Intravascular Angiomatosis in Cutaneous Vessels

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Abstract
To the Editor.— The publication by Rosai and Akerman1 notes the interesting and pertinent observation that vascular lesions that are probably reactive in nature may be similar to angiosarcomas histologically. These lesions, of course, must be distinguished from angiosarcoma in order to prevent unnecessary surgery or radiotherapy. On the basis of a study of a large number of organizing thrombi,2,3 it seems probable to us that the lesions described by Rosai and Akerman1 as intravenous atypical vascular proliferation represent peculiarly organizing thrombi, a possibility which they discussed. Masson4 and Stout and Lattes5 previously noted the difficulty in separating the proliferative phase of organizing thrombi from angiosarcomas. Reactive endothelial cells may exhibit striking atypia,3-5 and, thus, the presence of atypia in the cases of Rosai and Akerman1 is not evidence against the thrombotic origin of the lesions. Furthermore, vascular wall damage, including false aneurysm