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Tauziède-Espariat A, Raffoul J, Sun SR, Lassabe C, Monnin C. [A cutaneous case of angiolymphoid hyperplasia with eosinophilia: Presentation of a rare entity]. Ann Pathol 2018; 38:386-390. [PMID: 30119962 DOI: 10.1016/j.annpat.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 09/11/2016] [Accepted: 06/11/2018] [Indexed: 11/25/2022]
Abstract
We report the case of a Caucasian 73-year-old woman, without medical history, who is operated of two lesions of the forehead and the scalp measuring 0.4 and 1cm. There is no adenopathy. Histopathological examination revealed a diffuse vascular proliferation of the dermis and the hypodermis composed of small vessels bordered of plump "epthelioid" endothelial cells. There is no mitotic figure. The stroma is slightly fibrous accompanied by a polymorphic inflammatory infiltrate rich in lymphocytes, sometimes arranged in lymphoid follicles, plasma cells and eosinophils. The proposed diagnosis is angiolymphoid hyperplasia with eosinophilia. This is a rare vascular tumor, benign according with the OMS classification and preferentially observed in the skin. We report a cutaneous case, clinical and histopathological data of the reported cases and present the main differential diagnoses.
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Affiliation(s)
- Arnault Tauziède-Espariat
- Service de pathologie, centre hospitalier Montbéliard, 12, rue Docteur Flamand, 25200 Montbéliard, France.
| | - Johnny Raffoul
- Service de pathologie, centre hospitalier Montbéliard, 12, rue Docteur Flamand, 25200 Montbéliard, France
| | - Shan Rong Sun
- Service de pathologie, centre hospitalier Montbéliard, 12, rue Docteur Flamand, 25200 Montbéliard, France
| | - Catherine Lassabe
- Service de pathologie, centre hospitalier Montbéliard, 12, rue Docteur Flamand, 25200 Montbéliard, France
| | - Christine Monnin
- Service de pathologie, centre hospitalier Montbéliard, 12, rue Docteur Flamand, 25200 Montbéliard, France
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2
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Angiolymphoid Hyperplasia With Eosinophilia: A Clinicopathologic Study of 9 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2013.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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3
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Guinovart RM, Bassas-Vila J, Morell L, Ferrándiz C. Angiolymphoid hyperplasia with eosinophilia: a clinicopathologic study of 9 cases. ACTAS DERMO-SIFILIOGRAFICAS 2013; 105:e1-6. [PMID: 23845664 DOI: 10.1016/j.ad.2013.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 02/22/2013] [Accepted: 03/06/2013] [Indexed: 01/23/2023] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare disease characterized by single or multiple angiomatous lesions typically located on the scalp and the face. We present a retrospective analysis of 9 cases of ALHE. The lesions appeared largely as multiple grouped papules or, in some cases, subcutaneous nodules, located mainly on the scalp, particularly around the ear. We also observed lesions in atypical locations, such as areas of the head other than the scalp, and the shoulder, neck, and forearm. At these sites the lesions had an atypical clinical appearance that made diagnosis difficult; this should be borne in mind in patients with single, well-delimited lesions with a vascular appearance and superficial ulceration or crusting. Surgery was the most common treatment in our series, and even though ALHE is considered a benign condition, recurrence was common.
