Cutaneous Reactive Angiomatosis associated with Intravascular Cryoprotein Deposition as the Presenting Finding in a Patient with Underlying Lymphoplasmacytic Lymphoma: A Case Report and Review of the Literature. Journal of cutaneous pathology Zacher, N. C., Bailey, E. E., Kwong, B. Y., Rieger, K. E. 2021


Cutaneous reactive angiomatosis, a group of disorders defined by benign vascular proliferation, is associated with a number of systemic processes, including intravascular occlusion by cryoproteins. We report a case of a 64-year-old female patient who presented with a one-year history of non-tender petechiae of the bilateral arms and lower legs. Dermoscopic evaluation showed increased vascularity with a globular pattern. Over a period of months, her findings progressed to erythematous to violaceous plaques with admixed hypopigmented stellate scarring of the bilateral lower extremities, forearms, and lateral neck. Biopsy showed increased thin-walled, small dermal blood vessels with focal inter-anastamosis. Some vessels were occluded by eosinophilic globules suspicious for cryoprotein. Subsequent laboratory studies confirmed a diagnosis of type 1 cryoglobulinemia, prompting a bone marrow biopsy that revealed lymphoplasmacytic lymphoma. Herein we report the fourth case of angiomatosis secondary to intravascular cryoproteins as the initial presentation of an underlying hematologic malignancy. We also present a review of the literature and emphasize the need for thorough initial work-up and close and prolonged clinical monitoring for underlying systemic disease in these patients. This article is protected by copyright. All rights reserved.

View details for DOI 10.1111/cup.14144

View details for PubMedID 34617316