Vascular Transformation of Bilateral Cervical Lymph Node Sinuses: A Rare Entity Masquerading as Tumor Recurrence

Abstract

Vascular transformation of sinuses (VTS) is a rare and reactive vasoproliferative disorder infrequently affecting the cervical lymph nodes. It is characterized by effacement of nodal architecture by variable expansion of the subcapsular, intermediate, and medullary sinuses. We report a very rare and unique case of VTS in bilateral cervical lymph nodes along with angiolipomatous hamartoma in a postoperative patient of squamous cell carcinoma of buccal mucosa clinically masquerading as tumor recurrence. To the best of our knowledge, only 15 cases of VTS have been reported in cervical lymph nodes till date and associated angiolipomatous or angiomyomatous hamartoma-like area was noted only in two cases of cervical lymph node VTS.

Nodular Spindle Cell Vascular Transformation in Pelvic Lymph Nodes With Discovered on GIST1 (DOG1) Positivity Mimicking Metastatic Gastrointestinal Stromal Tumor

“…Several cases have been reported of VTS association with liver cirrhosis, metastatic gastric cancer, myelodysplastic syndrome, and polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes (POEMS) syndrome [ 4 - 8 ]. It is commonly located in the intra-abdominal lymph nodes as seen in our patient, but cervical lymph node vascular transformations have also been documented [ 9 ]. In our patient, it is unknown if this finding of VTS was associated with his recent prostate cancer, or if this vascular transformation had been present preceding his diagnosis.…”

Our Experience in Treating a Rare Clinical Case Angiomyomatous Hamartomas of Head and Neck Region; Case Report

“…Hamartomas are classified according to their predominant elements into two types as epithelial (seromucinous, respiratory or salivary) and mesenchymal (angiomatous, chondroid, lipomatous or neurogenic). 1,4 Histologically, hamartoma must be differentiated from other developmental tumors like teratoma and dermoid. 6 Hamartomas are most commonly derived from mesoderm whereas dermoid is derived from ectoderm & mesoderm and teratoma from all three germinal layers.…”

“…One of the types of hamartomas is angiomyomatous hamar-lymphoid follicles by haphazardly arranged combination of smooth muscle bundles, fibrous tissue and thick-walled blood vessels. 4 Only few cases in the head and neck region have been documented in the literature. 5,6 It should be borne in mind that hamartoma is one of the differential diagnoses of unilateral, painless, progressive vascular vascular edema of the cheek that does not respond to propranolol.…”

Large Groin Mass due to Vascular Transformation of Lymph Node Sinuses

“…Vascular transformation of lymph node sinuses is a rare condition that is reported in literature albeit sporadically. Most of the lesions were reported in the lymph nodes of the head and neck region [1,2] and almost never in the groin. Occasionally, myoid [3] and nodular transformation of these lesions are described, perhaps due to the fact that stem cells are ubiquitously present.…”