Table of Contents
Definition / general | Gram stain | Diagnosis | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosis | Additional referencesCite this page: DePond W. Bacillary angiomatosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesbacillaryangiomatosis.html. Accessed May 29th, 2020.
Definition / general
- Caused by Bartonella (formerly Rochalimaea) henselae, which also causes cat-scratch disease
- May also be caused by Bartonella quintana (Ann N Y Acad Sci 2005;1063:302)
- Almost all patients are HIV+ or otherwise immunosuppressed
- May have multiple red / violet skin lesions resembling Kaposi sarcoma, but also involves lymph nodes and spleen
- Bacterial reservoir is domestic cats (transmit to humans) and cat fleas (transmit to other cats)
- May appear neoplastic, but is reactive
Gram stain
- Small, curved, motile, gram negative rod that is difficult to culture
Diagnosis
- PCR
Case reports
- 17 year old renal transplant patient with persistent fever, pancytopenia, and axillary lymphadenopathy (Arch Pathol Lab Med 2004;128:e12)
Treatment
- Erythromycin, other macrolides or doxycycline are very effective
Microscopic (histologic) description
- Focal nodal effacement by multiple coalescing intranodal clusters of small blood vessels, lined by epithelioid endothelial cells with pale cytoplasm
- May have focal nuclear atypia
- Interstitium contains abundant eosinophilic to amphophilic, amorphous or granular material containing aggregates of bacteria (highlighted by Warthin-Starry stain)
- Also neutrophils
Microscopic (histologic) images
AFIP images:
Warthin-Starry stain
Images hosted on other servers:
AIDS patients
Figures 1/2: confluent nodular areas with proliferating vessels
3: solid clusters of plump endothelial cells without lumina;
inset: granular and amorphous material
4: Southern blot with
B henselae probe (specimen-tubes 1,3,5,7; positive control-tube 9)
Differential diagnosis
- Epithelioid hemangioma or hemangioendothelioma: eosinophilic and vacuolated cytoplasm, no amorphous / granular material
- Kaposi sarcoma: cleft-like vessels, spindled endothelial cells, no bacteria
Additional references
