Kodachi K, Kojima T, Shimbashi T, Furusato M
Department of Plastic and Reconstructive Surgery, Jikei University School of Medicine, Tokio.
Handchir Mikrochir Plast Chir. 1990 Jan;22(1):49-52.
Fingers often suffer trauma and the clinician is continuously faced with the difficult task of clarifying the distinction between a hemangioma and a traumatic lesion. This study was undertaken to examine ten cases in which a small skin mass located on a finger had been diagnosed preoperatively as hemangioma. Our results showed that seven masses were confirmed pathologically as hemangioma (five cavernous hemangiomas and two capillary hemangiomas), two as traumatic thrombosis and one varix. The clinical manifestations of the two cases of traumatic thrombosis were related to those of hemangioma. In the varix, endothelial proliferation was observed in the area of the thrombosis. This phenomenon is called "intravascular papillary endothelial hyperplasia", and can confuse the differential diagnosis between a vascular neoplasm and a traumatic thrombosis. Our findings demonstrate that since the traumatic lesions were firmer than the hemangiomas, hardness on physical examination may be a helpful indicator in the differential diagnosis of a hemangioma and a traumatic lesion.
手指经常遭受创伤，临床医生一直面临着区分血管瘤和创伤性病变的难题。本研究旨在检查十例术前诊断为手指上小皮肤肿物为血管瘤的病例。我们的结果显示，七例肿物经病理证实为血管瘤（五例海绵状血管瘤和两例毛细血管瘤），两例为创伤性血栓形成，一例为静脉曲张。两例创伤性血栓形成的临床表现与血管瘤的表现相关。在静脉曲张中，血栓形成区域观察到内皮细胞增生。这种现象称为“血管内乳头状内皮增生”，可能会混淆血管肿瘤与创伤性血栓形成的鉴别诊断。我们的研究结果表明，由于创伤性病变比血管瘤更硬，体格检查时的硬度可能是鉴别血管瘤和创伤性病变的有用指标。
