angioma

What is meant by the term "angioma"? It is a type of benign tumor consisting of blood or lymph vessels.

The pathology arises as a result of the expansion and modification of the vascular walls. The severity of the disease depends on the localization of the angioma, as well as on its size and the degree of influence on the flow of fluid inside the vessels.

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Causes angiomas

Angioma develops as a result of the proliferation of the vascular network and endothelial tissue. A typical sign of such a formation is the formation of small-vessel connections at the junctions of arterioles and venules. As a result, a kind of shunting of blood flow past the capillary network occurs, which explains the appearance of the morphological and clinical picture of angioma.

The disease can develop for various reasons, but most often it is a congenital anomaly. Even if such a pathology does not manifest itself in a child, it can make itself known already in adulthood.

Is angioma dangerous?

Angiomas are any benign tumors of vascular genesis, regardless of what system they represent - circulatory or lymphatic. Neoplasms can be located in the superficial layer of the skin or mucous membranes, in muscle tissue, in the cavities and tissues of internal organs, in the brain. Depending on where this tumor is located, the degree of its danger depends. Large angiomas that form in vital organs do pose a danger, and above all, the likelihood of bleeding.

Vascular formations that appear on the surface of the skin are very similar to moles: their danger is not so great.

The risk of bleeding may also depend on the type of formation. We will discuss these types below.

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Risk factors

The theory of congenital vascular anomaly is still just a guess by scientists. Reliable risk factors for the development of angiomas have not yet been determined. Other possible causes include excessive insolation, women's illnesses during pregnancy, hormonal imbalances, liver disease, etc.

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Symptoms angiomas

Clinical symptoms of angiomas may vary depending on the type of neoplasm, its location, volume and development characteristics.

In most cases, the first signs are detected already in the newborn period, or during the first year of life. According to statistics, the disease manifests itself more often in girls. Already a few months after the appearance of the neoplasm can increase from a few millimeters to 2-3 centimeters. In addition, the number of pathological elements that can occur anywhere can increase: on the surface of the skin, in the oral cavity, in the groin, in the respiratory and musculoskeletal system, liver, etc. Depending on the location, the presence of vascular neoplasms can provoke digestive disorders, breathing, urination, defecation, etc.

Bone angioma can appear in the area of the vertebrae, on tubular bones and bones of the cranium, which is often accompanied by pain, deformation, and damage to the periosteum.

Vascular brain tumors are considered extremely dangerous: they can provoke disturbances in brain functions and hemorrhages in the membranes of the brain.

Angiomas from lymphatic vessels most often form on the skin. In most cases, they are found in the neck, in the oral cavity, on the face, under the arms, on the genitals. Such tumors look like a painful lump that can reach considerable sizes. Lymphangioma grows relatively slowly, over several years.

Angioma of the spinal cord

The clinical picture of spinal cord angioma may differ depending on the area of the spinal column where the tumor is located. By location, there are:

• vascular tumors with craniospinal localization (from the cranium to the spinal cord);
• angiomas of the cervical spine;
• angiomas of the thoracic region;
• lumbosacral angiomas;
• vascular tumors of the sacrococcygeal region.

Symptoms develop as a result of pressure on the nerve endings and membranes of the spinal cord. The main signs most often include:

• pain (radiating, constant or intermittent);
• increased sensitivity of the skin in the area of nerve innervation;
• paresthesia;
• weakening of the back muscles;
• disruption of the functioning of some internal organs.

The listed signs are characteristic not only of angiomas, but also of some other tumor processes in the spinal column. Therefore, the diagnosis can only be made after a thorough diagnostics.

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Angioma of the frontal lobe

The frontal lobe of the brain is approximately 29% of the entire cortex, and its weight is more than half of the entire mass of the brain. The frontal lobe is responsible for movement, speech skills, manifestations of individuality and decision-making. Accordingly, when the angioma reaches large sizes, painful symptoms may appear:

• dizziness;
• headache;
• impaired motor coordination;
• lack of initiative, loss of interest in what is happening;
• speech disorders, inhibition, lethargy.

At the initial stages of development, the symptoms are weak. Sometimes signs of the disease appear only when bleeding begins in the tumor.

Due to excessive accumulation of vessels, their fusion and thinning of the walls of the litter, hemorrhage may occur, which has the symptoms of a stroke. Convulsions, paralysis, paresis, deterioration of vision, speech disorders, etc. are observed.

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Cerebellar angioma

Symptoms of cerebellar angioma may be the same as those of frontal lobe lesions. In addition, the disease may proceed latently if the tumor is small and does not press on surrounding tissues. Problems may be detected after the angioma begins to bleed.

