Reclassification and histopathological study of vascular anomalies according to ISSVA (2018 revision) classification

Abstract

Background: Vascular anomalies (VAs) represent a spectrum of disorders from simple birthmarks to life-threatening entities. Consistency in the terminology of vascular anomalies and diagnosis by routine histology is necessary for the proper diagnosis and clinical management. Aim: The present study aimed to classify the vascular anomalies according to the 2018 revised classification of ISSVA and to evaluate the role of GLUT-1 (glucose transpoter protein isoform 1) immunomarker as a complementary tool to aid in differentiating vascular anomalies. Materials and methods: In this retrospective study, clinical records of 47 cases reported as vascular anomalies from January 2017 to June 2019 were retrieved from the Department of Pathology, ASRAM Medical College, Eluru. The cases were analyzed based on findings of histochemical stains such as Verhoeff-van Gieson (VVG) and classified as per ISSVA. Further immunohistochemistry studies of GLUT-1 were done. Results: Of 47 patients, the male to female ratio was found to be 1.06:1 and 46.80% of cases were vascular tumors, whereas 53.19% cases were vascular malformations in this study. Of 22 cases histologically diagnosed as vascular tumors, 06 cases were infantile hemangiomas and showed immunopositivity with GLUT-1 marker and the rest of vacular tumors and malformations were immuno negative for GLUT-1. Conclusion: ISSVA classification provides a framework for understanding the morphology, guiding the treatment plan and prognosis. In addition to this, GLUT-1 precisely differentiated infantile hemangioma from other vascular tumors and malformations. Keywords: vascular anomalies; GLUT-1, infantile hemangioma; vascular malformation; vascular tumors