Cutaneous Epithelioid Angiomatous Nodule Research Articles

Cutaneous Epithelioid Angiomatous Nodule with Unusual Localization

Abstract: Brenn and Fletcher described cutaneous epithelioid angiomatous nodule (CEAN) as a benign vascular proliferation that was in 2004. It is very rare condition. It is characterized by endothelial cells that have histiocytoid appearance. It is generally found in the dermis or sub cutis and rarely, in visceral organs. Despite the etiology of CEAN is not clear, it is considered as a reactive entity and no association with either infection, trauma or immunosuppression has been described yet. A 76-year-old woman visited hospital for routine examination. The physician noticed an erythematous nodule on the upper part of her right labium minus which appears like a cystic lesion. Histopathological examination revealed a relatively circumscribed, unencapsulated, unilobular vascular lesion which is in the superficial dermis. There were also moderately lymphoplasmacytic infiltration on the background. There were also scattered extravasated erytrocytes around. Positive stained for CD34, CD31 and negative stained for HHV-8 (performed to rule out a possibility of Kaposi sarcoma), pancytokeratin and s-100 were prominent in epithelioid cells. The overall histopathological appearance was consistent with CEAN and there was not any previous report CEAN occurring at this area.

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

The status of cutaneous epithelioid angiomatous nodule (CEAN) as a distinct entity remains controversial. This study investigated the relationship between CEAN and epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia (ALHE). Data of seven lesions with CEAN features from four cases (Cases 1-4: 61-year-old, 76-year-old, 53-year-old, and 21-year-old men, respectively) were investigated. Cases 1 and 2 showed multiple lesions in the head and neck region, but Cases 3 and 4 showed solitary lesions on the back and scalp, respectively. Moreover, the histopathologic findings of the lesions of Cases 1 and 2 were consistent with those of conventional epithelioid hemangioma or classic cutaneous ALHE. Diffuse immunoexpression of FOSB was observed in Cases 1 and 2, but FOSB split signals were absent in break-apart fluorescence in situ hybridization (FISH). In contrast, the histopathologic findings of the lesions of Cases 3 and 4 were consistent with those of cellular-type epithelioid hemangiomas. Diffuse immunoreactivity for c-FOS was observed in Cases 3 and 4, and split signals of FOS were present in break-apart FISH in Case 3. This study showed that the seven tumors with CEAN features could be reclassified under the epithelioid hemangioma/ALHE group, although the small sample size is a limitation.

Giant Cutaneous Epithelioid Angiomatous Nodule

Cutaneous epithelioid angiomatous nodule (CEAN) is an uncommon benign vascular proliferation that presents as a reddish solitary nodule. Less than 60 cases have been reported in the literature. As it is benign, the prognosis is good, but it is sometimes difficult to differentiate it from other vascular neoplasms. A 16-year-old male presented with a single, large, brownish multinodular swelling over the left pinna. Biopsy showed conglomeration of epithelioid endothelial cells with eosinophilic cytoplasm in the dermis. These cells stained positive for CD31 and CD34. Diagnosis of CEAN was made

Cutaneous epithelioid angiomatous nodule: a report of a series including a case with moderate cytologic atypia and immunosuppression

BackgroundCutaneous epithelioid angiomatous nodule (CEAN) is a very rare and relatively recently recognized vascular proliferation characterized usually by minimal cytological atypia and accompanying mitotic activity. As such, CEAN represents an important diagnostic pitfall, which could lead to significant misdiagnosis and unnecessary treatment.MethodsThe clinicopathologic findings of 5 cases of CEAN were reviewed including a unique case with typical findings but also moderate cytologic atypia and brisk mitotic activity in a patient on immunosuppression.ResultsThe cases were in 3 women and 2 men ranging in age from 18 to 61 years with lesions in the neck (2 cases), upper arm, back and shoulder. In 4 of the cases, the patients did not have any relevant potentially contributory clinical history, and in 1 case the patient was on immunosuppressive treatment. All 5 cases were superficially located within the dermis, well-circumscribed and similarly composed of epithelioid cells displaying minimal (in 4 cases) and moderate (1 case) atypia. The mitotic count ranged from 1 to 3 per 10 high power fields (HPF) in 4 cases and up to 9 per 10 HPF in the immunosuppressed patient. Atypical mitoses were not encountered in any of the cases. Two lesions that were incompletely excised recurred, but none of the patients showed distant metastases.ConclusionWhile cytologically alarming, CEAN has a characteristic microscopic appearance and if completely excised follows an indolent course.

