Paravertebral fibrous pseudotumor: Four cases of a distinctive tumefactive lesion overlapping with eosinophilic angiocentric fibrosis and tumoral erythema elevatum diutinum

Agaimy A, Förster S, Kalla J, Stacher-Priehse E, Titze U, Vieth M (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Annals of Diagnostic Pathology WB Saunders

Book Volume: 62

Article Number: 152073

DOI: 10.1016/j.anndiagpath.2022.152073

Abstract

Eosinophilic angiocentric fibrosis (EAF) is a rare tumefactive fibroinflammatory disease with predilection for the upper respiratory tract, characterized by concentric (onionskin) fibrosis around small arterioles with variable intervening storiform fibrosis admixed with chronic inflammatory infiltrates rich in eosinophils. Erythema elevatum diutinum (EED), another autoimmunological disorder that mainly affects acral sites and extensor surfaces, is characterized by neutrophilic leukocytoclastic vasculitis. Rarely, older EED lesions may present as tumefactive nodular (pseudotumoral) fibrous masses closely mimicking EAF. We herein describe four patients (all males) aged 66–70 years who presented with large (median, 7 cm) tumor-like fibrous lesions in the paravertebral region not associated with a known clinical autoimmune disease. All cases were resected surgically with the suspicion of a neoplasm. They displayed a strikingly similar histological appearance with combined features of EAF and nodular fibrous EED. None had evidence of obliterative phlebitis or increased IgG4: IgG ratio. The etiology of this distinctive lesion and its predilection for the paravertebral area of males remains obscure. A distinctive tumefactive localized reaction to trauma caused by degenerative disease of adjacent vertebrae might be a possible explanation.

Authors with CRIS profile

Abbas Agaimy Medizinische Fakultät Michael Vieth Professur für Allgemeine Pathologie

Involved external institutions

Klinikum Bayreuth DE Germany (DE) Schwarzwald-Baar Klinikum DE Germany (DE) Asklepios Fachkliniken München-Gauting DE Germany (DE) Klinikum Lippe DE Germany (DE)

How to cite

APA:

Agaimy, A., Förster, S., Kalla, J., Stacher-Priehse, E., Titze, U., & Vieth, M. (2023). Paravertebral fibrous pseudotumor: Four cases of a distinctive tumefactive lesion overlapping with eosinophilic angiocentric fibrosis and tumoral erythema elevatum diutinum. Annals of Diagnostic Pathology, 62. https://doi.org/10.1016/j.anndiagpath.2022.152073

MLA:

Agaimy, Abbas, et al. "Paravertebral fibrous pseudotumor: Four cases of a distinctive tumefactive lesion overlapping with eosinophilic angiocentric fibrosis and tumoral erythema elevatum diutinum." Annals of Diagnostic Pathology 62 (2023).

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