Gameiro Ana, Cardoso José Carlos, Calonje Eduardo, Tellechea Oscar
*Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal; and †Department of Dermatopathology, St. John's Institute of Dermatology, London, United Kingdom.
Am J Dermatopathol. 2016 Jan;38(1):e15-7. doi: 10.1097/DAD.0000000000000376.
Lobular capillary hemangioma (LCH) or pyogenic granuloma is a very common benign vascular tumor. However, its etiology still remains unknown. This tumor classically arises from epithelium-lined tissue, such as skin and mucosa, but subcutaneous and intravenous variants have also been described. Intravenous LCH usually arises within the lumen of large caliber veins, but other intravascular examples have been reported in association with vascular malformations, namely port-wine stains and arteriovenous fistulas. A 54-year-old man presented after the sudden appearance of a subcutaneous nodule on his penile coronal sulcus. A partial biopsy disclosed a lesion with typical features of LCH but with the particularity of being located within the dilated vascular spaces of the corpus spongiosum. After the biopsy, the lesion completely regressed. Although no causal factor could be elicited, trauma was a possible trigger considering the site. Additionally, we speculate that perhaps the normal anatomy of the corpus spongiosum may mimic a similar "slow blood flow environment" found in some vascular malformations, thus providing a possible explanation for the unusual location of the lesion in our patient. This case represents, to our knowledge, the first intravascular LCH described in the corpus spongiosum. Awareness of this unusual intravascular variant of LCH is of paramount importance to avoid misdiagnosis and unnecessary treatment, because the lesion may resolve even if incompletely excised, like in this case.
小叶性毛细血管瘤（LCH）或脓性肉芽肿是一种非常常见的良性血管肿瘤。然而，其病因仍然不明。这种肿瘤通常起源于有上皮衬里的组织，如皮肤和黏膜，但也有皮下和静脉内变异型的报道。静脉内LCH通常发生在大口径静脉腔内，但也有其他血管内病例报道与血管畸形有关，即葡萄酒色斑和动静脉瘘。一名54岁男性因阴茎冠状沟突然出现皮下结节前来就诊。部分活检显示病变具有LCH的典型特征，但特殊之处在于位于海绵体的扩张血管腔内。活检后，病变完全消退。尽管未发现病因，但考虑到病变部位，外伤可能是一个触发因素。此外，我们推测，也许海绵体的正常解剖结构可能类似于某些血管畸形中发现的类似“缓慢血流环境”，从而为我们患者病变的异常位置提供了一种可能的解释。据我们所知，该病例是首次报道的发生在海绵体内的血管内LCH。认识到这种不寻常的血管内LCH变异型对于避免误诊和不必要的治疗至关重要，因为即使不完全切除，病变也可能消退，就像本病例一样。
