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Fine needle aspiration diagnosis of intramuscular bacillary angiomatosis. A case report
1Department of Diagnostic Pathology and Laboratory Medicine, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York, USA.
Background:
Bacillary angiomatosis (BA) is a localized infectious process that affects primarily patients with the acquired immunodeficiency syndrome. The microorganisms implicated in the pathogenesis of this disease belong to the Rickettsiaceae family.
Case:
A 43-year-old, human immunodeficiency syndrome-positive male presented with diffuse swelling in the right deltoid area. A neoplastic process was considered in the differential diagnosis. Fine needle aspiration biopsy showed proliferation of blood vessels lined with plump endothelial cells, and the interstitial space was occupied by neutrophilic infiltrate, leukocytoclastic debris and clumps of characteristic amphophilic, granular material. Warthin-Starry stain demonstrated clusters of bacilli diagnostic of bacillary angiomatosis.
Conclusion:
The diagnosis of this entity, made by fine needle aspiration cytology (as the only diagnostic procedure), was instrumental in preventing further surgical manipulation and in initiating appropriate and immediate antibiotic therapy.