The progression of a vascular tumor is accompanied by a circulatory disorder in the affected area, which is explained by the accumulation and interweaving of blood vessels of different calibers. The outcome of the disease largely depends on the general condition of the vascular system in the body. For example, with hypertension and high blood pressure, the risk of hemorrhage increases several times.

Multiple hemorrhages are especially dangerous and can lead to irreparable negative consequences.

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Angioma of the eye

Vascular changes can affect not only the skin surfaces of the body and the brain, but also organs, including the eyes.

Retinal angioma is generally considered a congenital disease. The vascular plexuses are detected at birth or somewhat later. Often the problem is identified when a person's vision gradually begins to deteriorate, up to complete blindness.

Retinal angioma occurs with the formation of weak vascular interlacing of different color shades - from crimson to grayish-greenish. A focus of edema and small areas of bleeding sometimes appear around the tumor.

Vascular neoplasms of the eye are characterized by slow development with normal preserved visual function. In this case, most often only one eye is affected.

Further progression of the disease leads to the appearance of cataracts or retinal detachment.

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Angioma of the pharynx

Vascular tumor in the pharynx resembles variously sized nodules of burgundy or brownish color on a wide base. The standard location of angioma is the area of the soft palate and palatine arches, the root of the tongue, the walls of the pharynx and tonsils.

The neoplasm can grow to a significant size. The first signs are a diffuse sensation of a foreign body in the throat and bleeding, although in some cases there may be no symptoms. Most often, bleeding occurs after eating coarse food that injures the vascular nodule. Large lesions can be accompanied by serious bleeding, even death.

General symptoms can be divided depending on the affected pharyngeal region:

• If the upper section is affected, problems with swallowing food, sore throat and coughing may occur;
• when the middle section is affected, hoarseness in the voice and streaks of blood in the salivary fluid are detected;
• When the lower section is affected, difficulties with breathing and speaking arise.

The exact causes of pharyngeal angioma have not been identified. Experts suggest a hereditary etiology of the disease.

Angiomas in HIV

Patients with the immunodeficiency virus often develop cardiovascular diseases. Vascular lesions can be suspected in patients with fluctuations in blood pressure, with frequent inflammatory processes in the joints and muscles, with diseases of the urinary system and nervous system, with myocardial and cerebral ischemia.

Angiomas are not detected more often in HIV patients than in other people. In some cases, vascular neoplasms are formed as a result of an inflammatory reaction in the vessel walls, mainly in patients aged 20 to 30 years, regardless of the presence of atherosclerotic changes. In this case, the peripheral capillary network is most often affected.

The symptoms of angioma are no different from those of other patients. The disease is detected during angiography or in the presence of characteristic signs of pathology.

Patients with angiomas against the background of HIV should undergo regular examinations by a specialist, since the risk of bleeding in such patients is much higher.

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Angioma in newborns

In most cases, angioma has a congenital etiology. A connection is assumed between some factors that occur during pregnancy and the development of vascular tumors. Thus, angioma in newborns can form as a result of the following reasons:

• disturbances in the intrauterine development of the fetus during the period of formation of the vascular network (this occurs already in the third week of pregnancy);
• infectious diseases of women during pregnancy;
• risk of spontaneous abortion.

If a newborn child has an angioma, a consultation with an oncologist and his observation are considered mandatory. If you ignore the signs of angioma, you can miss unpleasant complications in the form of bleeding. There is also a certain risk of degeneration of a vascular tumor into a malignant formation with an aggressive course. Therefore, most often in early childhood, the removal of suspicious vascular clusters is practiced.

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Angioma during pregnancy

As is known, during the period of bearing a child, a huge number of changes occur in the female body, which is mainly due to the redistribution of hormone levels. At this time, excessive pigmentation of the skin often appears, and the appearance of angiomas is not uncommon.

Vascular formations can be found on the face, in the décolleté area, on the forearms. The capillary network in pregnant women becomes especially vulnerable: hence the appearance of spider veins and stellate hemangiomas.

Some such formations may disappear on their own in the postpartum period, when the mother's hormonal background returns to normal. However, the tumor should be closely monitored: even a slight change in the shade or size of the angioma should alert you and serve as a reason for a doctor's consultation.

It is also necessary to avoid possible trauma to the neoplasm. Even a small-looking vascular growth can provoke severe bleeding.

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Forms

Angiomas are primarily divided into those that develop in the circulatory system (hemangioma) or in the lymphatic system (lymphangioma).

Classification by histological features:

1. monomorphic angioma – a formation based on any one vascular element;
2. polymorphic angioma – a formation of several vascular elements.

