Annular elastolytic giant cell granuloma associated with prostate carcinoma: demonstration of human metalloelastase (MMP-12) expression

Hybrid Clinical and Histopathological Pattern in Annular Lesions: An Overlap between Annular Elastolytic Giant Cell Granuloma and Granuloma Annulare?

“…Some authors believe that AEGCG is a subclassification of GA, when the last one is in sun-exposed areas [11]. However, recent studies highlight the role of the histopathology in the distinction between the two lesions, since the presence of elastolysis and elastophagocytosis and granulomatous inflammation indicates AEGCG, in the absence of mucin deposition and necrobiosis [12]. The pattern observed in the histopathology of our patient demonstrates the typical change, described above corresponding to AEGCG, but also shows characteristic features of granuloma annulare such as palisading granulomas and necrobiosis [12].…”

“…However, recent studies highlight the role of the histopathology in the distinction between the two lesions, since the presence of elastolysis and elastophagocytosis and granulomatous inflammation indicates AEGCG, in the absence of mucin deposition and necrobiosis [12]. The pattern observed in the histopathology of our patient demonstrates the typical change, described above corresponding to AEGCG, but also shows characteristic features of granuloma annulare such as palisading granulomas and necrobiosis [12]. This hybrid pattern has been described in 5 cases [9, 13–15], indicating an aetiopathogenic overlap with the possible influence of systemic diseases such as DM [9].…”

Elastolytic Actinic Giant Cell Granuloma

“…11,13 There are few reports associating EAGCG and malignancies, including hematologic disorders like leukemias or lymphomas 49-51 but also solid neoplasias like prostate carcinoma, although this relationship may be incidental. 15 Boussault and colleagues 50 explained this condition as a kind of immune response against a tumor antigen. In 2 of these cases the treatment of the malignancy was followed by the regression of the EAGCG, 49,50 and in 1 of the cases there was a relapse of the granuloma when the leukemia recurred.…”

“…14 Matrix metalloproteinase (MMP)-12, produced by macrophages, is expressed in the infiltrates of EAGCG, explaining the degradation of elastic fibers and inducing the formation of multinucleated giant cells. 15 Ultraviolet (UV) radiation, especially UVA, because of its longer wavelength, and heat are recognized as causal factors, by changing the antigenicity of elastic fibers and producing an immune response. 2,16 However, collagen is not affected by actinic radiation.…”

Annular elastolytic giant cell granuloma after a cardiac pacemaker implantation

“…In general, the diagnosis of actinic granulomas is reserved for AEGCG lesions confined to sun-exposed regions 1 . Recent molecular studies found an up-regulation of metalloproteinase-12 in AEGCG lesions, postulating its role in the degradation of elastic fibers 5 . Elastic fibers are essential to the development of AEGCG because scars devoid of such fibers are found to be spared of AEGCG 6 .…”