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Affiliation(s)
- R M Guinovart
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - L Morell
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - C Ferrándiz
- Departamento de Dermatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
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4
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Borghi A, Benedetti S, Corazza M, Gentili V, Ruina G, Di Luca D, Virgili A, Caselli E. Detection of human herpesvirus 8 sequences in cutaneous cherry angiomas. Arch Dermatol Res 2013; 305:659-64. [DOI: 10.1007/s00403-013-1346-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/12/2013] [Accepted: 03/18/2013] [Indexed: 10/27/2022]
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5
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Head and neck lesions of Kimura's disease: Exclusion of human herpesvirus-8 and Epstein-Barr virus by in situ hybridisation and polymerase chain reaction. An immunohistochemical study. J Craniomaxillofac Surg 2010; 38:266-70. [DOI: 10.1016/j.jcms.2009.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 07/23/2009] [Accepted: 08/19/2009] [Indexed: 12/11/2022] Open
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6
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CHEN JF, GAO HW, WU BY, TSAI WC, CHIANG CP. Angiolymphoid hyperplasia with eosinophilia affecting the scrotum: A rare case report with molecular evidence of T-cell clonality. J Dermatol 2010; 37:355-9. [DOI: 10.1111/j.1346-8138.2010.00818.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Güvenç MG, Midilli K, Özdoğan A, İnci E, Tahamiler R, Enver Ö, Şirin G, Ergin S, Kuşkucu M, Divanoğlu EÖ, Yılmaz G, Altas K. Detection of HHV-8 and HPV in laryngeal carcinoma. Auris Nasus Larynx 2008; 35:357-62. [DOI: 10.1016/j.anl.2007.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 08/18/2007] [Accepted: 08/28/2007] [Indexed: 10/22/2022]
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8
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Gyulai R, Kemeny L, Kiss M, Nagy S, Á ám É, Nagy F, Dobozy A. Human herpesvirus 8 DNA sequences in angiosarcoma of the face. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1997.d01-2136.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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9
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Vascular changes in merkel cell carcinoma based on a histopathological study of 92 cases. Am J Dermatopathol 2008; 30:106-11. [PMID: 18360111 DOI: 10.1097/dad.0b013e318162eaa2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although prominent vascular proliferation is a known feature of various neuroendocrine tumors, it has not been systematically studied in Merkel cell carcinoma (MCC) of the skin. The purpose of this study was to fully characterize the light microscopic, immunohistochemical, and ultrastructural features of vascular changes associated with MCC and to determine their frequency and differential diagnostic implications. Additionally, the presence of human herpesvirus 8 DNA in the lesional tissue was investigated. Of 92 studied cases of MCC, 18 cases (20%) were found to exhibit foci of prominent vascular changes which were classified into the following 6 patterns: pericyte hyperplasia, pyogenic granuloma-like, hemangioendothelioma-like, epithelioid hemangioma-like, peliosis-like, and follicular dendritic cell tumor-like pattern. In addition, Azzopardi phenomenon was observed. These changes occurred singly or in combination. Human herpesvirus 8 DNA was identified by polymerase chain reaction in none of the 18 cases. It is concluded that prominent vascular proliferations may be seen in 20% of MCC, and thereby, MCC resembles neuroendocrine tumors in other organs. When unduly prominent and encountered in a limited biopsy specimen, vascular alterations may represent a potential diagnostic pitfall, but, on the other hand, they themselves may serve as a clue to the correct diagnosis. Human herpesvirus 8 does not play a role in angiogenesis in MCC.
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10
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Ennibi K, Rabhi M, Al Bouzidi A, Labraimi A, Chaari J, Toloune F. Hyperplasie angiolymphoïde à éosinophiles. Rev Med Interne 2007; 28:346-8. [PMID: 17321010 DOI: 10.1016/j.revmed.2007.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2007] [Revised: 01/14/2007] [Accepted: 01/16/2007] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Angiolymphoid hyperplasia with eosinophilia is a rare affection. CASE REPORT A 36 years-old woman presented an angiolymphoid hyperplasia with eosinophilia manifesting by erythematous nodular lesions on the face and the forearms, severe neuropathy, visual loss and eosinophilia. Corticosteroids, immunosuppressive drugs and interferon-alpha were unsuccessful. DISCUSSION Angiolymphoid hyperplasia with eosinophilia is a dermatological disease with possible systemic features. Differential diagnosis with Kimura disease is based on clinical presentation and histological findings. Etiopathology remains unknown and the treatment is not codified.