A young woman with multiple cutaneous epithelioid angiomatous nodules on her forearm: A case report and follow-up of therapeutic intervention

Cutaneous epithelioid angiomatous nodule (CEAN) is regarded as a very rare entity of benign vascular hyperplasia that clinically manifests as mainly single, small, rapidly-growing reddish to bluish nodules or papules, mainly on the head and neck of adults. Most patients present with solitary lesions. We present a 39-year-old female with multiple, rapidly-growing, erythematous nodules on her left forearm during a one-year period. The overall histologic picture suggested Cutaneous Epithelioid Angiomatous Nodule (CEAN). In this case we tried different treatments and compared the results.

A case of multiple epithelioid angiomatous nodules

Cutaneous epithelioid angiomatous nodule (CEAN) is a distinct type of epithelioid vascular tumor that is usually solitary. Herein we present a 31-year-old man with multiple, rapidly growing nodules on the scalp.

Cutaneous Epithelioid Angiomatous Nodule: A Case With Metachronous Lesions

Cutaneous epithelioid angiomatous nodule is regarded as a benign vascular proliferation on the spectrum of epithelioid vascular lesions, probably most closely related to epithelioid hemangioma. Most patients present with solitary lesions. We present an unusual case of an 84-year-old man with multiple epithelioid angiomatous nodules that developed over a 1-year period. Given the multiple lesions, an extensive evaluation for a possible infectious etiology was undertaken. However, no evidence of an infectious agent was identified. The histopathologic differential diagnosis for epithelioid vascular lesions is reviewed.

Cutaneous epithelioid angiomatous nodule of the chest wall with expression of estrogen receptor: a mimic of carcinoma and a potential diagnostic pitfall

Cutaneous epithelioid angiomatous nodule (CEAN) is a rare vascular proliferation that develops on the trunk and extremities. The lesion arises over weeks to months and affects both sexes without age predilection. Histologically, CEAN is characterized by a circumscribed proliferation of epithelioid endothelial cells in the superficial dermis with a background of lymphocytes, plasma cells and eosinophils. The epithelioid cells are positive for CD31, CD34 and/or D2-40. We report a case of CEAN that had remained stable for more than 30 years on the chest wall of a woman with a history of breast cancer. The lesional cells were epithelioid in appearance and positive for estrogen receptor (ER), raising suspicion for breast carcinoma. However, the cells were positive for CD31, CD34, D2-40 and EMA (epithelial membrane antigen); they were negative for cytokeratins, carcinoembryonic antigen (CEA), CD1a, gross cystic disease fluid protein (GCDFP-15), S-100, a melanocytic cocktail, HHV-8 and progesterone receptor. The histologic and immunohistochemical features, including a low proliferation index (10% by Ki-67), helped to distinguish this lesion from carcinoma and other vascular lesions. This is the most comprehensive immunohistochemical profile reported for CEAN to date and the first time that ER expression has been described.

Multifocal cutaneous epithelioid angiomatous nodules of the penis

Cutaneous epithelioid angiomatous nodule (CEAN) represents a recently described benign vascular proliferation. We report a case affecting a 28-year-old man who presented with painful nodules on his glans penis. The patient is symptom-free 18 months after tumor excision. This is the first report of CEAN occurring on the glans penis.

Cutaneous epithelioid angiomatous nodule arising in capillary malformation

Cutaneous epithelioid angiomatous nodule (CEAN) represents a rare, benign vascular lesion described by Brenn and Fletcher in 2004. To the best of our knowledge, the development of CEAN in a pre-existing vascular malformation has not been previously reported. A 52-year-old Japanese woman presented with multiple erythematous papules developed on violaceous macule of the right back that had been diagnosed as capillary malformation (CM) in childhood. Histopathological examination of one erythematous papule revealed a relatively well-circumscribed nodule composed mostly of epithelioid cells in the dermis. Abnormal dilated vessels were also identified around the lesion in the dermis, suggesting a CM. Immunohistochemically, the epithelioid cells were positive for CD31 and CD34. Staining for α-smooth muscle actin highlighted pericytes with epithelioid features. These findings were consistent with a diagnosis of CEAN arising in CM. The excised specimens of other erythematous papules revealed pyogenic granuloma (PyG) with focal epithelioid morphology accompanied by CM. We present the first reported case of CEAN arising in CM. Considering the histopathological findings, we speculate that CEAN of our case could be associated with PyG developed in pre-existing CM, and may thus be a variant of PyG with a mostly epithelioid appearance.

Cutaneous Epithelioid Angiomatous Nodule: Different views or interpretations in the analysis of ten new cases

Classification schemes proposed for vascular lesions are the subjects of significant controversy. Cutaneous epithelioid angiomatous nodule (CEAN) was described in 2004, but there is no agreement as to whether this is a distinct entity or a type of either epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia. We present a typical case of CEAN and discuss nine other cases from our institution. We then provide two opposing viewpoints concerning its classification.

