Retrospective cases were retrieved from the files of basic medical science institute, of jpmc, over a period of 9 years 20002001. Angiolymphoid hyperplasia with eosinophilia alhe, also named epithelioid hemangioma eh, is an inflamed vascular tumefaction of uncertain pathogenesis. Although the disease is not deadly by itself, it usually presents with disfiguring lesions. If the tumor is in bone, it may cause swelling and pain. Angiolymphoid hyperplasia with eosinophilia alhe is a rare disorder presenting with. Angiolymphoid hyperplasia with eosinophilia lester dr thompson. Trauma and otitis externa may be precipitating factors. Angiolymphoid hyperplasia with eosinophilia, genital area, perianal area, vulva case report a lady with angiolymphoid hyperplasia with eosinophilia of the vulva cfy siu and kc lee introduction angiolymphoid hyperplasia with eosinophilia alhe is an uncommon idiopathic condition, which presents as red or purple coloured papules. They considered it to be a late stage of kimuras disease, adisorder described in the japanese literature twenty years. Angiolymphoid hyperplasia with eosinophilia treatment. Angiolymphoid hyperplasia with eosinophilia a case report. Mixed inflammatory infiltrate consisting of lymphocytes, plasma cells and eosinophils. The lesions responded to treatment with intravenous dexamethasone.
Angiolymphoid hyperplasia with eosinophilia is an uncommon, benign, vasoproliferative cutaneous neoplasm with uncertain origin. The predominant feature is the proliferation of small vessels lined by plump endothelial cells with abundant eosinophilic and vacuolated cytoplasm fig. Jeffrey medeiros, in diagnostic surgical pathology of the head and. Angiolymphoid hyperplasia with eosinophilia arash k. It has occurred following various forms of trauma or infection.
The histopathology report came as reac tive hyperplasia. Mostly, it affects middleaged adults manifesting as fleshplumcolored pruritic nodules and papules, most commonly affecting the ear and the periauricular area. Article pdf available in american journal of clinical pathology. Angiolymphoid hyperplasia with eosinophilia epithelioid hemangioma clinical features. Kimuras disease is associated with markedly elevated peripheral eosinophilia and elevated serum ige levels as well as lymphadenopathy. Several cases have been treated in the past with complete surgical excision, although the recurrence rate remains relatively high.
Angiolymphoid hyperplasia with eosinophilia alhe, also known as epithelioid haemangioma 1, 2 or histiocytoid haemangioma, is currently considered to be a true neoplasm rather than a reactive phenomenon. Angiolymphoid hyperplasia with eosinophilia alhe has been known by a variety of different names, such as. Several treatments have been reported but surgery is the most efficient one. In this case, we report a yearold caucasian girl with bilateral, huge. Histiocytoid endothelial cells with hobnail appearance. Angiolymphoid hyperplasia with eosinophilia is also known as epithelioid or histiocytoid haemangioma. Angiolymphoid hyperplasia with eosinophilia epithelioid. Clinically, it is usually a deep solitary large lesion with normal overlying skin. Angiolymphoid hyperplasia with eosinophilia is an uncommon condition that usually presents in early to middleaged adults as multiple red nodules or plaques, most commonly on the head and neck. Angiolymphoid hyperplasia with eosinophilia alhe is a benign vascular proliferative disorder of unknown etiology. Pdf angiolymphoid hyperplasia with eosinophilia alhe is a. Angiolymphoid hyperplasia involving large arteries journal.
Angiolymphoid hyperplasia with eosinophilia alhe is a benign but potentially disfiguring vascular lesion. Three cases of angiolymphoid hyperplasia with eosinophilia are reported at the site of tetanus toxoid vaccination. Later mehregens et al dropped the subcutaneous retaining the term angiolymphoid hyperplasia with eosinophilia2 subsequently others. Angiolymphoid hyperplasia with eosinophilia of the orbit and. Angiolymphoid hyperplasia with eosinophilia alhe is an uncommon, reactive vasoproliferative disease, presenting.
Pathology outlines angiolymphoid hyperplasia with eosinophilia. Some workers consider it to be a reactive process due to an unknown stimulus. It was first described by wells and whimster in 1969 1. Angiolymphoid hyperplasia with eosinophilia libre pathology. This entity is uncommon and has been frequently confused with kimuras disease in the past 1, 2.