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Affiliation(s)
- K Ennibi
- Service de médecine interne, hôpital militaire d'instruction Mohammed-V, Rabat, Maroc
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11
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Bhattacharjee P, Hui P, McNiff J. Human herpesvirus-8 is not associated with angiolymphoid hyperplasia with eosinophilia. J Cutan Pathol 2004; 31:612-5. [PMID: 15330993 DOI: 10.1111/j.0303-6987.2004.00240.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Angiolymphoid hyperplasia with eosinophilia (ALHE) is an angioproliferative lesion, typically consisting of single or multiple red papules or nodules in the head and neck region. The etiology of ALHE, whether reactive or neoplastic, is unclear. It has been well documented in the literature that human herpesvirus-8 (HHV-8) DNA is present in the majority of cases of Kaposi's sarcoma; however, there is contradictory data regarding the association of this virus with ALHE. METHODS We performed immunohistochemical studies for HHV-8 on paraffin-embedded tissue from 23 cases of histologically confirmed ALHE. Polymerase chain reaction (PCR) analysis for HHV-8 DNA was performed on 14 of the 23 cases that had adequate remaining tissue for the procedure. The results of the immunohistochemical studies and PCR analysis were compared. RESULTS HHV-8 immunohistochemical studies were negative in all 23 cases of ALHE. PCR-based analysis on 14 cases failed to identify HHV-8 DNA. CONCLUSIONS Combined data from several, small published studies are equivocal for an association between HHV-8 and ALHE. The results of our large study show no association between HHV-8 and ALHE.
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Affiliation(s)
- Pradip Bhattacharjee
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06520-8059, USA
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Ray V, Boisseau-Garsaud AM, Hillion G. [Kimura's disease on the hard palate in a patient from Martinique]. Rev Med Interne 2003; 24:253-6. [PMID: 12706782 DOI: 10.1016/s0248-8663(03)00076-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION We report an observation of Kimura's disease (angiolymphoid hyperplasia with eosinophilia) in a Black patient from West Indies, in a rare localisation on hard palate. EXEGESIS A 46-year-old male patient from French West Indies (Martinique) presented with a tumor of hard palate evolving from 2 years with locoregional lymph nodes. He had a history of chronic urticaria, prurigo, rhinitis and alopecia areata. Pathological examination of the tumor was consistent with the diagnosis of Kimura's disease. Blood tests showed hypereosinophilia, elevation of IgG and IgE. The serology of Toxocara canis with Western blott was positive. Corticosteroid therapy (0.7 mg/kg/d) and albendazole (800 mg/d) allowed regression of the tumor, lymph nodes, and urticaria. The remaining tumor was surgically excised. CONCLUSION Kimura's disease was first described in Japanese young men, between 20 and 40 years old, with subcutaneous nodules on head and neck area. Involvement of oral mucosa is rare, and the occurence in West Indian patients has been rarely reported.
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Affiliation(s)
- V Ray
- Service de médecine interne, centre hospitalier universitaire de Fort-de-France, 97261 cedex, Fort-de-France, Martinique
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Kempf W, Haeffner AC, Zepter K, Sander CA, Flaig MJ, Mueller B, Panizzon RG, Hardmeier T, Adams V, Burg G. Angiolymphoid hyperplasia with eosinophilia: evidence for a T-cell lymphoproliferative origin. Hum Pathol 2002; 33:1023-9. [PMID: 12395376 DOI: 10.1053/hupa.2002.128247] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is commonly regarded an angioproliferative process characterized by the presence of prominent, bizarrely shaped blood vessels. These vessels are accompanied by an inflammatory infiltrate that is thought to be a reactive component. Both the cell of origin and the pathogenesis of ALHE remain controversial. To define the histogenesis of this disorder, we analyzed the phenotypic and genotypic profile of the inflammatory infiltrate in ALHE by immunohistochemistry and T-cell receptor gene rearrangement by polymerase chain reaction (PCR) and denaturing gradient gel electrophoresis, as well as automated high-resolution PCR fragment analysis. Five of 7 ALHE patients displayed a clonal T-cell population and proliferative T-cell activity in lesional tissue. Most of these cases followed a protracted and therapy-reluctant course with recurrences. These data suggest that ALHE or a subset of ALHE cases harboring a clonal T-cell population may represent a T-cell lymphoproliferative disorder of a benign or low-grade malignant nature.
