Glomeruloid hemangioma. A cutaneous marker of POEMS syndrome.

Glomeruloid hemangioma is a histologically distinctive cutaneous hemangioma that recently has been associated with POEMS syndrome. We report a further case in which POEMS syndrome was signaled by multiple eruptive angiomas of the glomeruloid type. Histopathology showed multiple dilated vascular spaces containing a conglomerate of capillaries resulting in a structure resembling renal glomeruli. Eosinophilic globules, probably representing immunoglobulins, were found within the cytoplasm of some endothelial and stromal cells. The finding of focal histologic features of tufted angioma (angioblastoma) in the same lesion suggests that a spectrum of hemangiomatous lesions may be seen in POEMS syndrome. Alternatively, glomeruloid hemangioma may represent a reactive endothelial proliferation rather than a neoplastic lesion.