Isolated (localized) idiopathic granulomatous (giant cell) vasculitis in an intramuscular lipoma.
Isolated (localized) idiopathic granulomatous vasculitis (IGV) is an uncommon, heterogeneous, and poorly defined group of disorders characterized by infiltration of the arterial wall caused by compactly grouped mononuclear phagocytes, with or without giant cells, in segmental distribution. We report on a 55-year-old woman with IGV limited to an intramuscular lipoma of the left thigh. The vasculitis was identified incidentally upon microscopic examination of the removed tumor. The IGV was centered on two medium-sized arteries, accompanied by narrowing of the lumens, and not associated with secondary changes such as infart or postinfart fibrosis. The inflammatory infiltrate was rich in T-lymphocytes and macrophages, with the presence of giant cells. The patient was asymptomatic and well in a follow-up period of 2 months, during which she was not treated. To our knowledge, this is the first report of lipoma involvement in localized IGV. It is important to distinguish cases of isolated intratumorous IGV from systemic disease, because the latter implies a poor prognosis and requires an aggressive treatment.
Fernando Val-Bernal
J
J
Department of Anatomical Pathology, Medical Faculty, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla 1, ES-39008 Santander, Spain. apavbj@humv.es
Val
Daniel
D
Calvo
Ignacio
I
Francisca Garijo
M
M
D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001167:Arteritis / Q000473:pathology*; D001402:B-Lymphocytes / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis*; D017252:CD3 Complex / Q000378:metabolism; D005260:Female; D015726:Giant Cells / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D008067:Lipoma / Q000473:pathology*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D013601:T-Lymphocytes / Q000378:metabolism; D014657:Vasculitis / Q000473:pathology*; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D014408:Biomarkers, Tumor; D017252:CD3 Complex; C067980:CD68 antigen, human; D000097382:CD68 Molecule