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Affiliation(s)
- Werner Kempf
- Department of Dermatology, University Hospital Zurich, Switzerland
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14
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Kazakov DV, Prinz BM, Michaelis S, Schmid M, Müller B, Adams V, Burg G, Kempf W. Study of HHV-8 DNA sequences in archival biopsies from lesional skin of Kaposi's sarcoma, various mesenchymal tumors and related reactive conditions. J Cutan Pathol 2002; 29:279-81. [PMID: 12100627 DOI: 10.1034/j.1600-0560.2002.290503.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND HHV-8 has been identified as the causative agent of Kaposi's sarcoma (KS) and some lymphoproliferative disorders. In addition, there are anecdotal reports on the presence of HHV-8 in other tumors, especially cutaneous epithelial and mesenchymal neoplasms. The aim of the study was to ascertain the value of identification of HHV-8 viral DNA sequences in routinely processed, formalin-fixed, paraffin-embedded tissues for the diagnosis of Kaposi's sarcoma and other mesenchymal tumors. METHODS The presence of HHV-8 sequences in archival material was studied by nested PCR using specific primers for amplification of a 233-bp long fragment of HHV-8 (ORF 26). RESULTS Thirty-three patients with KS (18 classic/sporadic, six post-transplant and nine AIDS-related) and various mesenchymal tumors and related conditions (n = 76) were studied. HHV-8 DNA sequences were detected in 29 of the 33 cases of KS and in one case of multiple eruptive dermatofibroma (MEDF). CONCLUSIONS Identification of HHV-8 DNA sequences in routinely processed tissue is a useful diagnostic marker for KS. Although other mesenchymal tumors are usually not associated with HHV-8, its presence is not fully specific for KS since HHV-8 sequences were also found in one case of MEDF. Therefore, PCR analysis for the detection of HHV-8 should only be used as an additional diagnostic marker for KS and in the context of other tools such as routine histology.
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Affiliation(s)
- Dmitry V Kazakov
- Department of Dermatology, University Hospital, Zürich, Switzerland
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15
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Abstract
BACKGROUND Hobnail hemangioma (HH) is a rare subtype of hemangioma that shares the morphological feature of hobnail endothelia with retiform hemangioendothelioma (RHE) and has to be considered in the differential diagnosis of Kaposi sarcoma. Since DNA of the human herpesvirus type 8 (HHV-8) has been detected in more than 90% of Karposi sarcomas and could recently be demonstrated in RHE, we sought to detect HHV-8 DNA in HH. METHODS AND RESULTS DNA from 12 HH was extracted and subjected to polymerase chain reaction analysis for HHV-8 DNA using two independent protocols with a single set of primers and a nested PCR approach, respectively. PCR amplification was performed using the LightCycler as well as using a thermocycler. HHV-8 DNA could not be detected in HH, although each sample contained DNA adaequately preserved for PCR reactions, as determined by amplification of the beta actin gene. CONCLUSIONS HHV-8 appears to play no rule in the pathogenesis of HH. Absence of HHV-8 DNA in HH might be important in the differential diagnosis to other vascular tumours, in particular Kaposi sarcoma.
