more rare on skin of a shin, a hip, a trunk.
The solitary type represents the small knot of purple color with a diameter of 0,3 — 0,8 cm, a soft consistence which is accurately delimited, sharply painful, located in the depth of a derma.
Multiple glomusangiomas meet less often, they almost painless, are located vnutrikozhno or subcutaneously.
Arise more often at children's age, mainly at boys, can be combined with damages of internals.

The diagnosis and the recommended clinical trials

The diagnosis is made on the basis of clinical manifestations; at multiple type the biopsy of one of elements is shown.
The solitary node of a glomusangioma consists of a large number of small vessels which gleams are covered by one layer of the flattened endotheliocytes. To the periphery from them the glomal cells having slaboeozinofilny cytoplasm and large oval kernels, phaeochrous hematoxylin, the reminding epithelial elements are located in several layers. In many sites polymorphism, and also dystrophic changes are noted them. The tumor stroma scanty, is provided by the argyrophil fibers and posterior collagenic pyramids sometimes hyalinized. At impregnation by silver nitrate the large number of nerve fibrils comes to light, is more often than amyelinic.
Multiple glomusangiomas have no capsule and consist of larger vascular cracks of irregular shape. As well as in a solitary node, vascular cracks are covered by one layer of the flattened endotheliocytes, but the number of the glomal cells which are located to the periphery from endothelial are much less, and in places they are absent. Increase in number of nerve fibrils is not observed. The similar structure reminds a structure of a cavernous hemangioma.

Differential diagnosis

Gemangioperitsitoma.

General principles of treatment

Surgical excision of solitary tumors as a choice method, laser evaporation at multiple type of defeat.

Forecast

Favorable.
 
"Histiocytoses of X   Glucagonoma"