Multinucleate cell angiohistiocytoma (MCAH) was first described by Smith and Wilson-Jones in 1985. It is an uncommon entity but probably underdiagnosed because of lack of recognition by clinicians and pathologists. We report a 47-year-old man with asymptomatic grouped violaceous papules on the dorsum of the hands for 3 years. The histopathological and immunopathological features of our case revealed characteristics of MCAH similar to the initial description of Smith and Wilson-Jones and other reports.

No abstract

Presentación de casos clínicos RESUMENEl eritema indurado de Bazin es poco frecuente en la edad pediátrica. Presentamos el caso de una niña de 12 años procedente de China remitida para estudio por sospecha de eritema nudoso de larga evolución y prueba de tuberculina positiva (20 mm). La paciente no presentaba otros síntomas. En la exploración física se observaban nódulos violáceos, localizados en ambas regiones pretibiales, pero también en ambas pantorrillas. La radiografía de tórax fue normal. Se obtuvo muestra para biopsia, que mostró una paniculitis de predominio lobulillar con presencia de granulomas. La detección de micobacterias mediante cultivo y reacción en cadena de la polimerasa en la muestra fue negativa. Se aisló Mycobacterium tuberculosis en una de tres muestras de jugo gástrico. Se trató con isoniacida, rifampicina, pirazinamida y etambutol con curación de las lesiones. Este caso resalta la importancia de sospechar eritema indurado en las formas atípicas de eritema nudoso y de investigar exhaustivamente la existencia de una tuberculosis activa en estos casos. Palabras clave: paniculitis, Mycobacterium tuberculosis, eritema indurado de Bazin.

We describe a case of subacute cor pulmonale caused by tumor embolism from a gallbladder carcinoma in a 63-year-old woman. The patient was admitted to hospital with increasing dyspnea. Physical examination and echocardiography showed signs of pulmonary hypertension. She died of circulatory failure. At autopsy microscopic studies revealed tumor embolism in the pulmonary vessels and subsequent lesions causing the lethal pulmonary hypertension. This is the first case report of pulmonary hypertension caused by embolism from a gallbladder carcinoma in the literature worldwide.

High-endothelial venules are a common feature of 3 types of cutaneous pseudolymphomas: pretibial lymphoplasmacytic plaque (PLP) of children, acral pseudolymphomatous angiokeratoma of children (APACHE), and T-cell rich angiomatoid polypoid pseudolymphoma (TRAPP). In addition, primary cutaneous angioplasmacellular hyperplasia (PCAH) overlaps with these other 3 conditions. We intend to study the expression of peripheral node addressins in PLP, APACHE, TRAPP, and PCAH. We studied 1 case of PLP, 2 cases of APACHE, 2 cases of TRAPP, and 2 cases of PCAH. Immunostainings for MECA-79 and WT-1 were obtained in all cases. All cases showed a dense lymphohistiocytic dermal inflammatory infiltrate with abundant plasma cells. In addition, HEV were prominent in all cases. Cases of PLP, APACHE, and TRAPP expressed MECA-1. Cases of PCAH did not express MECA-1. Although PLP, APACHE, and TRAPP seem to fall under the same morphologic spectrum with different clinical representations, PCAH seems to be a different entity, with histopathologic peculiarities and a different immunophenotype.