title: Graft-versus-host disease-associated angiomatosis: a clinicopathologically distinct entity.
abstract: BACKGROUND
  Chronic graft-versus-host disease (GVHD) may present with various cutaneous manifestations. Isolated case reports describe eruptive angiomas in this setting.
  
  
  OBJECTIVE
  We sought to provide a clinical and pathologic description of vascular proliferations in patients with GVHD.
  
  
  METHODS
  Cases of documented GVHD associated with vascular proliferations were collected from the National Institutes of Health, Ohio State University, and MD Anderson Cancer Center.
  
  
  RESULTS
  Eleven patients with a diagnosis of GVHD who developed vascular proliferations were identified. All patients manifested sclerotic type chronic GVHD of the skin. Vascular lesions were first documented a median of 44 months after transplantation and occurred primarily on the lower extremities or trunk. Histopathology revealed anastomosing networks of thin-walled vascular proliferations in a vague lobular growth pattern, with overlying epidermal acanthosis, peripheral collarette, ulceration, and disorganized fibroblast-rich and fibrotic stroma. Improvement was noted in 1 patient treated with propranolol and sirolimus and 1 patient with electrocautery.
  
  
  CONCLUSIONS
  Given the retrospective nature of the study, the overall incidence of vascular lesions in patients with GVHD is unknown. Histopathology was present for review on only 3 of 11 patients.
  
  
  CONCLUSIONS
  The phenomenon of vascular lesions appears to be relatively specific for sclerotic type chronic GVHD when compared with other fibrosing diseases. We propose the term "graft-versus-host disease-associated angiomatosis" to describe this entity.
authors.affiliation: Division of Dermatology, Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: Benjamin.Kaffenberger@osumc.edu.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Kaffenberger
authors.affiliation: Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Rena C
authors.initials: RC
authors.lastname: Zuo
authors.affiliation: Division of Dermatology, Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Dermatopathology, Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gru
authors.affiliation: Division of Dermatology, Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Alisha N
authors.initials: AN
authors.lastname: Plotner
authors.affiliation: Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Sweeney
authors.affiliation: Division of Blood and Marrow Transplantation, Ohio State University James Cancer Hospital, Columbus, Ohio.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Devine
authors.affiliation: Department of Dermatology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Hymes
authors.affiliation: Dermatology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Cowen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000798:Angiomatosis / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D001707:Biopsy, Needle; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D019337:Hematologic Neoplasms / Q000473:pathology / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012883:Skin Ulcer / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology
keywords: angioendotheliomatosis; angiomatosis; eruptive angiomas; graft-versus-host disease; sclerosis; sclerotic; vascular tumors