Intravascular papillary endothelial hyperplasia diagnosed by fine needle aspiration: Report of a case and cytology literature review

Abstract

Intravascular papillary endothelial hyperplasia (IVPEH) is an unusual form of intravascular endothelial proliferation. Fine needle aspiration (FNA) diagnosis of IVPEH is quite challenging and only rare reports of the cytopathological features of this entity have been published. We report a case of a 55-year-old female patient who presented with a mass on her left jaw. FNA of the mass revealed pleomorphic polygonal and spindle cells. A preliminary (onsite) cytological diagnosis of suspicious for malignancy was rendered. Subsequent cell block showed delicate papillae composed of attenuated endothelial cells overlying collagenized cores. The endothelial cells were positive for CD34 and factor VIII, supporting the cytological diagnosis of IVPEH. Surgical excision confirmed the diagnosis. To the best of our knowledge, this is the first reported case of IVPEH diagnosed by preoperative FNA.

Intravascular Papillary Endothelial Hyperplasia of the Chest Wall Misdiagnosed as a Malignancy on Fine Needle Aspiration

“…The cytologic features of IPEH in the published literature show diverse morphologies, leading to frequent diagnostic error. 1 - 3 , 9 , 10 IPEH has been misdiagnosed as malignant vascular tumor, embryonal carcinoma, squamous cell carcinoma, adenoid cystic carcinoma, and giant cell tumor. Handa et al 10 suggested two types of cell populations that can assist in cytologic diagnosis of IPEH: spindle cells and round cells.…”

Intravascular Papillary Endothelial Hyperplasia of the Neck: A Case Report

“…FNA cytology has successfully diagnosed IPEH preoperatively in only 1 reported case. 5 In our patient, preoperative FNA confirmed the presence of a benign lesion; however, surgical excision was needed for definitive diagnosis, emphasizing surgical intervention as both a diagnostic and a therapeutic modality. Prognosis is excellent, and recurrence is rare, typically occurring only in the event of incomplete primary resection.…”