Age / Sex : 56 / F

Chief complaint : Pain in right 3rd finger for 4 months



What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer)

Courtesy :  한석 (Seok Hahn)  인제의대 해운대 백병원 (Inje University Haeundae Paik Hospital)

intravascular papillary endothelial hyperplasia (IPEH)

Discussion

Generally intravascular lesion thought to be a form of thrombus organization.
Average age : 34yrs; solitary firm mass with red-blue discoloration.
H&N, and “interestingly” fingers.
Small, well-defined oval heterogenous hypoechoic soft tissue mass.
Variable vascular pattern.
Internal septal structures with detectable origin vessel.


Findings
Approximately 1.20 x 0.42 x 0.84 cm sized heterogeneous echoic lesion.
- internal linear hyperechoic portions.
- at subcutaneous fat layer of right 3rd finger, PIP joint level.
- internal increased vascularity on Doppler image.
- with venous waveforms.


References
Skeletal Radiol. 2016 Feb;45(2):227-33.
Skeletal Radiol. 2016 Nov;45(11):1467-72.