PG Corner- Case 3

Dr Anuj ParkashWritten by | HISTOPATHOLOGY, PG CORNER

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Background

31-year-old male, presented with left thumb swelling. Swelling was circumscribed nodular and red in color measuring 1.7×1.5cm. Radiology was suggestive of Giant cell tumor of Tendon sheath. Wide local excision was done and tissue was sent for histopathological examination.

Microscopy

Fig.3a;H&E; 0.42x

Fig.3b; H&E; 5x

Fig.3c; H&E; 2.5x

Fig.3d; H&E; 10x

Fig.3e; H&E; 20x

Fig.3f; H&E; 20x

Images show hyperkeratotic and acanthotic stratified squamous epithelium with underlying dermis and subcutaneous tissue showing large blood filled spaces [Fig.3a-c]. On higher magnification an intravascular tumor with anastomosing vascular channels filled with blood and lined by spindle shaped cells with spindle shaped nuclei is noted with focal pseudopapillary pattern. [Fig.3d-e]. Thrombus and fibrin deposition also seen [Fig.3f].

 

Final Impression: Papillary Endothelial Hyperplasia.

 

  • Reactive condition
  • Also known as Masson’s tumor
  • Represents exuberant organization and recanalization of thrombus
  • Common Sites: Dermis and subcutis of head and neck, fingers & trunk
  • Immunohistochemistry:
    • Positive stains: SMA, CD34, FactorVIII
  • Commonly confused with Angiosarcoma.
    • Intravascular location, absence of frank necrosis or marked pleomorphism  or mitosis negates Angiosarcoma.

Contributed by: Dr. Sunil Pasricha

Compiled by: Dr. Ankur Kumar & Dr. Himanshi Diwan


In case of queries, email us at: kumar.ankur@rgcirc.org

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Last modified: 05/06/2021

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