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Ferreira-Santos RI, Santos KA, Scherma AP, León JE, Kaminagakura E. Unveiling an oral hemangiolymphangioma. Autops Case Rep 2023; 13:e2023435. [PMID: 37415646 PMCID: PMC10321783 DOI: 10.4322/acr.2023.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/29/2023] [Indexed: 07/08/2023]
Abstract
Hemangiolymphangioma is a very rare vascular malformation that develops as a combination of dilated venous and lymphatic vessels. We describe an unusual case of hemangiolymphangioma of the tongue affecting an adult man who complained of an uncomfortable, slowly progressing exophytic irregular dark red-violaceous nodular mass on his tongue that impaired speech and swallowing for two weeks. The clinical differential diagnoses were Kaposi's sarcoma and a COVID-19-related lesion. A complete blood count and serology for HIV-1 and 2 and RT-PCR for COVID-19 were requested and results were negative. An incisional biopsy was performed. Microscopically, the lesion exhibited several dilated vessels lined by normal-appearing endothelial cells, some filled with prominent intravascular erythrocytes and others containing proteinaceous eosinophilic material resembling lymphatic vessels, in close association with hyperkeratosis, papillomatosis, and acanthosis. From immunohistochemical analysis, most vessels were found to be CD34 positive, some highlighted by α-SMA, whereas D2-40 was focal. Positive staining for some lymphatic and blood vessel markers, i.e., D2-40 and CD34, respectively, indicates a mixed derivation of the lesion. HHV-8 was negative. Clinical features, the congested blood vessels with ectasia in intimate association with hyperplastic epithelium, and the immunohistochemical profile supported the final diagnosis of oral hemangiolymphangioma. The patient underwent minimally invasive surgical excision with no intercurrences. After 18 months of follow-up, there were no signs of relapse.
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Affiliation(s)
| | - Kamilla Alves Santos
- Universidade Estadual Paulista (UNESP), Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brasil
| | | | - Jorge Esquiche León
- Universidade de São Paulo (USP), Dental School, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto, SP, Brasil
| | - Estela Kaminagakura
- Universidade Estadual Paulista (UNESP), Institute of Science and Technology, Department of Biosciences and Oral Diagnosis, São José dos Campos, SP, Brasil
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Terao‐Hirayama K, Hayashi R, Ansai O, Deguchi T, Abe R. Adult-onset severe acral angiokeratoma-like pseudolymphoma: A case report and review of the literature. SKIN HEALTH AND DISEASE 2022; 3:e135. [PMID: 36751317 PMCID: PMC9892420 DOI: 10.1002/ski2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kana Terao‐Hirayama
- Division of DermatologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Ryota Hayashi
- Division of DermatologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Osamu Ansai
- Division of DermatologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Tokiko Deguchi
- Division of DermatologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Riichiro Abe
- Division of DermatologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
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3
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Hatfield J, Preston AK, Hendrick SJ. A solitary angiokeratoma on the toe of a teenaged girl. Proc (Bayl Univ Med Cent) 2022; 35:560-561. [DOI: 10.1080/08998280.2022.2068945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Jess Hatfield
- Texas A&M Health Science Center School of Medicine, Temple, Texas
| | - Allie K. Preston
- Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas
| | - Sophia J. Hendrick
- Department of Dermatology, Baylor Scott & White Medical Center – Temple, Temple, Texas
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Schmidt BAR, El Zein S, Cuoto J, Al-Ibraheemi A, Liang MG, Paltiel HJ, Anderson ME, Labow BI, Upton J, Fishman SJ, Mulliken JB, Greene AK, Warman ML, Kozakewich H. Verrucous Venous Malformation-Subcutaneous Variant. Am J Dermatopathol 2021; 43:e181-e184. [PMID: 33899768 DOI: 10.1097/dad.0000000000001963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Verrucous venous malformation (VVM), previously called "verrucous hemangioma," typically involves the dermis and the subcutaneous fat. We have encountered patients with VVM confined to the hypodermis. MATERIALS AND METHODS During a nearly 20-year period, 13 patients, aged 2-17 years, presented with a subcutaneous mass in the limb without clinically obvious epidermal alterations. Consequently, operative excisions did not include the skin. RESULTS Histopathologically, the specimens were composed of blood-filled channels with morphologic characteristics of capillaries and veins that infiltrated adipose tissue. Aggregates often formed nodules with variable fibrosis and a component of large and radially oriented vessels. A diagnosis of VVM was supported by endothelial immunopositivity for GLUT-1 (25%-75% immunopositive channels in 16/16 specimens); D2-40 (1%-25% channels in 14/15 specimens); and Prox-1 (1%-50% of channels in 14/16 specimens). A MAP3K3 mutation was identified by droplet digital PCR in 3 of the 6 specimens. CONCLUSIONS Diagnosis of VVM in this uncommon location is challenging because of absence of epidermal changes and lack of dermal involvement. Imaging is not pathognomonic, and mimickers are many. Appropriate immunohistochemical stains and molecular analysis contribute to the correct diagnosis.