Classification by structural feature:

• Capillary angioma is the most common type of disease in which the basis of the structure is capillaries. The capillary formation is most often located on the surface of the skin, less often - in the organs inside the body.

In most cases, capillary formation is detected during the neonatal period. Angioma has the ability to grow and increase in size, but by the time the body matures, the angioma gradually fades and disappears.

Self-elimination of the tumor occurs as follows:

1. the smallest vessels that are part of the structure of the formation stick together and stop passing blood;
2. the neoplasm becomes discolored and its size decreases;
3. destruction of capillaries occurs;
4. the tumor is not visually detectable.

It is worth noting that the further development of capillary angioma is unpredictable. Sometimes it can grow and expand to nearby vessels.

• Venous angioma is detected much less frequently, in contrast to capillary. As the name suggests, such a tumor consists of a venous vascular network, which, growing, acquires a bluish tint. Venous angioma can be quite large. It affects both superficial and deep venous vessels.
• Cavernous angioma is an even rarer type of vascular neoplasm. This tumor is built on the basis of thin-walled vessels, in which specific areas of expansion are formed - caverns, where thrombus formation can occur. Cavernous tumors are located in the skin and digestive organs. Visually, an angioma of this type resembles a bluish-red elevation with a spongy structure. The caverns of the sponge are filled with blood fluid.
• Cherry angioma is a dermatological disease that affects people in adulthood (mainly after 30 years). The disease is characterized by the appearance of small reddish papules (1-5 mm) on the surface of the body, mainly in the chest area or on the scalp. Such angioma is a cluster of dilated blood vessels in the dermis layer.

Why cherry angioma is formed is still unknown. Such formations are benign, but they tend to spread throughout the body with age. Multiple angioma is already a serious enough reason to see an oncologist.

• A stellate angioma (also known as a spider angioma) can occur at any age: the disease looks like a red formation, from which threads of the same color branch off – blood-filled capillaries. Externally, a stellate angioma really does resemble a star or a spider. The main vessel supplies nutrition to all the affected structures of the tumor. Due to this, the formation gradually increases to 8-10 centimeters, only in rare cases not changing its size.

The most common localization of spider veins is the skin of the face, head and shoulders. Experts see the reason in a sharp increase in the level of estrogens in the bloodstream, or in a genetic predisposition. Such tumors look unaesthetic, but do not cause their owner any unpleasant sensations.

• A punctate angioma is a so-called "common" angioma that poses absolutely no danger to human health. The tumor looks like a small, dense formation protruding above the skin surface. The color shade ranges from slightly pinkish to dark red or burgundy. In some cases, the punctate elements do not add visual appeal, but experts do not recommend removing them hastily - this can lead to further spread of the process.
• Glomus tumor (glomus angioma) consists of arteries and veins, and can be located independently or multiple. Glomus is a glomerular arteriovenous anastomosis (vascular connection). The vessels of such a tumor have a narrowed lumen and a large number of glomus cells, which are considered to be altered structures of smooth muscle tissue.

Glomus angiomas are located mainly on the fingers and toes, sometimes on the extremities. They do not cause pain, although they develop close to the surface of the skin. In most cases, the disease occurs in children, more often in boys.

• Senile angioma has a second name - senile. From this it is clear that this type of disease is most typical for elderly patients. Often the disease is taken for an ordinary mole, although its structure is somewhat different. Senile angiomas are not dangerous, even if they spread on the surface of the skin in large quantities. They are usually considered a type of cherry angioma.

In shape, a senile tumor can be spherical, oval, or hemispherical. The bulge has an uneven surface and reaches 1 to 6 mm in diameter. It occurs mainly in fair-skinned people, regardless of gender.

• Flat angioma is a congenital disease. It looks like a spot of various shapes, deep pink or purple. With physical exertion or temperature changes, the depth of the tumor color may change.

Flat angioma is usually located in the area of the face, neck, back, or upper limbs. This type of neoplasm can behave unpredictably: sometimes tumors can enter an active growth stage and occupy fairly large areas of the skin. In rare cases, tissues can undergo necrosis, bleed, and ulcerate. If this happens, a consultation with an oncologist-dermatologist is mandatory and urgent.

Vascular angiomas are also classified depending on their location in the body tissues. Thus, a distinction is made between angiomas of the brain, skin, internal organs, etc.

For example, a skin angioma is usually located in the superficial layers. It can be seen with the naked eye. Such tumors are usually left alone, unless they cause concern to their owner. Skin angiomas are not dangerous. However, they must be protected from injury and damage.

Unlike a superficial tumor, a brain angioma is considered a more serious pathology and can cause unpleasant symptoms such as headaches, convulsions, nausea, etc. Moreover, a long-term progressing brain angioma can provoke hemorrhage and other negative consequences.

