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Intravascular
papillary endothelial hyperplasia (Masson's tumour) was first described
by Pierre Masson , who named it 'hemangioendotheliome vegetant
intravasculaire' [Bull Soc Anat-( Paris) 1923; 93:517- 532].
It is a reactive condition representing an unusual form of organizing
thrombus.
Masson's tumour may either occur in pure form (primary), as a focal
change in a preexisting vascular lesion (hemangioma, pyogenic granuloma,
or vascular malformation) and rarely in an extravascular location as a
result of organization of a haematoma.
Site:
Masson's tumour may occur in any blood vessel in the body, but is commonly
located on the fingers, head and neck and trunk.
Macroscopic Features:
The lesion presents as a small (less than 2 cm in
diameter), firm, blue or purple nodule. Sectioning reveals cystic mass
containing clotted blood and surrounded by fibrous pseudocapsule.
DermAtlas1 ;
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Microscopic Features : Image
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This is a well circumscribed lesion which is usually
present within a blood vessel (commonly thin-walled vein).
Multiple
small, delicate papillary structures project into the lumen and these
are associated with some thrombus. These papillae are lined by single
layer of plump endothelial cells surrounding a collagenized core.
There is
no multilayering, tufting, solid areas, necrosis and little or no atypia.
There is little evidence of mitoses.
In the early lesions the the
papillae are composed of fibrin.
In the late stage there is clumping and
fusion of papillae forming an anastomosing network of blood vessel set in
a loose meshlike connective tissue.
Differential diagnosis: This lesion should not be confused with
angiosarcoma. Unlike angiosarcoma, Masson's tumour is usually confined to
the blood vessel (passive extension may occur following rupture of vessel)
and there is no evidence of pleomorphism, tissue necrosis and mitoses.
This lesion has an excellent prognosis and are usually cured by simple
excision.
(ESCOP): IMAGE
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