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Affiliation(s)
- Birgitta A R Schmidt
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Javier Cuoto
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Marilyn G Liang
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Megan E Anderson
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA
| | - Brian I Labow
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Joseph Upton
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Steven J Fishman
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA; and
| | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Arin K Greene
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Mathew L Warman
- Department of Orthopedics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harry Kozakewich
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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5
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Cuestas D, Perafan A, Forero Y, Bonilla J, Velandia A, Gutierrez A, Motta A, Herrera H, Rolon M. Angiokeratomas, not everything is Fabry disease. Int J Dermatol 2019; 58:713-721. [PMID: 30656678 DOI: 10.1111/ijd.14330] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/26/2018] [Accepted: 11/14/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Angiokeratoma corporis diffusum are benign capillary malformations typically associated with Fabry disease and other lysosomal storage disorders. Only in a few cases they appear in healthy individuals. METHODS AND CASE We carried out an exhaustive review of the literature on angiokeratomas and their main clinical, dermoscopy and histological features. Additionally, we reviewed the cases of healthy subjects illustrating the limitations of each case and comparing these results with our case. DISCUSSION Angiokeratoma corporis diffusum is mostly related to Fabry disease and other lysosomal storage disorders. However, some cases may occur in apparently healthy individuals. Therefore, there is a increasing interest in its etiology, pathogenesis and clinical evaluation. CONCLUSION This is an academic-clinical review on angiokeratomas and their main implications in daily dermatological practice. Additionally, we report the first case in the literature of angiokeratoma corporis diffusum in a healthy patient with up-to-date laboratory methods currently available. The clinician should remember that not all angiokeratoma corporis diffusum occurs with lysosomal storage disorders.
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Affiliation(s)
- Daniel Cuestas
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Alejandra Perafan
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Yency Forero
- Internal Medicine Program, La Sabana University, Chía, Colombia
| | - Juan Bonilla
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Alexander Velandia
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Ana Gutierrez
- Special Training in Dermatology, El Bosque University, Bogotá, Colombia
| | - Adriana Motta
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Hugo Herrera
- Dermatology Program, El Bosque University, Bogotá, Colombia.,Dermatology Service, Simon Bolivar Hospital, Bogotá, Colombia
| | - Mariam Rolon
- Dermatopathology Service, Simon Bolívar Hospital, Bogotá, Colombia
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Prindaville B, Lawrence H, Singh V, Nopper AJ, Horii KA. Immunohistochemical Staining of Pediatric Solitary Angiokeratomas. Pediatr Dermatol 2017; 34:211-213. [PMID: 28297141 DOI: 10.1111/pde.13089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The precise etiology and subtype of vessels constituting angiokeratomas is poorly understood. We sought to characterize the vessels by studying prospero-related homeobox gene-1 and D2-40 expression in 22 pediatric solitary angiokeratomas. Routine histologic examination demonstrated a mix of lymph-containing vessels and erythrocyte-filled small vessels. Our results suggest that angiokeratomas may in part be comprised of vessels with lymphatic differentiation.
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Affiliation(s)
- Brea Prindaville
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Hillary Lawrence
- Department of Dermatology, College of Medicine, University of Oklahoma, Oklahoma City, Oklahoma
| | - Vivekanand Singh
- Department of Pathology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Amy J Nopper
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Kimberly A Horii
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
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Saeb-Lima M, Uribe-Uribe NO, Ruiz-Matta JM, Fernandez-Flores A. Thrombotic phenomena in angiokeratoma can evolve into spontaneous involution of the lesions: a report of two cases. J Cutan Pathol 2015; 43:177-80. [PMID: 26395775 DOI: 10.1111/cup.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 11/18/2014] [Accepted: 05/03/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Marcela Saeb-Lima
- Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Norma Ofelia Uribe-Uribe
- Department of General Pathology and Neuropathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Juan Manuel Ruiz-Matta
- Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Ghosh SK, Ghosh S, Agarwal M. Multiple giant angiokeratoma of Fordyce on the shaft of the penis masquerading as keratoacanthoma. An Bras Dermatol 2015; 90:150-2. [PMID: 26312700 PMCID: PMC4540534 DOI: 10.1590/abd1806-4841.20153876] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 08/28/2014] [Indexed: 11/22/2022] Open
Abstract
The term 'angiokeratoma' includes a wide range of dermatological conditions of hyperkeratotic vascular disorders with a similar histologic combination of hyperkeratosis and superficial dermal vascular ectasia. Angiokeratomas can be classified into localized and systemic forms. Angiokeratoma of Fordyce (AKF) is a localized form of angiokeratoma, clinically characterized by 1- to 6-mm, black, blue, or dark red, dome-shaped papules located on the scrotum, shaft of penis, labia majora, clitoris, inner thigh, and lower abdomen. We describe herein a case of giant angiokeratoma of Fordyce on shaft of the penis in an elderly man, clinically masquerading as keratoacanthoma.
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Fernandez-Flores A, Fierro S, Larralde M. Expression of WT-1 by the vascular component of acral pseudolymphomatous angiokeratoma of children. J Cutan Pathol 2014; 42:50-5. [DOI: 10.1111/cup.12429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 05/29/2014] [Accepted: 06/07/2014] [Indexed: 12/21/2022]
Affiliation(s)
| | - Socorro Fierro
- Department of Dermatology; Clinica Virxe Da Mariña; Burela Spain
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10
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Wang L, Gao T, Wang G. Verrucous hemangioma: a clinicopathological and immunohistochemical analysis of 74 cases. J Cutan Pathol 2014; 41:823-30. [PMID: 25263605 DOI: 10.1111/cup.12385] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 07/26/2014] [Accepted: 09/01/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Lei Wang
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
| | - Tianwen Gao
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
| | - Gang Wang
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
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