case_images: PMC8464357_01
case_images: Acute inflammatory edema manifesting as erythematous, edematous plaques on the lower abdomen and dependent parts of the lower extremities with sparing of the skin folds.
case_images: JIR-14-4877-g0001.jpg
case_images: PMC8464357_01_JIR-14-4877-g0001.jpg
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case_images: Dermatological examination revealed ill-defined, blanchable, erythematous, edematous, mildly tender, warm plaques on the abdomen and lower extremities (Figure 1).
case_images: (A) Histopathology shows perivascular and interstitial inflammatory cell infiltration, predominantly in the markedly edematous papillary dermis (hematoxylin-eosin, original magnification x20); (B) Edema-phages, swelling or ballooning of histiocytes, containing either small or large clear vacuoles in their cytoplasm (hematoxylin-eosin, original magnification x400); (C) Numerous, large, irregular, thin-walled vascular channels lined by a single layer of flattened endothelial cells (hematoxylin-eosin, original magnification x40); (D) Immunohistochemistry reveals positive staining of the ectatic vessel endothelial cells with D2-40 (podoplanin) (original magnification x400).
case_images: JIR-14-4877-g0002.jpg
case_images: PMC8464357_01_JIR-14-4877-g0002.jpg
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case_images: Histopathological sections showed perivascular and interstitial inflammatory cell infiltration, predominantly in the markedly edematous papillary dermis (Figure 2A). The inflammatory cells comprised lymphocytes, neutrophils, and scattered histiocytes, including edema-phages with bubbly cytoplasm (Figure 2B). Furthermore, numerous, large, irregular, thin-walled vascular channels lined by a single layer of flattened endothelial cells were observed (Figure 2C). The immunohistochemical examination revealed positive staining of the ectatic vessel endothelial cells with monoclonal antibodies to D2-40 (podoplanin), which are highly selective lymphatic endothelial markers of lymphatic endothelium; hence, this indicates that the vessels were of a lymphatic nature (Figure 2D).