Atypical vascular lesion

Case 384   Nov 2011 (P. McKee)  F 38 erythematous lesion, breast (previous RT) 

Abnormal vessels, prominent endothelium, “promontory sign” 

Case 435  Feb 2012 (P. McKee)   F 37 breast ca treated with RT 

Case 945  5.2.14 (H. Diwan) F 41 lesion breast after RT. 

Case 2215   5.12.18   (H. Diwan)  F 58 H/O breast Ca and RT 

Dilated lymphatic channels in papillary dermis.  Biphasic pattern with narrower slit-like channels beneath.  No extravasated RBC’s or haemosiderin helps to distinguish from hobnail haemangioma. 

Ref: David R. Lucas. Angiosarcoma, Radiation-Associated Angiosarcoma, and Atypical Vascular Lesion. Archives of Pathology & Laboratory Medicine; November 2009, 133(11): 1804-1809.    Atypical vascular lesion refers to a small, usually lymphatic-type vascular proliferation in radiated skin. Although most atypical vascular lesions pursue a benign course, they recur and very rarely progress to angiosarcoma. 

Case 2938  11.10.21 (M. Abdel-Halim)  F 56 previous breast Ca, CT, RT.  Vascular papule, breast 

Multiple, dilated lymphatic channels.  No significant atypia.  C-MYC -ve. 

Ref: Mentzel T et al.  Mod Pathol  2012 Jan;25(1):75-85. doi:0.1038/modpathol.2011.134. Epub 2011 Sep 9  Article about MYC amplification in postradiation cutaneous angiosarcoma. 

Case 4066  22.8.22 (M. Abdel-Halim) F 70 breast cancer red papules on chest 

Case 4092  27.9.22 (U.Sundram) F 50 faint erythematous papule on breast 

Previous history of breast Ca, radiotherapy