A case of acquired digital fibrokeratoma accompanied by pyogenic granuloma

A 35-year-old male presented with a slowly growing keratotic tumor on the plantar aspect of his left second toe. Over a ten-year period, the projecting tumor had grown to the size of 7 x 18 mm without causing any symptoms. Three months prior to presentation, a red and polypoid papule of 5 x 5 mm-size began to develop within the original tumor. The tumor was diagnosed as acquired digital fibrokeratoma accompanied by pyogenic granoloma. Hereby, we report this unusual case.

Intestinal intussusception due to a pyogenic granuloma

Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a benign vascular tumor, most commonly arising on the skin and the oral mucosa. Gastrointestinal localization of PG, except for the oral cavity, is exceptionally rare. We describe a case of ileal PG occurring in a 13-year-old girl, presenting with intestinal obstruction. Histological examination revealed proliferation of capillary-sized vessels, with prominent intravascular component, involving the entire thickness of the intestinal wall. Immunohistochemistry showed positivity for CD31, CD34 and von Willebrand factor, whereas immunostaining for glucose transporter-1 protein (GLUT1) and for human herpes virus 8 (HHV-8) was negative. We suggest that PG should be considered in the differential diagnosis of childhood gastrointestinal polypoid lesions.

Pyogenic granuloma associated with bone loss in an eight year old child: A case report

Soft tissue enlargements of the oral cavity often present a diagnostic challenge because a diverse group of pathologic processes can produce such lesions. An enlargement may represent a variation of normal anatomic structures, inflammation, cysts, developmental anomalies and neoplasm. Within these lesions is a group of reactive hyperplasias, which develop in response to a chronic, recurring tissue injury that stimulates an exuberant or excessive tissue repair response. The pyogenic granuloma is a reactive enlargement that is an inflammatory response to local irritation such as calculus, a fractured tooth, rough dental restoration and foreign materials. This article aims to present a case of pyogenic granuloma in 8 year old child patient associated with resorption of bone in relation to the tooth.

[Pyogenic granuloma revealing fistula and deep infection: five cases]

BACKGROUND

Pyogenic granuloma, or botryomycosis, occurring after minor injury or scratching with a septic implement, is a rapidly growing benign inflammatory vascular tumour, often involving the skin or mucous membrane. We report 5 unusual cases of pyogenic granuloma revealing fistula tracking to foreign bodies such as a pace-maker or orthopaedic material, and deep infectious sites with fistula.

METHODS

This retrospective study included 5 men of average age 72.2 years over a period of 22 years (between 1981 and 2003). Clinical images were recorded and a diagnosis of botryomycosis was confirmed in all patients by histological analysis. Four patients presented suppuration. The time from initial clinical signs to diagnosis, presence of traumatic events, screening for microscopic organisms, response to systemic antibiotic therapy, recurrence and clinical features of botriomycosis were analysed.

RESULTS

All patients presented botryomycosis with fistula and suppuration revealing deep bone infection and in one patient, pace maker infection. Complete resolution of the lesions occurred after excision of foreign material and prolonged systemic antibiotic therapy.

CONCLUSION

We report the first series of botryomycosis revealed by fistula and showing deep infectious disease. Pyogenic granuloma is a well-known but rarely reported dermatologic condition.

Pyogenic granuloma of the sigmoid colon

Pyogenic granuloma (PG) is a polypoid form of lobular capillary hemangioma that usually occurs in the skin and some mucosal surfaces. However, it is extremely rare in the intestinal tract and its preoperative diagnosis is difficult. We report on a case of PG of the sigmoid colon in a 62-year-old woman with a 6-month history of rectal bleeding. A pedunculated polypoid lesion was detected by colonoscopy and a polypectomy was performed. A microscopical study revealed a lobular arrangement proliferation of varying sizes of capillaries within an edematous stroma. A critical review of the English literature yielded only another well-documented case of PG in the large intestine. Diagnostic consideration includes inflammatory polyp and other vascular tumors such as bacillary angiomatosis and the angiomatous variant of Kaposi's sarcoma. Precise recognition of this distinctive vascular neoplasm in the gastrointestinal tract is essential to avoid misdiagnosis and inappropriate treatment.

