Dermatopathology Unknown:
A 24 year old woman with an abdominal plaque

by

Ronald J. Barr, M.D.

Dermatology Online Journal, December 1995
Volume 1, Number 2



Clinical History:

The patient, a 24 year-old-woman, presented with a one month history of a right abdominal lesion. On examination, there was 1 cm., irregularly-shaped, reddish plaque with moderate induration. A small overlying erosion was present. A punch biopsy was obtained and the specimen re-excised one month later. The specimen for examination was from the re-excision.



Important Microscopic Features:

  1. On low magnification there is an obvious proliferation of small vessels present in an infiltrative pattern within the dermis.
  2. Many of these vessels are irregularly branched with inconspicuous lumina.
  3. there is minimal hypertrophy and atypia of endothelial cells.
  4. The stroma is variably sclerotic.
  5. The above alterations account for a "desmoplastic" appearance.
  6. There are rare scattered lymphocytes and mast cells.
  7. There are only minimal deposits of hemosiderin.
  8. Immunohistochemistry shows positive staining with ULEX and weak staining with Factor VIII.

Differential Diagnosis

  1. Kaposi's sarcoma
  2. Targetoid hemangioma
  3. Angiosarcoma
  4. Lobular capillary hemangioma

Answer

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