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MESH Headings
- DNA Primers/chemistry
- DNA, Neoplasm/analysis
- DNA, Viral/analysis
- Diagnosis, Differential
- Endothelium, Vascular/pathology
- Endothelium, Vascular/virology
- Hemangioendothelioma/genetics
- Hemangioendothelioma/pathology
- Hemangioendothelioma/virology
- Herpesviridae Infections/genetics
- Herpesviridae Infections/pathology
- Herpesviridae Infections/virology
- Herpesvirus 8, Human/genetics
- Herpesvirus 8, Human/isolation & purification
- Herpesvirus 8, Human/pathogenicity
- Humans
- Polymerase Chain Reaction
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
- Skin Neoplasms/virology
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Affiliation(s)
- Ralf Gutzmer
- Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
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16
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Jang KA, Ahn SJ, Choi JH, Sung KJ, Moon KC, Koh JK, Shim YH. Polymerase chain reaction (PCR) for human herpesvirus 8 and heteroduplex PCR for clonality assessment in angiolymphoid hyperplasia with eosinophilia and Kimura's disease. J Cutan Pathol 2001; 28:363-7. [PMID: 11437942 DOI: 10.1034/j.1600-0560.2001.280705.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Recently, human herpesvirus 8 (HHV-8) has been isolated from almost all cases of Kaposi's sarcoma. It has not been found in most cutaneous hemangioproliferative disorders other than Kaposi's sarcoma. Benign vascular lesions including Kimura's disease were not found to contain the HHV-8 DNA sequence. However, there has been contradictory data concerning the presence of HHV-8 in angiolymphoid hyperplasia with eosinophilia (ALHE). Clonality studies in ALHE and Kimura's disease were rare. METHODS We performed polymerase chain reaction (PCR)-based analysis to determine whether HHV-8 is present and heteroduplex analysis of rearranged T-cell receptor (TCR) gene for clonality assessment in paraffin-embedded skin biopsy samples of 7 ALHE and 2 Kimura's disease, taken from immunocompetent patients. RESULTS HHV-8 could not be identified in all the cases of ALHE and Kimura's disease. Although 2 cases (2/7) of ALHE and 2 cases (2/2) of Kimura's disease showed positive result for PCR analysis of TCR, all the cases were negative for heteroduplex-PCR. CONCLUSIONS We suggest that HHV-8 may not involve in a pathogenetic role in ALHE and Kimura's disease and the failure to demonstrate clonality may be consistent with the reactive nature of these diseases and lack of malignant transformation. In addition, heteroduplex-PCR can be applied to confirm doubtful cases of lymphoma in that heteroduplex-PCR is more specific than PCR as seen in our study.
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Affiliation(s)
- K A Jang
- Department of Dermatology, Seoul Paik Hospital, Inje-University, Seoul, Korea.
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17
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Hongcharu W, Baldassano M, Taylor CR. Kimura's disease with oral ulcers: response to pentoxifylline. J Am Acad Dermatol 2000; 43:905-7. [PMID: 11044818 DOI: 10.1067/mjd.2000.101931] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We describe a man with Kimura's disease whose presentation included lymphadenopathy and cutaneous nodules, but was most distinctive for painful oral ulcerations. His lesions showed an initially moderate, but ultimately minimal response to monthly triamcinolone injections. With oral pentoxyifylline, he showed resolution of all of his lesions for 14 months. On cessation of his treatment, his disease flared for 3 months. When pentoxyifylline was restarted, his lesions regressed again within 4 weeks. We review the literature on Kimura's disease.
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Affiliation(s)
- W Hongcharu
- Department of Dermatology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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18
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Blauvelt A, Cobb MW, Turner ML. Widespread cutaneous vascular papules associated with peripheral blood eosinophilia and prominent inguinal lymphadenopathy. J Am Acad Dermatol 2000; 43:698-700. [PMID: 11004630 DOI: 10.1067/mjd.2000.108372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A new section entitled "Dermatology Grand Rounds at the NIH" appears this month. The idea behind it is to provide a unique look at instructive dermatologic cases being presented at the weekly Dermatology Branch Grand Rounds at the National Cancer Institute, National Institutes of Health (NIH), Bethesda, Maryland. Patients seen at the NIH Clinical Center (which includes the NIH inpatient wards and outpatient clinics) are indeed unusual. To be evaluated here, they must be referred by an outside physician and must be placed in a research protocol. In other words, by this criterion, all NIH patients are considered research subjects. The diseases studied at the NIH range from the common to the obscure. Similarly, the dermatologic manifestations of these diseases are equally as diverse. Thus the purpose of this new section is to share some of these fascinating cases with the dermatologic community at large, as well as to provide a glimpse of exciting translational research that has relevance to clinical dermatologists. The format will be simple. Cases will be presented as unknowns, including relevant results from the history, physical examination, and histopathologic analyses. This will be done to challenge the clinicopathologic skills of the readers; authors will make every attempt to make the color clinical and pathologic photographs of the highest quality possible to assist readers in making the correct diagnoses. The discussion will be brief, focusing on the key teaching points of each case. These teaching points will vary from cases to case, covering clinical and histologic information, treatment issues, and/or novel laboratory advances with clinical relevance. Authors will emphasize brevity and clarity in all subsections of the case report, which I hope will promote a good learning experience for dermatology residents and busy practitioners alike. This section will initially be published 4 times annually. Finally, because the section is new to the JAAD, I welcome comments and suggestions to improve the quality of the articles.-Andrew Blauvelt, MD Feature Editor
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Affiliation(s)
- A Blauvelt
- Dermatology Branch, National Cancer Institute, Bethesda, MD 20892-1908, USA.
