Soft tissue tumors - Intravascular papillary endothelial hyperplasia

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Soft tissue tumors

Benign vascular tumors

Intravascular papillary endothelial hyperplasia

Reviewer: Vijay Shankar, M.D. (see Reviewers page)
Revised: 24 February 2013, last major update November 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Definition
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● Reactive, not neoplastic, representing exuberant organization and recanalization of thrombus
● In normal vessels but also varices, hemorrhoids, pyogenic granulomas, hematomas, angiosarcomas

Terminology
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● Also known as Masson's tumor

Sites
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● Dermis and subcutis of head and neck, lip, tongue, buccal mucosa
● Also seen in heart, larynx and hypopharynx

Clinical features
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● Pure type: within a dilated vascular space
● Mixed type: with preexisting vascular disorder or in a hematoma
● Extravascular form: rare and occurs in extravascular organizing hematoma

Case reports
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● 35 year old man with lesion of the paranasal sinus (Arch Pathol Lab Med 2000;124:1224)
● 39 year old man with painless enlargement of parotid gland (Indian J Pathol Microbiol 2011;54:226)
● 50 year old woman with small bowel lesion (Case Rep Gastroenterol 2010;4:124)
● 70 year old woman with mouth lesion (Case Rep Dermatol 2010;2:22)

Clinical description
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● Usually presents as a red blue nodue in skin

Clinical images
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Leg

Oral mucosa

Gross description
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● Small, firm, red-blue superficial masses in skin

Gross images
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Small bowel

Micro description
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● Intravascular lesion only, with papillary formations with hyaline or fibrous stalks, anastomosing vascular channels, plump endothelial cells; residual organizing thrombi
● No necrosis, no atypia, no atypical mitotic figures

Micro images
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Paranasal sinus lesion

Parotid gland lesion

Oral mucosa

Small bowel

Positive stains
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● Factor VIII, alpha smooth muscle adcin and CD34 in cells lining the papillae
● Occasionally podoplanin and CD105 (J Oral Sci 2011;53:475)

Differential diagnosis
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● Angiosarcoma

End of Soft tissue tumors > Benign vascular tumors > Intravascular papillary endothelial hyperplasia

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