Abstract
Vascular anomalies can be correctly diagnosed in the majority of instances using the combination of clinical history, physical examination and imaging. In certain cases, the clinical work-up may be inconclusive or unavailable to the radiologist, and the imaging findings can be nonspecific, yielding more than one possible diagnosis. In this pictorial essay, we discuss diagnoses that can mimic vascular anomalies and highlight key differentiating imaging features.
Similar content being viewed by others
References
Finn MC, Glowacki J, Mulliken JB (1983) Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 18:894–900
Mathes EF, Haggstrom AN, Dowd C et al (2004) Clinical characteristics and management of vascular anomalies: findings of a multidisciplinary vascular anomalies clinic. Arch Dermatol 140:979–983
Mamlouk MD, Nicholson AD, Cooke DL, Hess CP (2017) Tips and tricks to optimize MRI protocols for cutaneous vascular anomalies. Clin Imaging 45:71–80
Houbara S, Akita S, Yoshimoto H, Hirano A (2014) Vascular malformations that were diagnosed as or accompanied by malignant tumors. Dermatol Surg 40:1225–1232
Emil S, Milanchi S, Goldstein A (2005) Cecal vascular malformation mimicking appendicitis in a child. Pediatr Surg Int 21:723–724
Hoornweg MJ, Theunissen CI, Hage JJ, van der Horst CM (2015) Malignant differential diagnosis in children referred for infantile hemangioma. Ann Plast Surg 74:43–46
Gaur A, Ambey R, Sharma A, Gupta S (2013) Abscess mimicking pre-cervical and submandibular cystic hygroma in a newborn. Australas Med J 6:318–320
ISSVA Classification 2018. Available online: http://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf. Accessed 3 Jan 2019
Frieden IJ, Rogers M, Garzon MC (2009) Conditions masquerading as infantile haemangioma: part 1. Australas J Dermatol 50:77–97
Smith CJF, Friedlander SF, Guma M et al (2017) Infantile hemangiomas: an updated review on risk factors, pathogenesis, and treatment. Birth Defects Res 109:809–815
Darrow DH, Greene AK, Mancini AJ et al (2015) Diagnosis and management of infantile hemangioma: executive summary. Pediatrics 136:786–791
Dubois J, Patriquin HB, Garel L et al (1998) Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography. AJR Am J Roentgenol 171:247–252
Mamlouk MD, Hess CP (2016) Arterial spin-labeled perfusion for vascular anomalies in the pediatric head and neck. Clin Imaging 40:1040–1046
Malempati S, Rodeberg DA, Donaldson SS et al (2011) Rhabdomyosarcoma in infants younger than 1 year: a report from the Children’s Oncology Group. Cancer 117:3493–3501
Skapek SX, Ferrari A, Gupta AA et al (2019) Rhabdomyosarcoma. Nat Rev Dis Primers 5:1
Franco A, Lewis KN, Lee JR (2011) Pediatric rhabdomyosarcoma at presentation: can cross-sectional imaging findings predict pathologic tumor subtype? Eur J Radiol 80:e446–e450
Kralik SF, Haider KM, Lobo RR et al (2018) Orbital infantile hemangioma and rhabdomyosarcoma in children: differentiation using diffusion-weighted magnetic resonance imaging. J AAPOS 22:27–31
Megarbane H, Doz F, Manach Y et al (2011) Neonatal rhabdomyosarcoma misdiagnosed as a congenital hemangioma. Pediatr Dermatol 28:299–301
Lope LA, Hutcheson KA, Khademian ZP (2010) Magnetic resonance imaging in the analysis of pediatric orbital tumors: utility of diffusion-weighted imaging. J AAPOS 14:257–262
Jawahar A, Vade A (2014) Sonographic features of physiologic neonatal breast enlargement. J Clin Neonatol 3:106–108
Merrow AC, Gupta A, Patel MN, Adams DM (2016) 2014 revised classification of vascular lesions from the International Society for the Study of Vascular Anomalies: radiologic-pathologic update. Radiographics 36:1494–1516
Croteau SE, Liang MG, Kozakewich HP et al (2013) Kaposiform hemangioendothelioma: atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals. J Pediatr 162:142–147
Ryu YJ, Choi YH, Cheon JE et al (2017) Imaging findings of Kaposiform Hemangioendothelioma in children. Eur J Radiol 86:198–205
Sargar KM, Sheybani EF, Shenoy A et al (2016) Pediatric fibroblastic and myofibroblastic tumors: a pictorial review. Radiographics 36:1195–1214
