1
|
Dubus M, Kanitakis J. Cutaneous Epithelioid Angiomatous Nodule: Report of a New Case and Literature Review. Dermatopathology (Basel) 2023; 10:112-119. [PMID: 36975386 PMCID: PMC10047158 DOI: 10.3390/dermatopathology10010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/19/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Cutaneous epithelioid angiomatous nodule is a rare benign vascular tumour of the skin with characteristic microscopic features, of which 65 cases have so far been reported after the initial description of this entity in 2004. We present here a new typical case of this rare lesion and provide a comprehensive review of all the previously published cases, delineating the salient clinicopathological features of this rare tumour.
Collapse
Affiliation(s)
- Margaux Dubus
- Department of Dermatology, University of Grenoble Alpes, 38700 La Tronche, France
- Department of Dermatology, Ed. Herriot Hospital Group, University of Lyon, 69003 Lyon, France
| | - Jean Kanitakis
- Department of Dermatology, Ed. Herriot Hospital Group, University of Lyon, 69003 Lyon, France
- Department of Pathology, Centre Hospitalier Lyon Sud, 69310 Pierre Bénite, France
- Correspondence:
| |
Collapse
|
2
|
Atherton K, Hinen H. Vascular Anomalies. Dermatol Clin 2022; 40:401-423. [DOI: 10.1016/j.det.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
3
|
Goto K, Ogawa K, Fukai T, Miura K, Yanagihara S, Honma K, Motoi T. Categorization of cutaneous epithelioid angiomatous nodule as epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia: clinicopathologic, immunohistochemical, and molecular analyses of seven lesions. J Cutan Pathol 2022; 49:765-771. [PMID: 35490255 DOI: 10.1111/cup.14246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/28/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The status of cutaneous epithelioid angiomatous nodule (CEAN) as a distinct entity remains controversial. This study investigated the relationship between CEAN and epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia (ALHE). METHODS Data of seven lesions with CEAN features from four cases (Cases 1-4:61-year-old, 76-year-old, 53-year-old, and 21-year-old men, respectively) were investigated. RESULTS Cases 1 and 2 showed multiple lesions in the head and neck region, but Cases 3 and 4 showed solitary lesions on the back and scalp, respectively. Moreover, the histopathologic findings of the lesions of Cases 1 and 2 were consistent with those of conventional epithelioid hemangioma or classic cutaneous ALHE. Diffuse immunoexpression of FOSB was observed in Cases 1 and 2, but FOSB split signals were absent in break-apart fluorescence in situ hybridization (FISH). In contrast, the histopathologic findings of the lesions of Cases 3 and 4 were consistent with those of cellular-type epithelioid hemangiomas. Diffuse immunoreactivity for c-FOS was observed in Cases 3 and 4, and split signals of FOS were present in break-apart FISH in Case 3. CONCLUSIONS This study demonstrated that the seven tumors with CEAN features could be reclassified under the epithelioid hemangioma/ALHE group, although the small sample size is a limitation. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan.,Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.,Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan.,Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.,Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan.,Department of Clinical Laboratory and Diagnostic Pathology, Osaka National Hospital, Osaka, Japan.,Department of Dermatology, Hyogo Cancer Center, Akashi, Japan.,Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Tatsuo Fukai
- Department of Dermatology and Allergology, Juntendo Nerima Hospital, Tokyo, Japan
| | - Keiko Miura
- Department of Surgical Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigeto Yanagihara
- Department of Dermatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Keiichiro Honma
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| |
Collapse
|
4
|
Chetty R, Kamil ZS, Wang A, Al Habeeb A, Ghazarian D. Cutaneous epithelioid angiomatous nodule: a report of a series including a case with moderate cytologic atypia and immunosuppression. Diagn Pathol 2018; 13:50. [PMID: 30103782 PMCID: PMC6090800 DOI: 10.1186/s13000-018-0729-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/30/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Cutaneous epithelioid angiomatous nodule (CEAN) is a very rare and relatively recently recognized vascular proliferation characterized usually by minimal cytological atypia and accompanying mitotic activity. As such, CEAN represents an important diagnostic pitfall, which could lead to significant misdiagnosis and unnecessary treatment. METHODS The clinicopathologic findings of 5 cases of CEAN were reviewed including a unique case with typical findings but also moderate cytologic atypia and brisk mitotic activity in a patient on immunosuppression. RESULTS The cases were in 3 women and 2 men ranging in age from 18 to 61 years with lesions in the neck (2 cases), upper arm, back and shoulder. In 4 of the cases, the patients did not have any relevant potentially contributory clinical history, and in 1 case the patient was on immunosuppressive treatment. All 5 cases were superficially located within the dermis, well-circumscribed and similarly composed of epithelioid cells displaying minimal (in 4 cases) and moderate (1 case) atypia. The mitotic count ranged from 1 to 3 per 10 high power fields (HPF) in 4 cases and up to 9 per 10 HPF in the immunosuppressed patient. Atypical mitoses were not encountered in any of the cases. Two lesions that were incompletely excised recurred, but none of the patients showed distant metastases. CONCLUSION While cytologically alarming, CEAN has a characteristic microscopic appearance and if completely excised follows an indolent course.