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19
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Schommer M, Herbst RA, Brodersen JP, Kiehl P, Katenkamp D, Kapp A, Weiss J. Retiform hemangioendothelioma: another tumor associated with human herpesvirus type 8? J Am Acad Dermatol 2000; 42:290-2. [PMID: 10642690 DOI: 10.1016/s0190-9622(00)90143-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Retiform hemangioendothelioma is a rare low-grade angiosarcoma of the skin. It shares some clinical characteristics with Kaposi's sarcoma, a tumor with known human herpesvirus 8 (HHV-8) association. We report a case of retiform hemangioendothelioma in which we detected HHV-8 DNA sequences.
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Affiliation(s)
- M Schommer
- Department of Dermatology and Allergology, Hannover Medical University, Germany
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20
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Arnold M, Geilen CC, Coupland SE, Krengel S, Dippel E, Spröder J, Goerdt S, Orfanos CE. Unilateral angiolymphoid hyperplasia with eosinophilia involving the left arm and hand. J Cutan Pathol 1999; 26:436-40. [PMID: 10563499 DOI: 10.1111/j.1600-0560.1999.tb01871.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A case report of recurrent angiolymphoid hyperplasia with eosinophilia (ALHE) in an otherwise healthy 20-year-old female with manifestation of the disease limited to the left arm and hand is presented together with brief evaluation of the literature as well as the features distinguishing ALHE and Kimura's disease. Immunohistochemical investigations support the hypothesis that ALHE represents a reactive inflammatory lesion rather than a benign vascular neoplasm. A viral cause of ALHE (e.g., HHV8 or Epstein-Barr virus (EBV)) could not be demonstrated. The recurrent nature of the disease is shown by this case, which also demonstrates the need for frequent medical and surgical management.
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Affiliation(s)
- M Arnold
- Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Germany
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21
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Jang HS, Park JH, Oh CK, Kwon KS. Detection of human herpesvirus 8 in Korean Kaposi's sarcoma cases by polymerase chain reaction and in situ polymerase chain reaction. J Dermatol 1999; 26:434-41. [PMID: 10458083 DOI: 10.1111/j.1346-8138.1999.tb02022.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Several infectious agents, including herpesvirus-like particles, had been suggested as possible candidates for the development of Kaposi's sarcoma (KS), and a new herpesvirus, human herpesvirus 8 (HHV-8), was recently identified in the vast majority of KS lesions, irrespective of their association with human immunodeficiency virus (HIV) infection. However, the etiologic role of HHV-8 in KS remains controversial. We undertook this study to screen for and localize the presence of HHV-8 in KS in Korea. A total of 46 paraffin-embedded specimens were studied, including KS, hemangioproliferative disorders, and 10 non-KS lesions from HIV-positive patients. We performed nested polymerase chain reaction (PCR) and in situ PCR with HHV-8 specific primers. HHV-8 DNA sequences were detected in 8 of 11 KS specimens. All specimens of hemangioproliferative disorders, non-KS lesions from HIV-positive patients, and other skin samples were negative for HHV-8. When sequencing PCR products, the sequences were almost identical with the prototypic sequence for HHV-8. In PCR-positive tissues, in situ PCR staining of HHV-8 localized to nuclei of endothelial cells and perivascular spindle-shaped tumor cells. The results of this study suggest that HHV-8 is not widespread and has a certain causative role in the development of KS. Further studies, including serological and animal studies, will be helpful to appreciate an epidermiological link and pathogenetic mechanism between HHV-8 and KS.