Naffaa L, Khalifeh I, Salman R et al (2019) Infantile myofibromatosis: review of imaging findings and emphasis on correlation between MRI and histopathological findings. Clin Imaging 54:40–47
Chung S, Frush DP, Prose NS et al (1999) Subcutaneous granuloma annulare: MR imaging features in six children and literature review. Radiology 210:845–849
Hassanein AH, Mulliken JB, Fishman SJ, Greene AK (2011) Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 127:347–351
Greene AK (2011) Vascular anomalies: current overview of the field. Clin Plast Surg 38:1–5
Martinez-Corral I, Ulvmar MH, Stanczuk L et al (2015) Nonvenous origin of dermal lymphatic vasculature. Circ Res 116:1649–1654
Murphey MD, Smith WS, Smith SE et al (1999) From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 19:1253–1280
Petscavage-Thomas JM, Walker EA, Logie CI et al (2014) Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics 34:964–980
Catalano P, Fang-Hui E, Som PM (1997) Fluid-fluid levels in benign neurogenic tumors. AJNR Am J Neuroradiol 18:385–387
Verburg FA, Van Santen HM, Luster M (2016) Pediatric papillary thyroid cancer: current management challenges. Onco Targets Ther 10:165–175
Hoang JK, Branstetter BF 4th, Gafton AR et al (2013) Imaging of thyroid carcinoma with CT and MRI: approaches to common scenarios. Cancer Imaging 13:128–139
Torreggiani WC, Al-Ismail K, Munk PL et al (2002) Dermatofibrosarcoma protuberans: MR imaging features. AJR Am J Roentgenol 178:989–993
Millare GG, Guha-Thakurta N, Sturgis EM et al (2014) Imaging findings of head and neck dermatofibrosarcoma protuberans. AJNR Am J Neuroradiol 35:373–378
Bulman JC, Ulualp SO, Rajaram V, Koral K (2016) Pilomatricoma of childhood: a common pathologic diagnosis yet a rare radiologic one. AJR Am J Roentgenol 206:182–188
Hassanein AH, Alomari AI, Schmidt BA, Greene AK (2011) Pilomatrixoma imitating infantile hemangioma. J Craniofac Surg 22:734–736
Ludwig BJ, Wang J, Nadgir RN et al (2012) Imaging of cervical lymphadenopathy in children and young adults. AJR Am J Roentgenol 199:1105–1113
Wassef M, Blei F, Adams D et al (2015) Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics 136:e203–e214
White CL, Olivieri B, Restrepo R et al (2016) Low-flow vascular malformation pitfalls: from clinical examination to practical imaging evaluation--part 1, lymphatic malformation mimickers. AJR Am J Roentgenol 206:940–951
Barksdale EM Jr, Obokhare I (2009) Teratomas in infants and children. Curr Opin Pediatr 21:344–349
Martinez SJ, Moreno CC, Vinson EN et al (2016) Angiomatoid fibrous histiocytoma: novel MR imaging findings. Skeletal Radiol 45:661–670
Saito K, Kobayashi E, Yoshida A et al (2017) Angiomatoid fibrous histiocytoma: a series of seven cases including genetically confirmed aggressive cases and a literature review. BMC Musculoskelet Disord 18:31
Heo SH, Kim JW, Shin SS et al (2014) Review of ovarian tumors in children and adolescents: radiologic-pathologic correlation. Radiographics 34:2039–2055
Wallace D, Sian A, Carne A, Irvine TE (2013) Diagnosis and management of retroareolar cysts in adolescents: a case report. J Surg Case Rep 2013
La'porte SJ, Juttla JK, Lingam RK (2011) Imaging the floor of the mouth and the sublingual space. Radiographics 31:1215–1230
Acknowledgments
Presented as an education exhibit at the 2018 Radiological Society of North America annual meeting and was the recipient of the Cum Laude award.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
CME activity This article has been selected as the CME activity for the current month. Please visit the SPR website at www.pedrad.org on the Education page and follow the instructions to complete this CME activity.
Rights and permissions
About this article
Cite this article
Mamlouk, M.D., Danial, C. & McCullough, W.P. Vascular anomaly imaging mimics and differential diagnoses. Pediatr Radiol 49, 1088–1103 (2019). https://doi.org/10.1007/s00247-019-04418-0
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-019-04418-0