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Soft tissue tumors

Normal / benign

Bacillary angiomatosis


Reviewer: Vijay Shankar, M.D. (see Reviewers page)
Revised: 25 February 2013, last major update November 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Opportunistic infection of immunocompromised, first described in AIDS, manifesting as vascular proliferations in bone, CNS, skin, other organs
● Rarely imunocompetent individuals (Indian J Dermatol Venereol Leprol 2010;76:682)
● Caused by infection with Bartonella species (gram negative rods), either Bartonella henselae (causes cat-scratch disease, reservoir in cats, vector is cat flea), B. quintana (cause of trench fever during WW I, reservoir in humans, vector is human body louse) or other species; transmitted via traumatic inoculation of skin
● Bacillary peliosis: related vascular lesion of liver and spleen

Case reports
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● 23 year old HIV+ woman with disseminated disease (Rev Soc Bras Med Trop 2011;44:641)
● 59 year old immunocompetent woman with no exposure to cats (Indian J Dermatol Venereol Leprol 2010;76:682)
● 66 year old woman with onset after chemotherapy for CLL (J Med Microbiol 2011;60:142)

Treatment
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● Erythromycin

Clinical images
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Skin: nodules with ulceration
Skin: erythematous nodular lesions
Skin: post CLL chemotherapy
Skin: at site of burn

Gross description
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● Moist, eruptive, cutaneous lesion

Micro description
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● Acute neutrophilic inflammation with vascular proliferation and prominent endothelial cells with nuclear atypia and mitotic figures
● Nuclear dust and granular material (bacteria) present
● Bacteria highlighted by silver stain

Micro images
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Dermal lobular vascular proliferation with swollen endothelial cells and bacteria (Warthin-Starry)
Warthin-Starry stain
Mixed inflammation, capillary proliferation

Differential diagnosis
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Angiosarcoma
Kaposi sarcoma
Pyogenic granuloma

End of Soft tissue tumors > Normal / benign > Bacillary angiomatosis


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