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Affiliation(s)
- H S Jang
- Department of Dermatology, College of Medicine, Pusan National University, Korea
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22
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Sarid R, Olsen SJ, Moore PS. Kaposi's sarcoma-associated herpesvirus: epidemiology, virology, and molecular biology. Adv Virus Res 1999; 52:139-232. [PMID: 10384236 DOI: 10.1016/s0065-3527(08)60299-7] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- R Sarid
- Division of Epidemiology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA
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23
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Affiliation(s)
- T F Schulz
- Department of Medical Microbiology and Genitourinary Medicine, University of Liverpool, United Kingdom
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24
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Spittle MF. Spectrum of AIDS-associated malignant disorders. Lancet 1998; 352:907. [PMID: 9743013 DOI: 10.1016/s0140-6736(05)60048-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Li N, Anderson WK, Bhawan J. Further confirmation of the association of human herpesvirus 8 with Kaposi's sarcoma. J Cutan Pathol 1998; 25:413-9. [PMID: 9826166 DOI: 10.1111/j.1600-0560.1998.tb01767.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Recently, a new herpesvirus-like DNA sequence named Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV8) has been isolated from almost all cases of Kaposi's sarcoma (KS). It has not been found in most benign and malignant cutaneous hemangioproliferative disorders other than KS. To further verify the specificity of the association of this new viral DNA with KS, we examined in total 42 cases of vascular neoplasms of endothelial derivation using nested polymerase chain reaction (PCR) for the presence of a 233-bp segment of this KSHV/HHV8 on paraffin-embedded specimens. In our investigation, we added an additional step to conventional PCR protocol that uses UV light to pretreat all the PCR regeants except Taq DNA polymerase and the target DNA to eliminate the false positives caused by trace contamination. All 15 cases of typical KS, both AIDS and non-AIDS related, as well as 4 cases of atypical vascular tumors suspicious of KS, were positive for this KSHV/HHV8 DNA sequence. The remaining 23 cases of hemangioproliferative disorders other than KS, including angiosarcoma, capillary hemangioma, angiolymphoid hyperplasia with eosinophilia, epithelioid hemangioma, histiocytoid hemangioma, hemangioendothelioma, and microvenous hemangioma, were negative for HHV8. These results confirm the previous observation that KSHV/HHV8 is specific for KS within hemangioproliferative cutaneous disorders, and PCR for detection of KSHV/HHV8 might be used as an additional diagnostic tool in distinguishing KS.
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MESH Headings
- Antigens, CD34/analysis
- DNA/chemistry
- DNA/genetics
- DNA, Neoplasm/chemistry
- DNA, Neoplasm/genetics
- DNA, Viral/chemistry
- DNA, Viral/genetics
- Diagnosis, Differential
- HIV/genetics
- Herpesvirus 8, Human/genetics
- Histocytochemistry
- Humans
- Immunohistochemistry
- Polymerase Chain Reaction/methods
- S100 Proteins/analysis
- Sarcoma, Kaposi/genetics
- Sarcoma, Kaposi/pathology
- Sarcoma, Kaposi/virology
- Sequence Analysis, DNA
- Skin Diseases, Vascular/genetics
- Skin Diseases, Vascular/pathology
- Skin Diseases, Vascular/virology
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Affiliation(s)
- N Li
- Department of Dermatology, Boston University School of Medicine, Massachusetts, USA
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26
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Abstract
Human herpes virus 8 (HHV-8) is a recently discovered herpesvirus related to Herpesvirus saimiri and Epstein-Barr virus (EBV). It has been assigned to the Rhadinovirus genus (gamma-2 herpesvirus) on the basis of its genomic sequence and structure. HHV-8 is the first member of this genus known to infect humans and it is now evident that it is the likely cause of Kaposi's sarcoma (KS). The virus is present in endothelial and spindle cells of KS, and in HIV disease the presence of HHV-8 in peripheral blood, and/or serum IgG antibodies to HHV-8, predicts the development of AIDS-related KS. HHV-8 can also infect CD19 + B cells and is of aetiological significance in the development of body cavity B cell lymphomas of AIDS. Of note, the translation products of viral open reading frames (ORFs) reveal HHV-8 to be a molecular pirate, capable of producing homologues of several human gene products that may result in alterations in cell cycle arrest, inhibit apoptosis and cell-mediated immune responses, and thus provide the potential for tumour production.
