ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 it is important to make a macroscopic evaluation by predicting that malignancy may exist in the umbilical material. It should be kept in mind that umbilical lesions, although rare, have a malignant potential. E-PS-05-011 Adenolipoma: a rare benign tumour E. Souka*, G. Stanc, N. Novkovic, K. Ntatsis, C. Valavanis *Pathology Department Metaxa Cancer Hospital, Greece Background & objectives: Adenolipoma is a rare benign skin tumour, first described in 1993. We present a case of adenolipoma with a brief review of the literature. Methods: A 60-year-old male patient presented with a solitary, slow growing, painless lump on the right thigh. The lesion was subcutaneous, and the patient underwent surgical excision. Results: On gross resection, the lesion was soft, lobulated, yellowish mass measuring 4.7 cm in greatest diameter, with a thin encircling capsule. Microscopically, the lesion consisted of lobules of mature fat with intermixed benign eccrine glands and ducts. The morphological findings were consistent with subcutaneous adenolipoma. Conclusion: Adenolipoma is an unusual variant of lipoma, com- monly arising in arms, shoulders and chest of adults aged 25-75 years. The tumour is subcutaneous or located in the dermis and composed of mature adipose tissue and eccrine ducts and glands. The glands can show cystic dilation, epithelial hyperplasia and squamous or clear metaplasia. Differential diagnosis includes typi- cal lipoma, nevus lipomatosus superficialis, eccrine angiomatous hamartoma, spindle cell lipoma, and cutaneous myxolipoma. Treat- ment and prognosis are identical to those of common lipoma. E-PS-05-012 Viral exanthema in a COVID-19 patient E. Yumuk*, S. Cagaptay, G. Bülbül, B. Lebe *Department of Pathology, Dokuz Eylül University Faculty of Medicine, Turkey Background & objectives: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is quickly spreading and threatening global health. COVID-19 has been related to a variety of cutaneous manifestations with different clinical patterns. However, the identification and charac- teristics of COVID-19-related skin lesions remain speculative. Methods: A 70-year-old male patient developed itchy, erythema- tous papule, water-filled blisters over his body, particularly on his feet and hands, one week after contracting covid and lasting for 6-7 months. Diabetes, hypertension, and chronic renal disease were all present in the patient’s medical history. Histopathological exami- nation was performed in conjunction with the clinical preliminary diagnosis of viral exanthema or allergic dermatitis. Results: Microscopic examination revealed spongiosis, microve- siculations, and lymphocyte exocytosis in the epidermis. There were lymphocytic vasculitis pattern in the superficial and/or deep dermis with mild oedema and extravasated erythrocytes from the damaged vessels, as well as slight infiltration of eosinophils and neutrophils. In the direct immunofluorescence microscopy, no deposits were seen. The diagnosis was considered as spongiotic dermatitis and lymphocytic vasculitis. This patient was taking a lot of medications, and comorbidities could make the differential diagnosis more difficult. Therefore, the skin lesion may be asso- ciated with a primary, indirect cutaneous manifestation or drug eruption from COVID-19 infection. We needed clinicopathological correlation in the differential diagnosis. Conclusion: Histopathology plays an important role in describing skin lesions during the COVID-19 pandemic. The effects of COVID-19 on the skin can be seen as a result of lifestyle changes during the pan- demic, various medicines used in therapy, and indirectly induced vas- cular dysfunctions. In our case, we concluded that spongiotic dermatitis pattern and lymphocytic vasculitis may be reflected viral exanthem associated with COVID-19 infection. This is an additional case to the skin findings of COVID-19 infection that contributes to the literature. E-PS-05-013 Cryoglobulinemia and reactive angioendotheliomatosis, second- ary to multiple myeloma and Waldenström’s macroglobuline- mia, a report of two rare cases F. Kubba*, D. Ivan, F. Teixeira, H. Kagdi, A. Scur, R. Skinner, B. Barbosa *Department of Pathology, Ealing Hospital, London North West University Healthcare NHS Trust, United Kingdom Background & objectives: A 64-year-old female presented with bilat- eral toe numbness and painful erythematous rash on both legs and arms, worse in colder environment. An 81-year-old man presented with a vasculitis-type rash on the foot, legs, torso and arms, initially bullous/blistering then necrotic. Methods: Microscopically the skin showed lobular clusters of closely packed dermal glomeruloid capillaries. There was a striking proliferation of plumb endothelial cells forming capillaries within pre-existing dilated vessels associated with red cell extravasation. The capillaries were filled with pink-staining amorphous hyaline cryoglobulins material which was PAS-positive. These were high- lighted by CD34 and ERG. HHV8 and muscle specific actin were negative. Results: The first patient was recently diagnosed with lym- phoplasmacytic lymphoma with a monoclonal IgM protein (Waldenström’s macroglobulinemia). The second patient had a background of multiple myeloma and mixed cryoglobuline- mia. He developed sepsis and renal failure and passed away shortly afterwards. The differential diagnosis included Kaposi sarcoma, angiosarcoma, pyogenic granuloma, bacillary angi- omatosis, angioacrodermatitis and angioendotheliomatosis. Reactive angioendotheliomatosis (RAE) is a rare condition, the aetiology of which may be due to local ischaemia secondary to vascular obstruction. Only a few cases were reported in asso- ciation with cryoglobulinemia. Other causes include systemic or autoimmune diseases, such as chronic renal failure or car- diac valvular disease, lymphoproliferative diseases, systemic infections, antiphospholipid syndrome, rheumatoid arthritis and atherosclerosis. Conclusion: We presented two cases of cryoglobulinemia and reac- tive angioendotheliomatosis, induced by lymphoblastic lymphoma and multiple myeloma. They presented with erythematous/vasculitic rash, blisters, ulcers and necrosis. Histopathology showed distinct dermal lobules of glomeruloid capillary cluster proliferation filled with PAS- positive amorphous cryoglobulins and plumb endothelial cells. Despite the benign histopathology, the condition is very serious and one patient needed intensive care ending in a fatal course due to sepsis. Treatment is supportive with prevention of secondary infection and treating the underlying cause. E-PS-05-014 Melanoma with blue nevus-like features - diagnostic challenges and management A. Pup*, D. Szilagyi *County Emergency Hospital Timisoara, Romania S209