title: Diagnostic implications of oral intravascular papillary endothelial hyperplasia.
abstract: This study examined the clinical, histological, and immunohistochemical features as well as the differential diagnoses of oral intravascular papillary endothelial hyperplasia (IPEH) to aid clinicians and pathologists in its diagnosis. Clinical features of five oral IPEH cases were obtained from medical records, and all histopathological diagnoses were reviewed. Immunohistochemical reactions, including anti-CD-34, laminin, vimentin, estrogen receptor alpha, and Ki-67, were assessed. Microscopically, a reactive proliferation of vascular cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus was seen. CD-34, vimentin, and laminin staining were strongly positive, while estrogen receptor alpha was negative in all cases. A low percentage of cells were positive for Ki-67 in four of five lesions, but one case was strongly positive. A diagnosis of angiosarcoma was investigated and rejected. IPEH presents specific microscopic characteristics that along with clinical data lead to an accurate diagnosis. The general dentist, the first to participate in the diagnostic process, must share the responsibility for diagnosis with the pathologist, and they must work together to determine the correct diagnosis and management. Oral lesions of IPEH are uncommon. Their main significance is that they show a microscopic resemblance to angiosarcoma. Thus, clinicians should have more information regarding this benign entity. Finally, we suggest that in recurrent cases exhibiting strong immunolabeling of proliferative markers the possibility of angiosarcoma should be investigated.
authors.affiliation: Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Fontes
authors.affiliation: Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil. mscamp30@gmail.com.|Dentistry Graduate Program, Department of Dentistry, University of Taubaté, Avenida dos Operários, 9, Taubaté, SP, 12020-330, Brazil. mscamp30@gmail.com.
authors.forename: Marcia Sampaio
authors.initials: MS
authors.lastname: Campos
authors.affiliation: Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Suzana C O M
authors.initials: SCOM
authors.lastname: de Sousa
authors.affiliation: Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Marília Trierveiler
authors.initials: MT
authors.lastname: Martins
authors.affiliation: Department of Oral Pathology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabio Daumas
authors.initials: FD
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006390:Hemangioendothelioma / Q000737:chemistry / Q000473:pathology*; D006394:Hemangiosarcoma / Q000175:diagnosis; D006801:Humans; D006965:Hyperplasia; D019394:Ki-67 Antigen / Q000032:analysis; D007797:Laminin / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000737:chemistry / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D007797:Laminin; D014746:Vimentin