LYMPHANGIOSARCOMAS OF THE SCALP

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Abstract
To the Editor.— Reed et al (Arch Derm94:396, 1966) reported six cases of "lymphangiosarcomas of the scalp," which they considered an entity indistinguishable from "postmastectomy lymphangiosarcoma" (Stewart-Treves Syndrome). In our opinion, at least their case 6 represents a true lymphangioendothelioma arising from the lymphatics and characterized by a microscopic structure clearly separable from that of postmastectomy angiosarcoma. We, as well as others,1-4 believe that postmastectomy angiosarcoma originates from both lymph and blood vessels. This being the reason for the widely used designation angiosarcoma instead of the term lymphangiosarcoma originally proposed by F. W. Stewart and N. Treves. The most prominent histologic features of lymphangioendothelioma (Fig 1) are: (1) strongly dilated, sometimes cystic, cavities; (2) faintly eosinophilic masses and a few lymphocytes within the lumen which may also appear completely empty; (3) absence of erythrocytes from the cavities of newly formed vascular structures; (4) mature lymphatic tissue directly

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