Atypical Vascular Lesion 2 | Dermatopathology

Post-radiation atypical vascular lesion arising in a background of chronic radiation fibrosing dermatitis.

Overall case comment: The findings are highly characteristic for a post-radiation indeterminate vascular proliferation falling under the designation of atypical vascular lesion. The question arises regarding the exact biological significance of these lesions. The atypical vascular lesion does occur post-radiation therapy for breast carcinoma with a post-radiation that typically averages a few years (i.e. approximately 4 years). The lesions for the most part do behave in a benign fashion, although local recurrences can occur.

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Slide 1: 80 year-old woman with a 0.6 cm pink nodule of the breast and a history of treated breast carcinoma. <br><br>There are irregular vascular channels within the dermis that assume an infiltrative growth pattern along the pre-existing connective tissue framework.

Slide 2: A supervening perilymphatic lymphocytic infiltrate is noted.

Slide 3: The lymphatic channels are lined by somewhat plump appearing endothelial cells with conspicuous nucleolation.

Slide 4: There is extensive highlighting of the vascular channels for D2-40. The proliferation index was very low with only rare positive staining cells within the dermis.