Extramedullary hematopoiesis in a pyogenic granuloma: a case report and review

BACKGROUND

Extramedullary hematopoiesis in the adult life is usually associated with hematological disorders. It can often occur in several organs under certain pathological conditions, including the spleen, liver, and skin, which are normal sites during the embryogenesis, the skin being very uncommon.

CASE REPORT

A case of extramedullary hematopoiesis in a granuloma pyogenicum at the anterior aspect of the right thigh of a 31-year-old Japanese man is reported.

RESULTS

Histologic examination revealed an ulcerated polypoid lesion composed of numerous newly formed capillaries and a myxoid edematous stroma. In addition, three islands of hematopoietic precursors were found.

CONCLUSIONS

This is, to our knowledge, the second case of extramedullary hematopoiesis in a granuloma pyogenicum. We believe that vascular lesions have potential to generate hematopoietic precursor cells; however, hematopoiesis will only occur in a setting of adequate microenvironment, as it occurs in the bone marrow.

Rare case of pyogenic granuloma of the tongue in an 8-week-old infant

We present a case of a large pyogenic granuloma of the tongue causing swallowing difficulties in an 8-week-old infant. In the literature, we found no case reports of pyogenic granuloma in such a young infant. It is a quickly growing, hypertrophic inflammatory change consisting of exceptionally richly vascularized granular tissue. The granuloma was located in the central part of the tongue and appeared dark pink in color. It was an easily bleeding pedunculated tumor measuring 3 x 2.5 cm. The etiology of the tumor is unknown; it can arise in sites of previous injury, chronic irritation and infection. The course of the disease is benign and painless, though it can be recurrent. No recurrence was found in the control examination after 3 years.

Subcutaneous Granuloma pyogenicum in Patients with Antiphospholipid Antibodies

We describe 2 cases of subcutaneous granuloma pyogenicum occurring in patients with antiphospholipid antibodies. The 2 patients had asymptomatic nodules with histopathological findings of a typical subcutaneous granuloma pyogenicum. In addition, case 1 was diagnosed as primary antiphospholipid syndrome with livedo reticularis, superficial thrombophlebitis, thrombocytopenia, cerebral and pulmonary infarcts and renal involvement. Case 2 had no clinical manifestations of vascular occlusive diseases, although anticardiolipin antibody levels were highly positive. To our knowledge, these are the first reported cases of subcutaneous granuloma pyogenicum associated with antiphospholipid antibodies. Antiphospholipid-antibody-mediated thrombosis or immunological mechanisms may be involved in subcutaneous granuloma pyogenicum in our cases.

Pyogenic granuloma: an unrecognized cause of gastrointestinal bleeding

Pyogenic granuloma is a lobular capillary hemangioma that mostly occurs on the skin, but it is also encountered on the mucosal surface of the oral cavity. Only a few cases in other parts of the digestive tract have been reported in Japanese patients. In this report, two Caucasian patients are described, who presented with gastrointestinal bleeding due to the presence of a pyogenic granuloma. One was located in the distal esophagus and could be treated with local excision and laser-photocoagulation therapy. The other one was located in the small intestine and was removed by surgical resection. Although extremely rare, pyogenic granuloma as a cause of gastrointestinal bleeding needs consideration. The lesion is benign, presumably reactive and can be adequately treated by excision or laser photocoagulation. Immunohistochemistry and/or polymerase chain reaction for herpesvirus 8 can reliably distinguish pyogenic granuloma from Kaposi's sarcoma, an important differential diagnosis.

Pyogenic granuloma arising within a port-wine stain

Pyogenic granulomas are common overgrowths of vascular tissue that usually arise on the face, lips, or hands after episodes of minor trauma or during pregnancy. Pyogenic granulomas rarely have been reported to arise in congenital capillary malformations such as port-wine stains, a presentation that most often occurs after laser treatment of port-wine stains or in the setting of pregnancy. This co-occurrence of the 2 lesions represents an underreported event, and the presentation can be alarming or mimic malignancy when there is no prior history of trauma or other known circumstances in which pyogenic granulomas occur. We report a case of a pyogenic granuloma emerging within a port-wine stain in a 35-year-old man with no predisposing factors. A review of the literature regarding pyogenic granulomas that arise within port-wine stains is presented and yields informative conclusions regarding the clinical scenarios where this sometimes alarming event is likely to happen.

