ill-de
fi
ned purpuric mass, often painful; however, presen-
tation may be later in childhood.
24
The destructive/in
fi
l-
trative nature and very rapid growth of the vascular tumour
helps differentiation from IH. Kasabach
e
Merritt phenom-
enon (KMP) can be seen up to 50% of patients. KHE has a
high mortality rate (24%) related to coagulopathy or com-
plications from local tumour in
fi
ltration. The
fi
rm,
indurated lesion has a more invasive appearance and pur-
plish colouration (
Figs 1
and
5
).
These cells form slit-like lumina containing erythrocytes
that resemble Kaposi
’
s sarcoma, thus the name KHE.
25
KHE
appears as a solid mass with ill-de
fi
ned borders and vari-
able echogenicity at US.
26
MRI demonstrates an in
fi
ltrative
pattern with crossing of multiple soft-tissue planes with
Figure 7
(a) A 4-year-old male patient with a large,
fi
rm mass on his right shoulder/chest wall. It was
fi
rst noted soon after birth, and he
underwent surgical debulking at that time. A known LM that recently enlarged in size. (b
e
c) Coronal T2-weighted image with fat saturation
shows a T2 bright multicystic/septate, large mass that only shows enhancement of the cyst walls and septa (c), typical for LMs. Relatively large
size of each cyst quali
fi
es for a macrocystic LM. (d) Ultrasound during percutaneous access demonstrates macrocystic LM. (e) Contrast medium
injection into one of three macrocysts being treated with doxycycline sclerotherapy.
Figure 8
Two patients with Sturge
e
Weber, (a) 23 years-old, and (b) 35 years old, both with extensive CMs of the face. Note the thickening of the
CM especially in b, which can be seen in CMs over time.
A. Tekes et al. / Clinical Radiology 69 (2014) 443
e
457
250