Granular cell cutaneous epithelioid angiomatous nodule

Abstract

Cutaneous epithelioid angiomatous nodule is an uncommon vascular lesion usually described as composed of epithelioid endothelial cells with vesicular nuclei and eosinophilic cytoplasm. A granular cell variant has not been previously described.Endothelial cells can present with granular cytoplasm as documented with reports of granular cell angiosarcoma. The granularity is thought to be due to increased intracytoplasmic lysosomes. We present a case of a benign superficial vascular lesion composed of a sheet-like proliferation of epithelioid endothelial cells with distinctly granular cytoplasm confirmed as of endothelial origin with positive staining for CD31 and ERG.

Cutaneous Epithelioid Angiomatous Nodule: Report of a New Case and Literature Review

“…CEAN is a rare vascular proliferative lesion, of which 66 cases have so far been reported after the initial description of this entity in 2004 [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], including the case presented here. Clinically, CEAN presents as a bluish-red papule or nodule measuring 0.2–2.5 cm.…”

“…They were only focal in 31 cases and with a homogenous distribution in 3 cases [ 24 ]. The epithelioid endothelial cells often contain intracytoplasmic vacuoles, representing (abortive) lumina within which red blood cells may be found ([ 3 , 4 , 6 , 12 , 14 , 18 , 19 , 21 , 22 , 23 , 26 ], this case). A chronic inflammatory infiltrate is almost consistently present, composed mainly of lymphocytes.…”

“…Cutaneous epithelioid angiomatous nodule (CEAN) is a rare benign vascular tumour of the skin first described by Brenn and Fletcher in 2004 [ 1 ], of which 65 cases have so far been reported [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. It belongs to the spectrum of epithelioid vascular proliferative lesions, including other neoplasms, either benign (such as epithelioid haemangioma and pyogenic granuloma) or malignant (such as epithelioid haemangioendothelioma and epithelioid angiosarcoma).…”

Categorization of cutaneous epithelioid angiomatous nodule as epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia: Clinicopathologic, immunohistochemical, and molecular analyses of seven lesions

“…We performed a thorough search regarding CEAN using PubMed search engines and found 66 CEAN cases in 28 existing studies in English between 2004 and 2021 1–28 . These CEAN tumors were observed in patients (38 males and 28 females) aged 14–84 years (average, 42.0 years).…”

“…A cutaneous epithelioid angiomatous nodule (CEAN) is a rare cutaneous vascular entity first described in 2004 by Brenn and Fletcher 1 . Since then, 66 cases have been reported in 28 papers 1–28 . Owing to the histopathological features of the epithelioid endothelial cells, this benign tumor can be easily confused with other benign, borderline, or malignant vascular tumors, including bacillary angiomatosis, Kaposi sarcoma, epithelioid hemangioendothelioma, and epithelioid angiosarcoma.…”