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April 2010

Solitary Erythematous Nodule on the Back—Diagnosis

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Dermatol. 2010;146(4):439-444. doi:10.1001/archdermatol.2010.40-b

Histologic examination revealed an acanthotic epidermis with an underlying well-circumscribed vascular proliferation extending from the papillary dermis to the base of the biopsy specimen. The vascular proliferation consisted of solid sheets of large polygonal epithelioid cells containing abundant eosinophilic cytoplasm and vesicular nuclei as well as open vascular channels lined by a single layer of variably epithelioid-appearing endothelium. The epithelioid-appearing cells, composing the solid areas, demonstrated prominent intracytoplasmic vacuoles forming microlumina. Cytologic atypia was absent, and only rare typical-appearing mitotic figures were present. The adjacent dermis contained a mild chronic inflammatory infiltrate of lymphocytes, plasma cells, and histiocytes. Eosinophils and lymphoid follicles were absent. The epithelioid cells were positive for the endothelial marker CD31.

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