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Complications and consequences

Of the most dangerous consequences of vascular tumors, bleeding should be singled out first. The risk of hemorrhage is estimated at approximately 3% of annual cases, from minor bleeding to massive bleeding. It is especially dangerous if such complications occur in the brain or spinal cord.

It is almost impossible to prevent hemorrhage in advance. Vascular accumulation may have a stable course, but sometimes deterioration occurs suddenly. A sharp regression of the tumor, up to its disappearance, is also not excluded.

However, there are a number of factors that increase the risk of bleeding:

• tumor size;
• disruption of blood flow in the altered vessels;
• increased intravascular pressure;
• increase in circulating blood volume;
• existing hemorrhages.

It is noted that the superficial location of the neoplasm is characterized by a lower ability to bleed. However, such hemangiomas also require regular medical monitoring.

Recurrence, or relapse of an angioma may occur after conservative non-radical removal of the neoplasm. Almost all vascular pathological clusters are prone to such recurrence. Therefore, if an angioma causes discomfort, it is recommended to remove it radically, surgically.

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Diagnostics angiomas

Superficial cutaneous angioma is diagnosed directly during a routine external examination and palpation. In this case, the characteristic sign is the formation becoming pale after pressing on its central area.

If the pathology is deeply located, a comprehensive diagnosis is prescribed. Among the many diagnostic methods, the following can be used:

• X-ray of the skeletal system;
• angiography of the cerebral vascular network;
• angiography of other organs;
• lymphangiography;
• Ultrasound of blood vessels;
• consultation with a specialist (otolaryngologist, urologist, neurologist, pulmonologist, etc.).

Standard blood tests are of little use. When diagnosing lymphangioma, a puncture may be performed with subsequent analysis of the intratumor fluid.

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Differential diagnosis

Differential diagnostics are carried out with the following diseases:

• angiokeratoma;
• pigmented nevus;
• melanoma;
• angioleiomyoma;
• hemangiopericytoma.

Lymphangioma should be distinguished from isolated scleroderma and pachydermia.

Instrumental diagnostics is most often represented by angiography. This is a radiopaque method of examination, which makes it possible to visualize the vascular network, its direction, size and other characteristics on film. Recently, a more advanced method has often been used - superselective angiography. This method differs from the previous one in that the contrast is introduced not into the general vascular bed, but directly into the area of vascular accumulation.

Treatment angiomas

The choice of treatment method may depend on the type of angioma, its location, size and course characteristics. If the tumor is insignificant and does not cause discomfort to the patient, then it is most often left alone. For disturbing neoplasms, the most common methods are:

• laser removal;
• electrocoagulation;
• cold therapy (cryocoagulation);
• radiation therapy;
• traditional surgery;
• hormonal therapy.

Treatment should be aimed at stopping further tumor development and restoring blood flow.

Nutrition for angioma

If you are prone to developing vascular tumors, it is very important to regulate your diet and lifestyle. To do this, you should give up alcohol, smoking, get used to moderate physical activity, and also review your diet.

Nutrition for angioma should be aimed at providing the body with all the necessary substances, as well as preventing obesity, atherosclerosis and metabolic disorders in the body.

In case of vascular pathologies, it is recommended to avoid meat broths, animal fats (including butter and lard), fried foods, and offal. It is also advisable to exclude sweets and baked goods, since easily digestible carbohydrates increase the fragility of vascular walls.

It is necessary to reduce the daily amount of salt and hot spices.

The daily menu should include the following products:

• dark bread, biscuits and dry cookies;
• vegetable first courses;
• vegetable side dishes;
• lean meats;
• lean fish;
• egg whites;
• seafood, greens;
• cereals;
• fruit dishes;
• vegetable sauces;
• low-fat dairy products;
• vegetable oil;
• dried fruits.

When forming a diet, it is permissible to use therapeutic table No. 10.

Prevention

Prevention of congenital pathologies consists of the pregnant woman following a proper diet and lifestyle, timely treatment and prevention of diseases during pregnancy.

Other methods of prevention include:

• maintaining the health of the reproductive system;
• prevention of metabolic disorders;
• timely treatment of acute and chronic diseases of the cardiovascular system.

It is very important to pay attention to the state of the hormonal background in the body: avoid long-term use of oral contraceptives, do not use hormonal agents without a doctor's prescription. You should not sunbathe for a long time and often, visit a solarium.

If an angioma is already present, then its growth process should be monitored, avoiding injuries and damage, so as not to provoke bleeding.

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Forecast

The prognosis for minor superficial angiomas is favorable: such formations do not have a negative impact on general health and life expectancy.

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