Angiohistiocytoma with giant cells D23.9

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 06.08.2021

Dieser Artikel auf Deutsch

Synonym(s)

multinucleate cell angiohistiocytoma

History
This section has been translated automatically.

Smith and Wilson Jones, 1985

Definition
This section has been translated automatically.

Rare, usually asymptomatic, slow-growing, benign tumor of the skin of unknown etiology and pathogenesis.

You might also be interested in

Advertisment

Dermatology

Giant comedo

Differently applied term for a monstrous comedo.

Occurrence/Epidemiology
This section has been translated automatically.

Very rare (less than 200 cases have been reported in the literature worldwide to date - Frew JW 2015).

Etiopathogenesis
This section has been translated automatically.

Unknown. Triggering by a primary inflammatory event is discussed.

Manifestation
This section has been translated automatically.

Mainly women in middle age (w:m=3:1). In a retrospective analysis of 142 cases (Frew JW 2015), the average age at onset of the disease was 50.1 years.

Localization
This section has been translated automatically.

Mainly acra, legs, less often face.

Clinical features
This section has been translated automatically.

Solitary or multiple, occasionally also disseminated or generalized, 0.3-3.0 cm in size, pale reddish to livid, firm, flat, asymptomatic (mild itching is rarely described) papules with smooth surface, which tend to confluence.

Histology
This section has been translated automatically.

Under a slightly acanthotic epidermis there is a variably dense, partly perivascular, partly diffuse infiltrate of lymphocytes, spindle-shaped cells and bizarre, large, multinucleated giant cells as well as numerous vascular incisions.

Endothelial cells: positive staining with factor VIII related antigen, Ulex europaeus I lectin, CD31, CD 34.

Giant cells (multinuclear histiocytes): Positive staining with vimentin.

Mononuclear histiocytes: positive staining with CD 68, lysozyme, alpha-1 antitrypsin; negative for S100 protein and CD1a.

Differential diagnosis
This section has been translated automatically.

Since the clinical picture is very heterogeneous (solitary and multiple, isolated or confluent papules, no symptoms) the diagnosis is based on the histological findings. As clinical differential diagnosis the following diseases are possible:

Kaposi's Sarcoma
Histiocytoma(s)
Anulare granuloma.
Lichen planus
Arthropod reaction (see below pseudolymphomas of the skin)

A clinical evaluation is not made.

Therapy
This section has been translated automatically.

Lesions arranged in groups can be ablated with the laser (_{CO2 laser}), individual lesions can be removed surgically, e.g. by punching. Recurrence rate apparently low (?).

Literature
This section has been translated automatically.

Frew JW (2015) Multinucleate cell angiohistiocytoma: clinicopathological correlation of 142 cases with insights into etiology and pathogenesis. Am J Dermatopathol 37:222-228.
Grgurich E et al (2019) Multinucleate cell angiohistiocytoma: case report and literature review. J Cutan Pathol 46:59-61.
Jones EW et al (1990) Multinucleate cell angiohistiocytoma: an acquired vascular anomaly to be distinguished from Kaposi's sarcoma. Br J Dermatol 122: 651-663
Puig L (2002) Multinucleate cell angiohistiocytoma: a fibrohistiocytic proliferation with increased mast cell numbers and vascular hyperplasia. J Cutan Pathol 29: 232-237
Smith NP, Wilson Jones E (1985) Multinucleate cell angiohistiocytoma: a new entity. Br J Dermatol 113: 15
Vakeva L et al (2003) Multinucleate cell angiohistiocytoma: a report of four cases in Finland. Acta Derm Venereol 83: 222-223
Weinstabl A et al (2010) Angiohistiocytoma withz multinucleate giant cells. JDDG 8: 951-952