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October 1997

A Rapidly Developing Violaceous Plaque

Author Affiliations

The University of Texas Medical Branch at Galveston

Arch Dermatol. 1997;133(10):1303-1304. doi:10.1001/archderm.1997.03890460127017

REPORT OF A CASE  A 67-year-old white man presented with a 4-week history of a rapidly growing, purple plaque on his back. The lesion had been asymptomatic for several years and was originally described as a brown spot or bruise. The patient denied any history of trauma or radiation to the area.Physical examination revealed a 5×6-cm violaceous plaque with a surrounding halo of edema and ecchymosis (Figure 1). Blanching of the periphery was elicited on deep pressure. Axillary and cervical lymphadenopathy were absent. The results of all laboratory tests were unremarkable. Several biopsy specimens were obtained (Figure 2 and Figure 3).What is your diagnosis?A Rapidly Developing Violaceous Plaque

DIAGNOSIS:  Angiosarcoma.

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  The biopsy specimens revealed collapsed, anastomosing, vascular channels lined by atypical endothelial cells that appeared to rest directly on the collagen bundles. The endothelial cells lining the vessels were enlarged and atypical, protruding

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