[Histiocytoid hemangioma of the scalp].

We report a case (the second from France) of histiocytoid haemangioma, an entity created by Rosai et al. (14) in 1979 to accommodate several cutaneous and extra-cutaneous diseases hitherto known under other names and characterized histologically by the proliferation of vessels with peculiar "histiocytoid" endothelial cells. Our patient was a 56-year old woman who developed, within a few weeks, a slightly haemorrhagic nodule of the scalp. The histological examination, performed in a private laboratory, led to a diagnosis of cavernous angioma or angioleiomyoma. Two months after the lesion was removed, the condition recurred in the form of about 10 sessile subcutaneous nodules, 3 to 20 mm in diameter; the nodules were firm, painless, little pruriginous and sometimes ulcerated. An old-standing lymph node enlargement was palpable on the right side of the posterior aspect of the neck. The rest of the scalp was normal. Physical examination of the skin and mucosae revealed no other abnormality. These alarming lesions were suggestive of metastasis or angiosarcoma. X-ray films of the skull were normal, as were the results of blood examination; in particular, there was no eosinophilia. Histology showed a papillomatous epidermis, while the superficial and mid dermis were occupied by a lobulated vascular proliferation. The vessels were of the capillary type; they were lined with two or three layers of endothelial cells remarkable for their large indented nucleus and for their abundant eosinophilic cytoplasm bulging out into the lumen. These vessels were surrounded by fairly dense nodular masses of small lymphocytes with a few histiocytes and some neutrophils. There were no lymphoid follicles.(ABSTRACT TRUNCATED AT 250 WORDS)