Although the head and neck region is most commonly. Angiolymphoid hyperplasia with eosinophilia is a rare, benign vascular tumor affecting principally the head and neck region of young adult females. On the skin, it may appear as firm pink to red bumps that may be itchy or painful. A biopsy was carried out on one of the lesions, and histopathological examination revealed. Angiolymphoid hyperplasia with eosinophilia alhe, first described in 1969, 1 is a skin disease characterized by solitary or multiple dermal and subcutaneous nodules usually located on the head and neck fig 1. Angiolymphoid hyperplasia with eosinophilia alhe is a rare benign but potentially disfiguring vascular proliferation. Angiolymphoid hyperplasia with eosinophilia versus kimura. Angiolymphoid hyperplasia with eosinophilia wikipedia. Angiolymphoid hyperplasia with eosinophilia differs morphologically from kimuras disease.
Angiolymphoid hyperplasia with eosinophilia successfully. Available formats pdf please select a format to send. Angiolymphoid hyperplasia with eosinophiliaeh most commonly presents in young to middleaged adults as single or multiple, nondescript. Angiolymphoid hyperplasia with eosinophilia alhe has been known by a variety of different names, such as epithelioid haemangioma, pseudopyogenic granuloma, inflammatory angiomatous nodule, papular angioplasia, subcutaneous angioblastic lymphoid hyperplasia with eosinophilia and lymphofolliculosis, intravenous atypical vascular proliferation and histiocytoid haemangioma. A patient with multiple erythematous nodules on her posterior scalp presented to our dermatology clinic. Mar 24, 2014 angiolymphoid hyperplasia with eosinophilia eh most commonly presents in young to middleaged adults as single or multiple, nondescript, flesh to plumcolored papules or nodules, ranging in size from a few to several centimeters. Only 8 cases were reported over a period of 9 years giving an average of one case every.
Angiolymphoid hyperplasia with eosinophilia journal of. Later mehregens et al dropped the subcutaneous retaining the term angiolymphoid hyperplasia with eosinophilia 2 subsequently others. Angiolymphoid hyperplasia with eosinophilia associated with. Angiolymphoid hyperplasia with eosinophilia presenting as.
Angiolymphoid hyperplasia with eosinophilia is an apparently nonmalignant, locally proliferating lesion composed of channels of small blood vessels surrounded by lymphocytes and eosinophils these are two types of white blood cell. Angiolymphoid hyperplasia with eosinophilia versus kimuras. It is a benign vascular proliferation of unknown etiology with a characteristic component of epithelioid endothelial cells. Angiolymphoid hyperplasia with eosinophilia alhe has been known by a variety of different names, such as epithelioid haemangioma, pseudopyogenic granuloma, inflammatory angiomatous nodule, papular angioplasia, subcutaneous angioblastic lymphoid hyperplasia with eosinophilia and lymphofolliculosis, intravenous atypical vascular proliferation. Inflammatory focus in dermal lesion containing capillaries and venules with plump. Extensive angiolymphoid hyperplasia with eosinophilia with. Angiolymphoid hyperplasia with easinophilia alhe is an unusual but distinctive vascular tumor that was first described by wells and whimster1 as subcutaneous angiolymphoid hyperplasia with eosinophilia. The disorder is commonly regarded as an angioproliferative process accompanied by an inflammatory. Histopathology of kimuras disease demonstrates a marked follicular hyperplasia with follicles surrounded by a large number of eosinophils, lymphocytes, and mast cells. Apr 11, 2019 angiolymphoid hyperplasia with eosinophilia alhe is an uncommon, vasoproliferative, idiopathic condition that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck. Although considered a benign condition, it may recur in up to onethird of cases in the absence of complete.
Jun 29, 2007 angiolymphoid hyperplasia with eosinophilia volume 109 issue 3 d. Biopsy confirmed the diagnosis of angiolymphoid hyperplasia with eosinophilia. Spontaneous regression is common, but persistent or recurrent lesions may require treatment. These proliferating small vessels often can be seen. Alhe is a vascular proliferation with secondary lymphoid and eosinophilic infiltration. Angiolymphoid hyperplasia with eosinophilia and kimuras. Angiolymphoid hyperplasia with eosinophilia alhe, also named epithelioid hemangioma eh, is an inflamed. Clinical presentation with a nodular brownish lesion on the head patient 1 in table 1. Epithelioid hemangioma and pseudopyogenic granuloma are the other names for this entity. From the department of pathology, southern california permanente medical group.
