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Skin - Nonmelanocytic tumors

Vascular tumors

Pyogenic granuloma

Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 19 August 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Very common; rapidly growing polypoid red mass surrounded by thickened epidermis, often in finger or lips
● Also called granuloma pyogenicum, lobular capillary hemangioma
● May be associated with keratinous cyst
● Benign, often regresses spontaneously
● May be disseminated, occur within port-wine stains, be in deep dermis / subcutis or be intravenous

Variants:
● Classic polypoid, dermal, subcutaneous, intravenous, eruptive, with multiple satellites

Treatment
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● None or excision (may recur as multiple satellites)

Gross description
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● Fleshy cutaneous tumor

Micro description
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● Lobular pattern of vascular proliferation with inflammation and edema resembling granulation tissue
● Thin epidermis at top with variable ulceration
● Acanthosis and hyperkeratosis at sides
● Central branching vessel is called capillary or vascular lobule, with no/rare red blood cells, surrounded by endothelial cells
● Variable mitotic activity
● Deep lesions often lack edema and inflammation

Micro images
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Low magnification

Differential diagnosis
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● Acrodermatitis
● Bacillary angiomatosis
● Benign (infantile) hemangioendothelioma
● Reactive angioendotheliomatosis
● Venous stasis
● Verruga peruana

End of Skin - Nonmelanocytic tumors > Vascular tumors > Pyogenic granuloma

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