Perilobular Hemangioma of the Breast

Differential Diagnosis

Angiosarcoma of the Breast	Perilobular Hemangioma
Almost always a hemorrhagic mass >2 cm	Microscopic, incidental lesion
Diffuse, infiltrating	Localized
Complex anastomoses	No complex anastomoses
Intermediate and high grade tumors are cytologically atypical	No significant cytologic atypia
Frequent papillae or tufting	No papillae or tufting

Complete excision and examination are required to insure accurate diagnosis of an apparently benign vascular lesion in the breast

Perilobular Hemangioma	Pseudoangiomatous Stromal Hyperplasia
Endothelial lined spaces	No true lining to spaces
CD31 positive	CD31 negative
Red blood cells in some spaces	No red blood cells in spaces

Both are usually incidental findings

Angiomatosis	Perilobular Hemangioma	Hemangioma	Venous Hemangioma
Mass lesion	Microscopic, incidental lesion	Mass lesion	Mass lesion
Diffuse, infiltrating	Localized	Localized	Localized
Cavernous	Predominantly capillary	Usually cavernous	Cavernous

Complete excision and examination is required for the diagnosis of any benign vascular lesion in the breast