Angiolymphoid hyperplasia with eosinophilia journal of skin. Angiolymphoid hyperplasia with eosinophilia alhe is a rare vascular proliferative disorder, which most commonly involves the skin of the head and neck regions. Angiolymphoid hyperplasia involving large arteries. Angiolymphoid hyperplasia with eosinophilia clinical gate. Angiolymphoid hyperplasia with eosinophilia the journal. Although the disease is not deadly by itself, it usually presents with disfiguring lesions that grimly affect the patients quality of life. Angiolymphoid hyperplasia ramesh aravamuthan a mani suryakumar sarankumar s stanley medical college abstract angiolymphoid hyperplasia with eosinophilia alhe is an uncommon benign idiopathic condition that manifests in adults, characterized by isolated or grouped papules, plaques, or nodules in the skin of the head and neck. Angiolymphoid hyperplasia with eosinophilia dermnet nz. Angiolymphoid hyperplasia with eosinophillia a rare. Definition of angiolymphoid hyperplasia with eosinophilia. Several treatments have been reported but surgery is the most efficient. Angiolymphoid hyperplasia with eosinophilia alhe is an uncommon idiopathic condition that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck.
Angiolymphoid hyperplasia with eosinophilia affecting the oral mucosa. Angiolymphoid hyperplasia with eosinophilia versus kimuras disease. We report here two cases of alhe manifested as masses of the occipital and. Angiolymphoid hyperplasia with eosinophilia treated with. Angiolymphoid hyperplasia with eosinophilia is manifested by benign vascular tumors that usually occur about the head in young adults. The lesions were alleviated temporarily, but they did not subside entirely without therapy. Similar to kimuras disease, the process frequently involves the head and neck region in young adult asian men. Angiolymphoid hyperplasia with eosinophilia alhe is often confused with kimuras disease but is a morphologically and clinically distinct entity. Pdf two cases of primary angiolymphoid hyperplasia with eosinophilia epithelioid. A lady with angiolymphoid hyperplasia with eosinophilia of. Angiolymphoid hyperplasia with eosinophilia is a benign neoplasm that includes blood vessel proliferation and a dense eosinophilic inflammatory infiltrate. Most patients present with lesions in the periauricular region, forehead, or scalp.
It is an uncommon disease, so data on its natural course and treatment response are based on a small number of patients. Angiolymphoid hyperplasia with eosinophilia usually presents with pink to redbrown, domeshaped, dermal papules or nodules of the head or neck, especially about the ears and on the scalp. Angiolymphoid hyperplasia with eosinophilia alhe is an uncommon, benign disorder that presents as solitary or multiple papulonodules, located predominantly in the head and neck region. Angiolymphoid hyperplasia with eosinophilia alhe is a tumor of skin and. Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. Angiolymphoid hyperplasia with eosinophilia accessed 7 january 2019. It preferably affects middleaged adults, manifesting as plumcolored pruritic papules, nodules and plaques, which can persist indefinitely, relapsing over time. Also called epithelioid histiocytoid hemangioma rare, benign angiomatous subcutaneous process, usually of auricle and external canal. Angiolymphoid hyperplasia with eosinophilia proves a therapeutic dilemma, because there is a large variety of proposed treatments, yet there is not enough data on most of them. Angiolymphoid hyperplasia with eosinophilia associated. Angiolymphoid hyperplasia should be distinguished from kimuras disease. The patient is a healthy 43 woman with a 20year history of pruritic lesions on her ears and periauricular areas. Noncutaneous localization of this pathology is unusual, and its primary localization in large arteries presenting as a pulsatile mass is extremely rare. Angiolymphoid hyperplasia with eosinophilia also known as.
