Vascular tumors
Bacillary angiomatosis

Author: Vijay Shankar, M.D. (see Authors page)

Revised: 8 March 2018, last major update September 2013

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Bacillary angiomatosis spleen

Cite this page: Shankar, V. Bacillary angiomatosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/spleenbacillaryangiomatosis.html. Accessed March 20th, 2018.
Definition / general
  • Rare vasculoproliferative disorder due to Bartonella henselae or Bartonella quintana
  • Called peliosis hepatitis in liver and spleen
  • Usually cutaneous angioma-like tumor, solitary or multiple
  • Rare dissemination to liver, spleen or other viscera
Clinical features
  • Cutaneous vascular lesions, vague abdominal pain, lymphadenopathy with or without subcutaneous lesions
  • Most patients present with fever
  • Splenic involvement associated with severe illness
  • Histopathological examination
  • Low: CD4 lymphocyte counts, hematocrit
  • High: alkaline phosphatase, AST levels
Case reports
  • Erythromycin or doxycycline
Microscopic (histologic) description
  • Lobular proliferation of small, round blood vessels with plump endothelial cells which protrudes into vascular lumen
  • Variable endothelial atypia
  • Necrosis often seen in center of vascular lobule
  • Mixed inflammatory cell infiltrate with neutrophils and leukocytoclasis
Microscopic (histologic) images

Images hosted on other servers:

Soft tissue: capillaries with pink granular material in interstitium

Warthin-Starry stain demonstrating bacilli

Positive stains
Electron microscopy description
  • Activated endothelial cells with Weibel-Palade bodies
Electron microscopy images

Images hosted on other servers:

Skin: bacilli with trilaminar cell walls

Differential diagnosis