Angiolymphoid Hyperplasia With Eosinophilia

Abstract

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. Although considered a benign condition, it may recur in up to one-third of cases in the absence of complete surgical excision. The pathogenesis of ALHE/EH is still controversial. However, reaction to trauma and arteriovenous shunting are considered relevant. Histologically, ALHE/EH may be differentiated from other vascular neoplasms by its several unique characteristics including prominent proliferation of plump endothelial cells, and accompanying eosinophilic and lymphocytic inflammation, often with formation of lymphoid follicles. Surgery is the mainstay of treatment and various other treatment strategies have been used with varying results.

Angiolymphoid Hyperplasia with Eosinophilia: A Study of Two Cases

“…In our second case, who did not accept the treatment at the initial stage, surgical excision was performed on the absence of regression of lesion and increased complaint of itching. Despite treatment, it has been reported recurrence of the disease approximately 30% of ALHE cases but no metastasis [10]. No recurrence was observed at 6 months follow-up after surgical excision in both of our cases.…”

“…It is generally seen as painless subcutaneous nodules unilaterally located in head and neck, and diffuse lymphadenopathy. 8 Histiocytic endothelial cells that characteristic of ALHE are rare in KD [10]. In the histopathological examination of the lesions in both of our cases; germinal-centered lymphoid follicles and fibrosis were not observed.…”

“…Another option is to follow up the lesion 3-6 months for the possibility of spontaneous regression [2]. Surgical excision which has a high success rate is widely used [10,11]. In our first case, surgical excision was performed because of bleeding and itching.…”

Angiolymphoid hyperplasia with eosinophilia and its response to the combination of radiofrequency ablation and topical timolol

“…[1] ALHE affects young women with no racial predilection. It presents as multiple erythematous or violaceous papules or nodules on the head and neck region.…”

“…[1] The etiopathogenesis is still unknown, however, it is considered to be a vascular malformation with proliferation of vessels in response to trauma, external otitis media, pregnancy or low T cell clonality. [1] Histopathology shows vascular proliferation with large epithelioid or histoid endothelial cells with infiltrate of lymphocytes and eosinophils. [1] The condition is chronic and resistant to treatment.…”