Angiolymphoid hyperplasia with eosinophilia alhe is a benign vascular neoplasm mainly affecting middle. Angiolymphoid hyperplasia with eosinophilia developing in a patient with history of peripheral tcell lymphoma. It presents most commonly in patients aged 2050 years, with a mean onset of 3033 years. Microscopic analysis reveals hyperplastic blood vessels lined by a hypertrophic endothe. Apr 11, 2019 angiolymphoid hyperplasia with eosinophilia alhe is an uncommon idiopathic condition that manifests in adults as isolated or grouped papules, plaques, or nodules in the skin of the head and neck. Angiolymphoid hyperplasia with eosinophilia alhe was first described by wells and whimster in 1969. Pdf angiolymphoid hyperplasia with eosinophilia epithelioid. Angiolymphoid hyperplasia with eosinophilia, histopathology. Creagh skip to main content accessibility help we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Angiolymphoid hyperplasia with eosinophilia is general ly a solitary lesion most often located on the scalp or face,3 but multiple lesions on the extremities also have been described. A rare benign not cancer tumor of small blood vessels surrounded by lymphocytes and eosinophils types of white blood cells. Our dermatology online case report aangiolymphoid hyperplasia. Angiolymphoid hyperplasia with eosinophilia an overview. Angiolymphoid hyperplasia with eosinophilia usually forms on or in the skin, especially the skin of the head, but can occur in other areas of the body, such as in bone.
Angiolymphoid hyperplasia with eosinophilia alhe, also known as epithelioid hemangioma, is a uncommon benign vasoproliferative disease. Angiolymphoid hyperplasia with eosinophilia archives of. Angiolymphoid hyperplasia with eosinophillia a rare entity. Angiolymphoid hyperplasia with eosinophilia is a rare disease considered as being a vascular. Different responseresistance to various therapeutic modalities and frequent recurrences. Angiolymphoid hyperplasia with eosinophilia alhe, also named epithelioid hemangioma eh, is an inflamed vascular tumefaction of uncertain pathogenesis, characterized by proliferation of histiocytoid endothelial cells with prominent lymphocytic and eosinophilic infiltration.
After a period of three months a similar swelling reappeared at the same site and it was again op erated in the same hospital without any definitive diagno. Alhe shares clinical as well as histopathological characteristics with kimura disease kd, but they. Although considered a benign condition, it may recur in up to onethird of cases in the absence of complete surgical excision. Angiolymphoid hyperplasia with eosinophilia archives of pathology. To know the frequency of angiolymphoid hyperplasia with eosinophilia. Rune pallesen, bent sorensen, md \sb\a 28yearold man with slight blood eosinophilia had multi ple dermal lesions of angiolymphoid hyperplasia with eosino philia in the right knee region. All presented as nodules on the upper arm, a known adverse effect of the vaccine following superficial inoculation. Angiolymphoid hyperplasia with eosinophilia presenting as an. Angiolymphoid hyperplasia with eosinophilia kimura s disease a case with dermal lesions in the knee region and a popliteal arteriovenous fistula j\lo\rgenmoesner, md. Discussion angiolymphoid hyperplasia with eosinophilia of the oral mucosa is a rare disease that is often confused. Angiolymphoid hyperplasia with eosinophilia the journal of. Angiolymphoid hyperplasia with eosinophilia accessed 7 january 2019 usually men and women in 20s to 40s, may have history of trauma.
It clinically presents itself by angiomatous papules or nodules located on the. Angiolymphoid hyperplasia with eosinophilia kimuras disease. Low grade vascular tumor characterized by proliferation of blood vessels lined by plump endothelial cells. Angiolymphoid hyperplasia with eosinophilia alhe is an uncommon, reactive vasoproliferative disease, presenting with painless, vascular nodules in the dermal and subcutaneous tissues, sually seen in the head and neck region.
Angiolymphoid hyperplasia with eosinophilia associated to a squamous cell carcinoma of the ear. Disseminated angiolymphoid hyperplasia with eosinophilia. Histopathology results indicated angiolymphoid hyperplasia with eosinophilia alhe, and the. Histopathology results indicated angiolymphoid hyperplasia with eosinophilia alhe, and the patient was diagnosed with disseminated alhe dalhe. Pdf angiolymphoid hyperplasia with eosinophilia and kimuras. It is usually characterized by dermal and subcutaneous nodules, primarily in the head and neck region.
1298 951 243 715 979 308 466 264 1155 505 824 802 1015 904 558 1019 795 144 681 176 1299 69 528 652 143 118 1220 680 164 1011 395