1974/11/01 by William R. Salyer
Medicine · #Vascular Tumors and Angiosarcomas #Cardiac tumors and thrombi #CNS Lymphoma Diagnosis and Treatment
paper · doi:10.1001/archderm.1974.01630110089036
To the Editor.— The publication by Rosai and Akerman1notes the interesting and pertinent observation that vascular lesions that are probably reactive in nature may be similar to angiosarcomas histologically. These lesions, of course, must be distinguished from angiosarcoma in order to prevent unnecessary surgery or radiotherapy. On the basis of a study of a large number of organizing thrombi,2,3it seems probable to us that the lesions described by Rosai and Akerman1as intravenous atypical vascular proliferation represent peculiarly organizing thrombi, a possibility which they discussed. Masson4and Stout and Lattes5previously noted the difficulty in separating the proliferative phase of organizing thrombi from angiosarcomas. Reactive endothelial cells may exhibit striking atypia,3-5and, thus, the presence of atypia in the cases of Rosai and Akerman1is not evidence against the thrombotic origin of the lesions. Furthermore, vascular wall damage, including false aneurysm