Nodular spindle cell proliferation in the wall of a varicose vein mimicking Kaposi's sarcoma.
Exuberant reparative reactions resembling sarcoma have been reported in the genitourinary tract, thyroid, breast, lymph node, oral cavity and skin, but not in a varicose vein. Presented herein is the case of a 55-year-old man who showed an incidental nodular lesion in the wall of a varicose vein on the left leg. The nodule consisted of fascicles of spindled cells with ovoid or elongated nuclei and delicate chromatin that showed diffuse reactivity for CD31, alpha-smooth muscle actin and D2-40. This histopathological appearance, when coupled with extravasated erythrocytes and interstitial hemosiderin deposits, resembled Kaposi's sarcoma or spindle cell angiosarcoma. Key features helpful for recognizing that the proliferation we describe is a form of tissue repair include an association with obvious hemorrhage; lack of well-formed curved fascicles of spindled cells; lack of intracytoplasmic hyaline globules; lack of intracellular vacuolization; cytological blandness; low mitotic count; absence of inmmunoreactivity for human herpesvirus-8 (HHV-8) latent nuclear antigen-1; and absence of HHV-8 in polymerase chain reaction (PCR) analysis.
Val-Bernal
José Fernando
JF
Anatomical Pathology Department, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain. apavbj@humv.es
Val
Daniel
D
Garijo
María Francisca
MF
Gómez-Román
José Javier
JJ
D049109:Cell Proliferation; D003937:Diagnosis, Differential; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000473:pathology*; D012514:Sarcoma, Kaposi / Q000473:pathology*; D014648:Varicose Veins / Q000473:pathology*; D019043:Vascular Neoplasms / Q000473:pathology*