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.
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
- 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
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Last modified: 05/06/2021