Cutaneous Reactive Angiomatosis Associated With Chronic Lymphoid Leukemia

Abstract

Cutaneous reactive angiomatosis is an unusual benign vascular disorder of the skin usually associated to systemic diseases. It is characterized by lobular or diffuse proliferation of small blood vessels with hyperplasia of endothelial cells, pericytes, and sometimes histiocytes. We report a 59-year-old man with asymptomatic erythematous-violaceous patches on back, palms, and elbows for 9 months. Laboratory examination revealed changes consistent with B-chronic lymphocytic leukemia. Cutaneous biopsy showed a predominantly lobular small blood vessel proliferation in dermis with pericytic hyperplasia and mild perivascular lymphoplasmacytic infiltrate. Spontaneous involution of lesions occurred after 6 months. A second biopsy performed at the beginning of clinical involution showed a less prominent vascular component with perivascular giant cells with coexpression of CD68 and CD 31. To our knowledge, this is the first case of cutaneous reactive angiomatosis with documented histopathological findings of clinical involution.

Incidental Simultaneous Finding of Intravascular Histiocytosis and Reactive Angioendotheliomatosis

“…A summary of the clinical and histopathologic features of these entities is presented in Table 1. 3,4,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32][33][34][35][36][37][38] Our case supports the previous proposal that both RAE and IH are actually 2 different aspects of the same Majority: B cells phenotype; CD20 + , CD79a + , MUM1 + (95%), bcl-2 + (91%), CD3 2 ; Rare: T/NK-cell phenotype 35 Immunofluorescence findings Granular deposits of IgA, IgM, and complement may be found around the vessels and at the DEJ 34 …”

“…[1][2][3][4][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Most of them were associated with infections such as acute otitis media and pulmonary tuberculosis, coexistent systemic diseases (renal disease, valvular cardiac disease, alcoholic cirrhosis, and rheumatoid arthritis/polymyalgia rheumatica), blood disorders (myelodysplastic syndrome, cryoproteinemias, monoclonal gammopathies, antiphospholipid syndrome), and vascular abnormalities (iatrogenic arteriovenous fistulas, severe peripheral vascular atherosclerotic disease). 9,[11][12][13][14][15][16][17][18][19][20][21][22] The number of reports of IH in the literature is similar to those of RAE. 7,8 There is a frequent association of IH with rheumatoid arthritis.…”

Recurrent reactive angioendotheliomatosis in pregnancy: a case report

“…Clinical presentations of RAE may resemble that of Kaposi sarcoma, morphea/scleroderma, pyoderma gangrenosum, calciphylaxis, eruptive disseminated lobular capillary hemangioma, angiosarcoma, lichen ruber verrucosus, pyogenic granuloma, sarcoid, and lupus panniculitis . Among the causative agents or associations, infectious, immunological, and neoplastic diseases have been the most frequently reported diseases . RAE secondary to dermal amyloid angiopathy or neutrophilic dermatosis has been also reported .…”

Manifestations dermatologiques des gammapathies monoclonales : apport de l’histopathologie cutanée

“…De telles lésions peuvent se développer au cours des gammapathies monoclonales ou des cryoglobulinémies. Les diagnostiques différentiels sont l'angiomatose bacillaire, que l'on ne rencontre plus depuis l'amélioration de la prise en charge de l'infection par le VIH, le granulome pyogénique disséminé et le sarcome de Kaposi, et surtout, dans le cadre d'une dysglobulinémie monoclonale, l'angiome gloméruloïde [17,[46][47][48]. Ces derniers ont un aspect histologique bien particulier que peuvent reconnaître facilement les pathologistes, permettant alors de suspecter un syndrome POEMS et une dysglobulinémie monoclonale sous-jacents.…”