PMC5174169_01
Clinical appearance of the submucosal nodule on the lower labial mucosa (arrow) (a). The same patient presented numerous varices of irregular shape and variable size in the foot (b).
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At intraoral examination, a bluish firm nodule on the lower labial mucosa, painless, measuring 10 x 5 x 5 mm, and covered by normal mucosa, was observed (Figure 1).
Histopathological findings of IPEH. (a) Photomicrograph showing thrombus in organization in the peripheral region (black stars) and intravascular papillary endothelial proliferation in the central region (red star) (H&E, x4). (b) Close relationship between papillae structures in association with hemosiderin deposition (black star) and the thrombus (red star) (H&E, x10). (c) Close-up of reactive papillary endothelial proliferation containing hemosiderin deposits (H&E, x40).
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No cellular or nuclear atypia, abnormal mitosis, or necrosis was present (Figure 2).
Immunohistochemical findings. CD34 was strongly positive highlighting the papillary endothelial proliferation (a) with low Ki-67 proliferation index (4%) (b). D2-40 was negative (notice the hemosiderin deposits) (c), whereas alpha-SMA stained the vessel walls (d) (all figures, x10; all insets x40).
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D2-40 was negative, whereas alpha-smooth muscle antigen (alpha-SMA) highlighted the smooth muscle cells in vessel walls (Figure 3).