case_images: PMC5174169_01
case_images: 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).
case_images: CRIPA2016-1908767.001.jpg
case_images: PMC5174169_01_CRIPA2016-1908767.001.jpg
case_images: fig1
case_images: 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).
case_images: 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).
case_images: CRIPA2016-1908767.002.jpg
case_images: PMC5174169_01_CRIPA2016-1908767.002.jpg
case_images: fig2
case_images: No cellular or nuclear atypia, abnormal mitosis, or necrosis was present (Figure 2).
case_images: 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).
case_images: CRIPA2016-1908767.003.jpg
case_images: PMC5174169_01_CRIPA2016-1908767.003.jpg
case_images: fig3
case_images: D2-40 was negative, whereas alpha-smooth muscle antigen (alpha-SMA) highlighted the smooth muscle cells in vessel walls (Figure 3).