Pediatric lobular capillary hemangioma of the nasal cavity

Lobular capillary hemangioma (LCH), also called pyogenic granuloma, is a benign vascular tumor that is pedunculated on the skin and the mucous membranes of the oral cavity. This disease occurs in all ages, but more often in the 3rd decade, and is seen in females more than males. LCH commonly appears in early childhood and affects males more than females in the pediatric age group. The gingiva, lips, tongue and buccal mucosa are the most common sites of mucosal LCH, but the nasal cavity is rare. Micro-trauma and hormonal factors are the most common etiologic factors. Epistaxis and nasal obstruction are the most marked symptoms. We describe the case of a 6-year-old girl with intra-nasal lobular capillary hemangioma presented with epistaxis and nasal obstruction. This should be considered in the differential diagnosis of childhood endonasal masses with bleeding. Total excision using endoscopic technique is the treatment of choice.

Pyogenic granuloma appearing on port-wine stain: a case report

BACKGROUND

Pyogenic granuloma has been reported to be associated with hemangiomas and hamartomas, including port-wine stain. It has been suggested that the spontaneous development of pyogenic granuloma in port-wine stain might be associated with microscopic arteriovenous anastomoses in highly vascularized areas such as the fingers, hands, lips, tongue and face.

CASE REPORT

A 25-year-old male patient presented with a history of a reddish, solitary nodule on the posterior cervical area for eight months. There had been an associated port-wine stain at the same localization since birth. Physical examination revealed a solitary, strawberry-like dome-shaped papule, 12 mm in diameter, within a well-demarcated reddish colored surrounding patch which had been present on the posterior cervical area. The lesion was excised, considering pyogenic granuloma arising in a port-wine stain. Histopathologic examination showed a mass of capillaries with variable luminal diameters, infiltration of inflammatory cells, and immature endothelial proliferation in the upper dermis. The capillaries were organized into lobules separated by fibrous stroma and were surrounded by an epithelial collarette. Immunohistochemical staining for factor VIII-related antigen supported all these findings of the port-wine stain.

CONCLUSION

We present a pyogenic granuloma arising in port-wine stain on the posterior cervical area, since the posterior cervical area is not as highly vascular as the fingers, hands, lips, tongue and face. We believed that the collar of the patient's shirt continuously traumatized port-wine stain, and consequently led to the development of pyogenic granuloma.

Tracheal lobular capillary hemangioma: a rare cause of recurrent hemoptysis

Lobular capillary hemangioma (LCH) is a polypoid form of capillary hemangioma occurring on the skin and mucosal surfaces. While LCH of the oral and nasal cavity is a well-known entity, tracheal localization is extremely rare. We present the case of a 72-year-old woman with recurrent hemoptysis due to a small tumor of the proximal trachea. By endoscopic removal of the tumor by flexible bronchoscopy, the diagnosis of LCH was made, and during the following year there was no recurrent hemoptysis. To our knowledge, this is the first case of histologically proven LCH of the trachea.

[Infantile dyspnea due to pyogenic laryngeal granuloma]

Two appearances are outstanding in this case report. First is the clinical picture of chronic laryngeal stridor of a child due to an acquired haemangioma. And that the anatomopathologic subtype of angioma is a pyogenic granuloma noteworthy, as we shall see, the use of the term "pyogenic granuloma" based only on anatomopathological findings in order to circumscribe this lesion.

Pyogranulomatous skin disease and cellulitis in a cat caused by Rhodococcus equi

This report describes a case of Rhodococcus equi infection causing pyogranulomatous skin disease and cellulitis in a two-year-old female domestic shorthaired cat. The case differed from previously reported cases in cats in its clinical presentation and in the locations of the lesions, which were similar to those seen in horses. The presence of an intracellular organism was confirmed by cytology and on histopathology. The aetiological diagnosis was confirmed by routine biochemical tests specific for R. equi on a pure isolate obtained from a biopsy specimen. The report also reviews the literature of the documented feline cases and discusses the common pitfalls in the diagnosis of such infections.