Diagnosis: Glomeruloid hemangiomas associated with POEMS syndrome.
MICROSCOPIC FINDINGS AND CLINICAL COURSE
Microscopic evaluation revealed that there were several dilated vascular spaces containing groups of irregular aggregates of capillary loops, resulting in structures resembling renal glomeruli, in the upper dermis. These dilated vascular spaces were lined by a single layer of endothelial cells surrounded by pericytes and interspersed with stromal cells. The endothelial cells were characterized by intracytoplasmatic vacuoles containing multiple eosinophilic periodic acid–Schiff–positive globules. On the basis of these histopathologic features, a diagnosis of glomeruloid hemangiomas was made.
The presence of glomeruloid hemangiomas in a patient with multiple myeloma and polyneuropathy suggested the diagnosis of POEMS syndrome. Additional studies, including hormonal determination and abdominal echography, revealed no abnormalities, ruling out any endocrinopathy or organomegaly.
DISCUSSION
Glomeruloid hemangiomas are multifocal vascular lesions that are usually found in middle-aged individuals, often in association with POEMS syndrome. They appear as red to purple papules scattered over the trunk and proximal aspect of the limbs and . . . [Full Text of this Article]
