Bacillary angiomatosis: presentation of six patients, some with unusual features

Abstract

Bacillary angiomatosis (BA) is an unusual systemic vascular proliferation seen predominantly in patients with the acquired immunodeficiency syndrome. These vascular lesions are probably due to infection with a Bartonella species, most often B. henselae and, in some patients, B. quintana. BA is treatable and often curable, but without therapy, may be life-threatening. Clinically, the lesions, when superficial, are said to often resemble pyogenic granulomas, appearing polypoid histologically with an epidermal collarette. We now report six patients, three of whom showed lesions of BA morphologically and histologically distinct from the other patients reported to date. Two patients lesions appeared clinically as violaceous plaques and tumours resembling Kaposi's sarcoma; one of them had lesions histologically reminiscent of a papular angiokeratoma; and the other had lesions histologically suggestive of a combination of Kaposi's sarcoma and BA. Another patient presented with soft subcutaneous nodules which histologically showed extensive acute inflammation characteristic of an acute abscess, but which also displayed proliferating dilated small blood vessels with bulbous endothelial cells adjacent to numerous bacteria and also containing them. The Grocott-methenamine silver stain and the Warthin-Starry stain showed the organisms to better advantage in lesions of all six patients, although bacteria were also evident with the haematoxylin and eosin, periodic acid-Schiff and alcian blue stains.

Kaposi's sarcoma: An update

“…Bacillary angiomatosis may resemble KS both clinically and histologically [80,81]. Histologically, the Grocott-methenamine silver stain and the Warthin-Starry stain at pH 3.2 show the bacterial etiologic agent to good advantage, although these bacteria may also be evident employing the hematoxylin-eosin, periodic acid-Schiff, and alcian blue stains.…”

“…Disorders that may require distinction include blue rubber bleb nevus syndrome, pyogenic granuloma (lobular capillary hemangioma), tufted angioma, melanocytic nevi, melanoma, cavernous hemangioma, angiokeratoma, Stewart-Treves syndrome, carcinoma cutis (especially renal cell carcinoma), nodal myofibromatoma, spindle cell hemangioendothelioma, arteriovenous malformations (pseudo-KS), severe statis dermatitis (pseudo-KS), and bacillary angiomatosis [3,6,[79][80][81][82][83][84][85][86][87]. Bacillary angiomatosis merits special consideration.…”

Fine‐needle aspiration cytology of subcutaneous toxoplasmosis: A case report

“…Bacillary angiomatosis 10,11 is an unusual systemic vascular proliferation seen predominantly in patients with AIDS. This vascular lesion is due to infection with Bartonella henselae.…”

Pyogenic Granuloma of the Lip – Treatment with Carbon Dioxide Slush Cryosurgery as an Approach in a Resource-Poor Country

“…lips and mucosal membranes such as gingiva, buccal mucosa, nasal mucosa and laryngeal mucosa are also common sites, as in our patient [15][16][17]. In our differential diagnosis, we were most concerned about other neoplasms, in particular melanoma and bacillary angiomatosis, both of which may resemble a PG [18][19][20]. We have had a pediatric patient with an apparent PG on the earlobe which did not respond to cryosurgery.…”