Interactive Case Study - August 2018

An Erythematous, Friable, Pedunculated Papule on the Abdomen

Christina DiCarlo MD

Eric Hossler MD

A 28-year-old healthy female presented with a 1-cm erythematous, friable pedunculated papule on the upper abdomen at the site of a prior trauma.

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Figure 1. 20X

Figure 2. 100X

Figure 3. 200X

Figure 4. CD34, 40x

Figure 5. CD3, 40X

Figure 6. CD20, 40X

What is the best diagnosis?

bacillary angiomatosis

cutaneous epithelioid angiomatous nodule

epithelioid hemangioma

lobular capillary hemangioma

T-cell rich angiomatoid polypoid pseudolymphoma

Which of the following combinations of CPT (Current Procedural Terminology 2018) codes would be appropriate for the stains (CD20, CD3, & CD34) ordered for this case?

88342; 88341; 88341

88344

88346; 88350; 88350

88341; 88342; 88342

88312; 88312; 88312

Dayrit J, Wang W, Goh S, et al. T-cell-rich angiomatoid polypoid pseudolymphoma of the skin: a clinicopathologic study of 17 cases and a proposed nomenclature. J Cutan Pathol 2011;38(6):475-482.
Romero-Pérez D, Martínez M, Encabo-Durán B. Cutaneous Pseudolymphomas. Actas Dermosifiliogr 2016;107(8):640-651.
Sandhya V, Jayaraman A, Srinivas C. T-Cell Rich Angiomatoid Polypoid Pseudolymphoma: A Novel Cutaneous Pseudolymphoma. Indian J Dermatol 2014;59(4):361-363.
Ramsay B, Dahl M, Malcolm A. Acral Pseudolymphomatous Angiokeratoma of Children. Arch Dermatol 1990;126:1524-1525.
Fernández-Figueras M. Of APACHEs and PALEFACEs. Am J Dermatopathol 1995;17(2):209-211.
Fernández-Figueras M, Puig L, Armengol M, et al. Cutaneous angiolymphoid hyperplasia with high endothelial venules is characterized by endothelial expression of cutaneous lymphocytic antigen. Human Pathol 2001;32(2):227-229.
Lindberg M, Lucas D, Cassarino D, et al. Diagnostic pathology: soft tissue tumors. Philadelphia (PA): Elsevier; 2016. p. 402-403, 414-417.
Ko J, Billings S. Diagnostically challenging epithelioid vascular tumors. Surg Pathol Clin 2015; 8(3):331-51.
American Medical Association. 2018 AMA CPT® Professional Edition Book. Chicago: American Medical Association; 2018.

Acknowledgements

Author Profiles

Christina DiCarlo

Geisinger Medical Center

Christina DiCarlo, MD, is a dermatopathology fellow at Geisinger Medical Center in Danville, Pennsylvania USA. She attended medical school at Case Western Reserve University School of Medicine in Cleveland, Ohio. She completed her residency in anatomic and clinical pathology at Allegheny General Hospital in Pittsburgh, Pennsylvania.

Eric Hossler

Geisinger Medical Center

Eric Hossler, MD, is an associate in dermatology and dermatopathology at Geisinger Medical Center in Danville, Pennsylvania USA. He serves as the dermatology residency program director and clerkship director. He received his medical degree from East Tennessee State University College of Medicine. He completed an internship in internal medicine, a residency in dermatology and a fellowship in dermatopathology at Geisinger Medical Center in Danville, Pennsylvania USA.

Question:

Interactive Case Study - August 2018

Acknowledgements

Author Profiles

An Erythematous, Friable, Pedunculated Papule on the Abdomen

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