Nódulo angiomatoso epitelioide cutáneo proliferativo

The cutaneous epithelioid angiomatous nodule is an uncommon benign vascular proliferation that has only recently been described. Clinically, it usually presents as a solitary, fast-growing, small reddish papulous or nodular lesion on the trunk or limbs of adults. Histopathologic study reveals a proliferation of epithelioid cells and predominantly solid, well delimited, unilobular growth in the superficial dermis. Well defined vessels are often found permeating the lesion, which also shows a certain degree of inflammatory infiltration. The cells contain abundant pink cytoplasm, often with vacuoles, and vesicular nuclei with prominent nucleoli. The morphology of these cells is relatively uniform, without atypia or pleomorphism, although mitoses are not uncommon.We report 2 new cases of cutaneous epithelioid angiomatous nodules, the first in a 28-year-old pregnant woman and the second in a 27-year-old man. In both cases, the usual characteristics of this entity were present, but with the peculiarity of a high mitotic index. We discuss the differential diagnosis of cutaneous epithelioid angiomatous nodules with other vascular proliferations that exhibit epithelioid cytology.

Proliferative Cutaneous Epithelioid Angiomatous Nodule

The cutaneous epithelioid angiomatous nodule is an uncommon benign vascular proliferation that has only recently been described. Clinically, it usually presents as a solitary, fast-growing, small reddish papulous or nodular lesion on the trunk or limbs of adults. Histopathologic study reveals a proliferation of epithelioid cells and predominantly solid, well delimited, unilobular growth in the superficial dermis. Well defined vessels are often found permeating the lesion, which also shows a certain degree of inflammatory infiltration. The cells contain abundant pink cytoplasm, often with vacuoles, and vesicular nuclei with prominent nucleoli. The morphology of these cells is relatively uniform, without atypia or pleomorphism, although mitoses are not uncommon. We report 2 new cases of cutaneous epithelioid angiomatous nodules, the first in a 28-year-old pregnant woman and the second in a 27-year-old man. In both cases, the usual characteristics of this entity were present, but with the peculiarity of a high mitotic index. We discuss the differential diagnosis of cutaneous epithelioid angiomatous nodules with other vascular proliferations that exhibit epithelioid cytology.

Large Cutaneous Epithelioid Angiomatous Nodule on the Glabella Repaired Using a Medially Based Upper Eyelid Myocutaneous Flap

CHEN, CHIEN-HSUN MD*; TSAI, YI-LUN MD*; SHIH, PO-YU MD*; CHIU, CHENG-SHENG MD, MPH* Author Information

Large Cutaneous Epithelioid Angiomatous Nodule on the Glabella Repaired Using a Medially Based Upper Eyelid Myocutaneous Flap

CHEN, CHIEN-HSUN MD*; TSAI, YI-LUN MD*; SHIH, PO-YU MD*; CHIU, CHENG-SHENG MD, MPH* Author Information

Cutaneous vascular tumours: an update

This review evaluates changes in vascular nomenclature particularly in the category of vascular tumours of intermediate malignancy that includes the various haemangioendotheliomas, Kaposi's sarcoma and giant cell angioblastoma. Recently described entities in this category, including the latter tumour and composite haemangioendothelioma, are described. Several newly characterized vascular tumours not included in recent classifications of vascular tumours are also summarized. These include acquired elastotic haemangioma, symplastic haemangioma, cutaneous epithelioid angiomatous nodule and cutaneovisceral angiomatosis with thrombocytopenia. The newly introduced clinical classification of congenital haemangiomas into non-involuting and rapidly involuting variants and radiation-induced atypical vascular lesions are also reviewed.

Cutaneous Epithelioid Angiomatous Nodule: A Case Series and Proposed Classification

Cutaneous epithelioid angiomatous nodule is a peculiar and recently recognized vascular proliferation. Clinically, these lesions affect different areas of the body and histologically are characterized by a well-circumscribed, mainly unilobular, solid proliferation of endothelial cells with prominent epithelioid features. The cytoplasm is abundant and eosinophilic, and many of the neoplastic cells contain prominent vacuoles. Inflammatory infiltrates are variable. All the cases reported thus far have followed a benign course. We report 10 additional cases of this curious entity, including 2 which presented in an eruptive fashion and 5 that were located on the head and neck. We also discuss the histological differential diagnoses with other epithelioid proliferations and propose categorization within the spectrum of epithelioid hemangioma.

Cutaneous epithelioid angiomatous nodule: report of a case and absence of microsatellite instability

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Relationship between Cutaneous Epithelioid Angiomatous Nodule and Epithelioid Hemangioma

Relationship between Cutaneous Epithelioid Angiomatous Nodule and Epithelioid Hemangioma