PMC10173827_01
(a) A 60-year-old asymptomatic man presented with a focal swelling on the dorsal surface of the left wrist (white arrows). (b) Anatomy of the veins of the dorsal surface of the left wrist, the cephalic vein runs in the swollen position (black arrow)
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F1
A 60-year-old asymptomatic man presented with focal swelling of the dorsal surface of the left wrist that spontaneously appeared 2 months earlier [Figure 1].
Ultrasonographic B-mode images showing a nodular echogenic mass in the cephalic vein on the dorsal aspect of the left wrist. (a) Longitudinal scan showed a homogeneous and hypoechoic mass (arrow). (b) Axial scan showed the same mass (arrowhead)
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F2
The lesion was hypoechoic without acoustic enhancement or edge shadowing [Figure 2a] was adherent to the vein wall and was not compressible [Figure 2b].
(a) Longitudinal scan color Doppler imaging showed prominent hypervascularization within the lesion. (b) On superb microvascular imaging, fewer blooming effects and less color noise were found
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F3
CDUS imaging demonstrated prominent hypervascularization within the lesion [Figure 3a] as well as vessel signals with color blooming artifact, which displays color outside of a vessel and makes the vessel appreciable, and color noise. However, SMI revealed the color signal of the microvasculature in the lesion [Figure 3b].
The surgically excised sample was a 2-cm long vascular segment with the mass inside
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F4
The lesion, a 2-cm long vascular segment containing the mass in continuity with the venous wall, was surgically excised [Figure 4].
(a) Low-power photograph of the lesion showing an intravascular nodule in the lumen of the vein. (b) High-power view showed a tumor composed of bifurcated proliferating vascular endothelium, lumen, and edematous stroma (H and E, x100)
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F5
They were lined with lobular structures, and fibrous connective tissue was found in the interlobular area [Figure 5].