Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Aug 2018

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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
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Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2012 | Month : May | Volume : 6 | Issue : 3 | Page : 483 - 484 Full Version

Venous Hemangioma of the Breast: Report of an Unusual Case

Published: May 1, 2012 | DOI:
Leena, Suma

1. Corresponding Author, 2. Assistant Professor, Department of Pathology NAME OF DEPARTMENT(S)/INSTITUTION(S) TO WHICH THE WORK IS ATTRIBUTED: Department of Pathology, M V J Medical College and Research Hospital, Hoskote, Bangalore, Karnataka, India.

Correspondence Address :
Dr. Leena
Assistant Professor,
No 56/74, 4th Main, Nehru Street,
Behind Tin Factory, Udaynagar, Bangalore- 560016
Phone: 9902766378


Vascular tumours of the breast are uncommon and they include angiosarcomas and hemangiomas. Hemangiomas are rare and angiosarcomas are more common than hemangiomas of the breast. Here, we are reporting a case of a 19-year old girl who presented with a non tender palpable lump in the left breast since 15 days. Mammography and FNAC were inconclusive and the diagnosis was established on the basis of histopathology. This case was reported to highlight that a single diagnostic modality may not be sufficient to diagnose a case of hemangioma. Though it is a benign lesion, a histopathological evaluation is necessary for its accurate diagnosis and to rule out underlying malignancy, if any.


Hemangioma , Breast , Benign tumour, Histopathology

Vascular tumours of the breast are rare and most of them can be classified as angiosarcomas or hemangiomas (1). Hemangiomas are benign tumours that are rarely seen in the breast, although they have been found incidentally on the microscopy of biopsy material which had been sent for other indications. Breast hemangiomas are reported to be found in ~1.2% of all the mastectomy specimens and 11% of all the post-mortem specimens. The hemangiomas that occur within the breast are most commonly of the cavernous type. While the lesions are most often superficial within the breast tissue, there is no recognised predilection towards any particular location within the breast. On mammography, the findings are non-specific and they include a normal mammogram or a sonographic finding of a well circumscribed hypo echoic or hyper echoic mass with or without calcification (2). Complete excision and examination is required for the diagnosis of any benign vascular lesion in the breast.

Case Report

A 19-year old girl visited the surgery OPD with complaints of a non tender palpable lump in the left breast since 15 days. She was nulliparous and gave no other history of trauma, nipple discharge, fever or any prior breast disease. On examination, a single, well defined, mobile, firm mass, which was 3 cm in diameter, was found in the upper outer quadrant of the left breast. A clinical diagnosis of lipoma was offered. Mammography showed a well circumscribed isodense mass in the left breast. Repeated FNAC yielded only blood. The possibility of a vascular lesion was suggested and a complete excision of the lump was done. We received a globular mass cut section, which showed red brown areas. Haematoxylin and eosin sections showed large cavernous vascular channels of smooth muscles which were filled with blood and focal areas of adipocytes, which were suggestive of a subcutaneous hemangioma (Table/Fig 1). There was no recurrence after 6 months of follow up.


Hemangiomas are benign vascular tumours that are usually identified incidently during the histological examination of specimens of lumpectomy or mastectomy (3). They occur in patients of the age group of 18-82 years (4). The mammographic appearance of hemangiomas is as macrolobulated lesions and they may contain calcification. Our case did not show any calcification and the findings were nonspecific. Most often, they are located superficially, either subdermally or in the subcutaneous tissue. Rarely may hemangioma be intraparenchymal (5). Oval lobulated lesions with poorly defined borders have been reported (6). However, because of their typical pattern of enhancement, magnetic resonance imaging may be useful in the diagnosis of breast hemangiomas (7). The imaging features appear to be inconclusive for the diagnosis of most of the hemangiomas (6). Fine needle aspiration cytology too is inconclusive and a complete excision is required for the diagnosis. They are grossly described as well circumscribed masses which are red brown and spongy. Most of the hemangiomas are well circumscribed grossly, but microscopically, they blend well with the breast parenchyma (8). Microscopically, there are two common types of hemangiomas: capillary and cavernous. Most of these have vascular channels which are separated by fibrous septa, with extensive fibrosis and sometimes with phleboliths (3). Capillary hemangiomas are composed of capillary sized blood vessels and cavernous hemangiomas have large vascular channels. Cavernous hemangiomas are more common than the capillary hemangiomas (4). Hemangiomas are sub-divided into four types: perilobular, parenchymal, non parenchymal or subcutaneous and venous. Perilobular hemangiomas occur in the extralobular stroma in the form of microscopic lesions. In parenchymal hemangiomas, the individual vessel varies in size from capillary to cavernous. Venous hemangiomas form large cavernous vascular channels, with disorderly vascular proliferation. Sub-cutaneous hemangiomas are located superficial to the anterior pectoral fascia in the sub-cutaneous fat (9). Histologically, hemangiomas should be differentiated from pseudoangiomatous stromal hyperplasia (PASH) which do not have a true endothelial lining and do not show luminal RBCs (4). Furthermore, venous hemangiomas of the breast are rarer, with only few cases being reported (9). Hemangiomas, although they are not known to be precursors of angiosarcomas, follow up imaging techniques are recommended for their diagnosis and wide local excision is necessary to rule out the possibility of underlying angiosarcoma (10). In conclusion, venous hemangioma of the breast is uncommon and we should be aware of this entity. Imaging findings and fine needle aspiration cytology are inconclusive in most of the cases and this may lead to a diagnostic dilemma. Histopathology is essential for a definitive diagnosis.


Dener C, Sengul N, Tez S, Caydere M. Hemangiomas of the breast. Eur J Surg 2000;166:977-79.
Hoda SA, Cranor ML, Rosen PP. Hemangiomas of the breast with atypical histologic features: further analysis of the histological subtypes confirm their benign character. Am J Surg Pathol 1992; 16:553-60.
Kim SM, Kim HH, et al . Cavernous hemangioma of the breast. British Journal of Radiology. 2006; 79: e177-e280.
Kavatra V, Lakshmikantha A, Dingra KK, Gupta P, Kurana N . A rare coexistence of concurrent breast hemangioma with fibrodenoma- a case report. Cases Journal 2009, 2:7005
Siewert B, Jacobs T, Baum JK. Sonographic evaluation of subcutaneous hemangioma of the breast. AJR 2002; 178:1025-27
Sung HK, Jae HL, Kim DC, Song BJ. Sub-cutaneous venous hemangioma of the breast. J Ultrasound Med 2007; 26:1097-100
Flis M, Michelle M, Akbar N . An unusual case of an enlarging mass on a screening mammogram. A case report and review of radiology and current literature. The Breast 2003; 220-22.
Rosen PP, Rosen’s Breast Pathology, 2nd edn. Lippincott Williams and Wilkins 2001; 789-97.
Rosen PP, Jozefczyk MA, Boram LH. Vascular tumors of the breast IV: the venous hemangiomas. Am J Surg Pathol 1985;9:659-65.
Rosen PP, Jozefczyk MA, Boram LH. Vascular tumors of the breast V : non parenchymal hemangiomas of the mammary subcutaneous tissue. Am J Surg Pathol 1985; 9:659-65.

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[Table / Fig - 1]
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DOI: JCDR/2012/3613:1984


Date of Submission: Sep 29, 2011
Date of Peer Review: Nov 03, 2011
Date of Acceptance: Dec 23, 2011
Date of Publishing: May 01, 2012

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