Benign vascular proliferation


Benign vascular proliferation is a term pathologists use to describe a non-cancerous growth of small blood vessels. These growths are made up of endothelial cells, which are the cells that line the inside of blood vessels. The word “benign” means the lesion is not cancer, and “vascular proliferation” means there is an increased number of blood vessels forming in the tissue.

This term is often used in biopsy reports, especially when only a small piece of tissue is examined and the appearance suggests a harmless process, but there is not enough information to give a more specific diagnosis. In many cases, the lesion is caused by healing, inflammation, or a previous injury.

Where are benign vascular proliferations found?

Benign vascular proliferations can occur anywhere in the body but are most often seen in:

  • Skin and soft tissue – often after minor trauma or irritation.

  • Mucosal surfaces – such as the mouth, lips, or genital area.

  • Lymph nodes – sometimes as a reactive change.

  • Organs – rarely, small benign vascular growths can be seen in organs like the liver or spleen.

In some cases, the proliferation is part of the body’s normal healing response, especially after surgery, infection, or inflammation.

Are benign vascular proliferations cancer?

No. By definition, a benign vascular proliferation is not cancer. These lesions do not invade nearby tissues or spread to other parts of the body. They are typically self-limited and may go away on their own or remain unchanged for many years.

However, in a small biopsy, it can sometimes be difficult to tell the difference between a reactive proliferation of blood vessels and a true vascular tumour such as a hemangioma. For this reason, your doctor may recommend removing the entire lesion or doing further testing to confirm the diagnosis and rule out other possibilities.

What causes benign vascular proliferation?

Benign vascular proliferations often develop as part of the body’s response to injury, irritation, or inflammation.

Common causes include:

  • Trauma or surgery.

  • Infection.

  • Radiation therapy.

  • Inflammatory conditions.

  • Healing after skin ulcers or wounds.

Sometimes no clear cause is found, and the lesion is discovered during a biopsy for another reason.

What does benign vascular proliferation look like under the microscope?

Under the microscope, a benign vascular proliferation appears as a cluster of small, thin-walled blood vessels, often arranged in a disorganized pattern. The endothelial cells lining the vessels look bland and uniform, with no signs of cancer.

There may be signs of inflammation, fibrosis (scar tissue), or blood clots, especially if the lesion is healing from a previous injury. The appearance can sometimes mimic other vascular growths, so pathologists often use special stains to help confirm the diagnosis.

How is the diagnosis made?

The diagnosis is usually made by examining a biopsy sample under the microscope. In some cases, immunohistochemistry may be used to confirm that the cells are of vascular origin.

Common markers include:

  • CD31, CD34, and ERG – markers that highlight endothelial cells.

  • D2-40 or podoplanin – used to detect lymphatic vessels.

  • Ki-67 – a marker of how quickly the cells are growing.

If the biopsy is small or the features are not entirely typical, the pathologist may call the lesion a “benign vascular proliferation” until more information is available.

What does benign vascular proliferation mean for my treatment?

In most cases, no further treatment is needed. However, if there is any uncertainty in the diagnosis, or if the lesion is growing, bleeding, or causing symptoms, your doctor may recommend:

  • Complete removal of the lesion for a more thorough examination.

  • Follow-up visits to make sure the lesion does not change over time.

  • Imaging or further testing in rare cases if the lesion is in an internal organ or not easily accessible.

Your doctor will determine the best approach based on your clinical history, location of the lesion, and the pathology findings.

Questions to ask your doctor

  • What caused the benign vascular proliferation in my case?

  • Was this found on a biopsy or after a complete excision?

  • Do I need additional treatment or follow-up?

  • Is there any chance this could be something more serious?

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