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Affiliation(s)
- S R Porter
- Department of Oral Medicine, Eastman Dental Institute for Oral Healthcare Sciences, London, U.K
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27
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Viviano E, Romano N, Sorce M, Castelli E, Marasà L. Absence of human herpesvirus 8 DNA in benign and malignant endothelial lesions. J Clin Microbiol 1997; 35:3010. [PMID: 9350784 PMCID: PMC230112 DOI: 10.1128/jcm.35.11.3010-3010.1997] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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28
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Gyulai R, Kemény L, Kiss M, Nagy S, Adám E, Nagy F, Dobozy A. Human herpesvirus 8 DNA sequences in angiosarcoma of the face. Br J Dermatol 1997; 137:467. [PMID: 9349352 DOI: 10.1111/j.1365-2133.1997.tb03761.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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29
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Takata M, Hatta N, Takehara K, Fujiwara H. Absence of human herpesvirus-8 DNA in angiosarcomas and other skin tumours in immunocompetent patients, and in graft-versus-host disease in the immunosuppressed recipients of bone marrow transplants. Br J Dermatol 1997; 137:156-7. [PMID: 9274652 DOI: 10.1111/j.1365-2133.1997.tb03727.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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30
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Kemény L, Gyulai R, Kiss M, Nagy F, Dobozy A. Kaposi's sarcoma-associated herpesvirus/human herpesvirus-8: a new virus in human pathology. J Am Acad Dermatol 1997; 37:107-13. [PMID: 9216532 DOI: 10.1016/s0190-9622(97)70220-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The discovery of a new human herpesvirus in Kaposi's sarcoma (KS) tissue of patients with AIDS has opened up new vistas in virology and oncology. This herpesvirus was first descriptively named KS-associated herpesvirus (KSHV), but was recently renamed human herpesvirus 8 (HHV8). KSHV/HHV8 DNA has been found in all forms of KS, suggesting that it might be involved in the pathogenesis of KS. In addition, KSHV/HHV8 can be detected in both malignant and benign lymphoproliferative disease. KSHV/HHV8 was also found in patients with angiosarcoma of the face and angiolymphoid hyperplasia with eosinophilia. Although only a limited portion of the virus has been sequenced, KSHV/HHV8 is equipped with genes that could confer oncogenic potential. The virus can now be cultured, providing the possibility for studies of viral replication and the mode of transmission. The recently developed serologic assays for antiviral antibodies suggest that infection with KSHV/HHV8 is not ubiquitous because KSHV/HHV8 seropositivity is limited to a small proportion of the population.
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Affiliation(s)
- L Kemény
- Department of Dermatology, Albert Szent-Györgyi Medical University, Szeged, Hungary
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31
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Abstract
Three new human herpesviruses have been recognised in the past decade, and add further to our knowledge of human diseases with potential viral aetiologies. These viruses can be included with the other known human herpesviruses found in normal body secretions, particularly saliva. HHV6 and HHV7 have been associated with febrile illnesses and the childhood disease, exanthem subitum. HHV8 seems to resemble Epstein-Barr virus in its possible transforming properties and poses challenging questions for researchers directed at determining its potential role in lymphomas and Kaposi's sarcoma. Research on these herpesviruses can provide valuable new insights into virus/host relationships and mechanisms involved in replicative and latent stages of virus infection.
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Affiliation(s)
- J A Levy
- Department of Medicine, University of California, San Francisco 94143-1270, USA
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32
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Steiner MC, Smith ME, Spittle MF. A patient with classical Kaposi's sarcoma and angiosarcoma: bad luck or a common aetiology? Clin Oncol (R Coll Radiol) 1997; 9:186-8. [PMID: 9269554 DOI: 10.1016/s0936-6555(97)80079-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Classical Kaposi's sarcoma and angiosarcoma are rare malignant tumours arising from vascular tissue. However, they have distinct histological features and appear also to differ in their epidemiology and pathogenesis. We present the case history of a patient in whom both these tumours occurred simultaneously. The relationship between these events is discussed in the light of the new virus, human herpes virus 8.
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