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Intravascular endothelial proliferations in children
Insights
This study describes six pediatric cases of benign vascular lesions. Five cases showed features of intravascular papillary endothelial hyperplasia, a variant of organizing thrombus.
Area of Science:
- Dermatology
- Pathology
- Pediatrics
Background:
- Benign vascular lesions in children can present diagnostic challenges.
- Intravascular papillary endothelial hyperplasia (IPEH) and intravenous atypical vascular proliferation are recognized pseudomalignant vascular disorders.
Purpose of the Study:
- To describe the clinical and histological features of six pediatric cases with benign cutaneous vascular lesions.
- To discuss the differential diagnosis and classification of these lesions, particularly IPEH and atypical vascular proliferation.
Main Methods:
- Retrospective review of six pediatric patients with benign cutaneous vascular lesions over a 16-year period.
- Histopathological examination of lesion biopsies.
Main Results:
- Five of six children had lesions consistent with intravascular papillary endothelial hyperplasia (IPEH).
- One IPEH case presented in pure form, while four were focal changes within hematomas.
- The sixth patient's lesion exhibited features compatible with "intravenous atypical vascular proliferation."
Conclusions:
- The authors support the view that IPEH is a peculiar variant of an organizing thrombus.
- Distinguishing these benign vascular proliferations from malignant entities is crucial in pediatric dermatology and pathology.
Abstract:
Six children who had benign cutaneous vascular lesions characterized by papillary or solid proliferation of the endothelial cells were seen in a 16-year period. In five of them, the lesions had the histologic features of the entity originally described by Masson and recently reported by Clearkin and Enzinger as intravascular papillary endothelial hyperplasia. In one of the five, the lesion appeared in the pure form within large vascular spaces, whereas in the remaining four it appeared as a very limited focal change in a hematoma. The authors agree with others that this lesion represents a peculiar variant of an organizing thrombus. The histologic features of the lesion in the sixth patient were compatible with the so-called "intravenous atypical vascular proliferation," another pseudomalignant vascular disorder recently described by Rosai and Akerman.