Collapse
Affiliation(s)
- Runjan Chetty
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, 11th floor Eaton wing, Toronto General Hospital 200 Elizabeth Street, Toronto, M5G 2C4 Canada
| | - Zaid S. Kamil
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, 11th floor Eaton wing, Toronto General Hospital 200 Elizabeth Street, Toronto, M5G 2C4 Canada
| | - Ami Wang
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, 11th floor Eaton wing, Toronto General Hospital 200 Elizabeth Street, Toronto, M5G 2C4 Canada
| | - Ayman Al Habeeb
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, 11th floor Eaton wing, Toronto General Hospital 200 Elizabeth Street, Toronto, M5G 2C4 Canada
| | - Danny Ghazarian
- Department of Pathology, Laboratory Medicine Program, University Health Network and University of Toronto, 11th floor Eaton wing, Toronto General Hospital 200 Elizabeth Street, Toronto, M5G 2C4 Canada
| |
Collapse
|
5
|
McLemore MS, Huo L, Deavers MT, Curry JL, Torres-Cabala CA, Wang WL, Prieto VG. Cutaneous epithelioid angiomatous nodule of the chest wall with expression of estrogen receptor: a mimic of carcinoma and a potential diagnostic pitfall. J Cutan Pathol 2011; 38:818-22. [PMID: 21752053 DOI: 10.1111/j.1600-0560.2011.01743.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Cutaneous epithelioid angiomatous nodule (CEAN) is a rare vascular proliferation that develops on the trunk and extremities. The lesion arises over weeks to months and affects both sexes without age predilection. Histologically, CEAN is characterized by a circumscribed proliferation of epithelioid endothelial cells in the superficial dermis with a background of lymphocytes, plasma cells and eosinophils. The epithelioid cells are positive for CD31, CD34 and/or D2-40. We report a case of CEAN that had remained stable for more than 30 years on the chest wall of a woman with a history of breast cancer. The lesional cells were epithelioid in appearance and positive for estrogen receptor (ER), raising suspicion for breast carcinoma. However, the cells were positive for CD31, CD34, D2-40 and EMA (epithelial membrane antigen); they were negative for cytokeratins, carcinoembryonic antigen (CEA), CD1a, gross cystic disease fluid protein (GCDFP-15), S-100, a melanocytic cocktail, HHV-8 and progesterone receptor. The histologic and immunohistochemical features, including a low proliferation index (10% by Ki-67), helped to distinguish this lesion from carcinoma and other vascular lesions. This is the most comprehensive immunohistochemical profile reported for CEAN to date and the first time that ER expression has been described.
Collapse
Affiliation(s)
- Michael S McLemore
- Division of Pathology and Laboratory Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | | | | | | | | |
Collapse
|
6
|
Shiomi T, Kaddu S, Yoshida Y, Yamamoto O, Yamane T, Shomori K, Ito H. Cutaneous epithelioid angiomatous nodule arising in capillary malformation. J Cutan Pathol 2011; 38:372-5. [PMID: 20602659 DOI: 10.1111/j.1600-0560.2010.01573.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cutaneous epithelioid angiomatous nodule (CEAN) represents a rare, benign vascular lesion described by Brenn and Fletcher in 2004. To the best of our knowledge, the development of CEAN in a pre-existing vascular malformation has not been previously reported. A 52-year-old Japanese woman presented with multiple erythematous papules developed on violaceous macule of the right back that had been diagnosed as capillary malformation (CM) in childhood. Histopathological examination of one erythematous papule revealed a relatively well-circumscribed nodule composed mostly of epithelioid cells in the dermis. Abnormal dilated vessels were also identified around the lesion in the dermis, suggesting a CM. Immunohistochemically, the epithelioid cells were positive for CD31 and CD34. Staining for α-smooth muscle actin highlighted pericytes with epithelioid features. These findings were consistent with a diagnosis of CEAN arising in CM. The excised specimens of other erythematous papules revealed pyogenic granuloma (PyG) with focal epithelioid morphology accompanied by CM. We present the first reported case of CEAN arising in CM. Considering the histopathological findings, we speculate that CEAN of our case could be associated with PyG developed in pre-existing CM, and may thus be a variant of PyG with a mostly epithelioid appearance.
Collapse
Affiliation(s)
- Tatsushi Shiomi
- Department of Organ Pathology, Tottori University, Faculty of Medicine, Yonago, Japan.
| | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
Cutaneous epithelioid angiomatous nodule (CEAN) represents a recently described benign vascular proliferation. We report a case affecting a 28-year-old man who presented with painful nodules on his glans penis. The patient is symptom-free 18 months after tumor excision. This is the first report of CEAN occurring on the glans penis.
Collapse
Affiliation(s)
- Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India.
| | | | | | | |
Collapse
|
8
|
Segura-Palacios J, Gómez-Moyano E, Hiraldo-Gamero A, Sanz-Trelles A. Nódulo angiomatoso epitelioide cutáneo. Un nuevo tumor vascular recientemente descrito. Actas Dermo-Sifiliográficas 2010. [DOI: 10.1016/j.ad.2010.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
9
|
Segura-Palacios J, Gómez-Moyano E, Hiraldo-Gamero A, Sanz-Trelles A. Cutaneous Epithelioid Angiomatous Nodule: A Recently Described Vascular Tumor. Actas Dermo-Sifiliográficas (English Edition) 2010. [DOI: 10.1016/s1578-2190(10)70739-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
10
|
Sun ZJ, Cai Y, Zhao YF, Hu X, Zhang W, Chen XM, Lai FMM. Epithelioid angiomatous nodule of head and neck. Pathol Res Pract 2009; 205:753-7. [DOI: 10.1016/j.prp.2009.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 06/08/2009] [Accepted: 06/15/2009] [Indexed: 11/25/2022]
|