History

A single, asymptomatic, slowly expanding patch, plaque, or nodule usually manifests during adolescence or young adulthood.^[10]Congenital lesions have been reported. A single example of a giant variant has also been described.^[11]

Physical Examination

Flat to slightly elevated, slowly expanding, red-brown lesions that resemble a bruise may be observed. Occasionally, a red-brown dermal nodule or a skin-colored subcutaneous mass may be observed, either within the patch or alone (see the image below).^{[12, 13]}

Erythematous nodule with macular component at the periphery.

View Media Gallery

Differential Diagnoses

Guillou L, Fletcher CD. Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series. Am J Surg Pathol. 2000 Aug. 24(8):1047-57. [QxMD MEDLINE Link].
Requena L, Sangueza OP. Cutaneous vascular proliferation. Part II. Hyperplasias and benign neoplasms. J Am Acad Dermatol. 1997 Dec. 37(6):887-919; quiz 920-2. [QxMD MEDLINE Link].
Jones EW, Winkelmann RK, Zachary CB, Reda AM. Benign lymphangioendothelioma. J Am Acad Dermatol. 1990 Aug. 23(2 Pt 1):229-35. [QxMD MEDLINE Link].
Messeguer F, Sanmartín O, Martorell-Calatayud A, Nagore E, Requena C, Guillen-Barona C. [Acquired progressive lymphangioma (benign lymphangioendothelioma)]. Actas Dermosifiliogr. 2010 Nov. 101(9):792-7. [QxMD MEDLINE Link].
Wang L, Chen L, Yang X, Gao T, Wang G. Benign lymphangioendothelioma: a clinical, histopathologic and immunohistochemical analysis of four cases. J Cutan Pathol. 2013 Nov. 40 (11):945-9. [QxMD MEDLINE Link].
Mizuno K, Okamoto H. Benign lymphangioendothelioma on a vascular birthmark following examination of a cardiac catheter. Int J Dermatol. 2015 Jul. 54 (7):e273-4. [QxMD MEDLINE Link].
Fernandez-Flores A. Benign lymphangioendothelioma. Dermatopathonline. Available at http://www.dermatopathonline.com/lymphangioendothelioma2.html. Accessed: February 24, 2013.
Kato H, Kadoya A. Acquired progressive lymphangioma occurring following femoral arteriography. Clin Exp Dermatol. 1996 Mar. 21(2):159-62. [QxMD MEDLINE Link].
Paik AS, Lee PH, O'Grady TC. Acquired progressive lymphangioma in an HIV-positive patient. J Cutan Pathol. 2007 Nov. 34(11):882-5. [QxMD MEDLINE Link].
Schnebelen AM, Page J, Gardner JM, Shalin SC. Benign lymphangioendothelioma presenting as a giant flank mass. J Cutan Pathol. 2015 Mar. 42 (3):217-21. [QxMD MEDLINE Link].
Revelles JM, Díaz JL, Angulo J, Santonja C, Kutzner H, Requena L. Giant benign lymphangioendothelioma. J Cutan Pathol. 2012 Oct. 39 (10):950-6. [QxMD MEDLINE Link].
Hwang LY, Guill CK, Page RN, Hsu S. Acquired progressive lymphangioma. J Am Acad Dermatol. 2003 Nov. 49(5 Suppl):S250-1. [QxMD MEDLINE Link].
Kim HS, Kim JW, Yu DS. Acquired progressive lymphangioma. J Eur Acad Dermatol Venereol. 2007 Mar. 21(3):416-7. [QxMD MEDLINE Link].
Herron GS, Rouse RV, Kosek JC, Smoller BR, Egbert BM. Benign lymphangioendothelioma. J Am Acad Dermatol. 1994 Aug. 31(2 Pt 2):362-8. [QxMD MEDLINE Link].
Watanabe M, Kishiyama K, Ohkawara A. Acquired progressive lymphangioma. J Am Acad Dermatol. 1983 May. 8(5):663-7. [QxMD MEDLINE Link].

Media Gallery

Erythematous nodule with macular component at the periphery.
Overview of a histologic section from a tumor depicting dilated vascular spaces interspersed between collagen fibers and a more central accumulation of many complex vascular spaces.
High-power view showing dilated vascular channel with innocent endothelial cells.
High-power view showing lymphatic endothelial cells in a hematoxylin and eosin–stained section.
High-power view showing lymphatic endothelial cells stained positively with podoplanin.

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Author

Donald Shenenberger, MD, FAAD, FAAFP Board Certified Dermatologist

Donald Shenenberger, MD, FAAD, FAAFP is a member of the following medical societies: American Academy of Dermatology, American Academy of Family Physicians, Association of Military Dermatologists, Medical Society of Virginia, Uniformed Services Academy of Family Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Walter HC Burgdorf, MD Clinical Lecturer, Department of Dermatology, Ludwig Maximilian University, Munich, Germany

Walter HC Burgdorf, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Society of Dermatopathology, International Society of Dermatopathology, and Society for Pediatric Dermatology

Disclosure: Nothing to disclose.