Angiolymphoid hyperplasia with eosinophilia: A disease that may be confused with malignancy

Abstract

Twelve new cases of an unusual, benign vasoproliferative and inflammatory disorder of unknown etiology, angiolymphoid hyperplasia with eosinophilia (ALHE), are described and contrasted clinically and pathologically with those appearing in the literature. Only recently recognized in the United States, the disease is of singular importance because the vascular component may be confused histologically with angiosarcoma, thereby resulting in unwarranted aggressive therapeutic measures. ALHE characteristically affects adults and presents in the head and neck region as either solitary or multiple cutaneous tumors. The lesions are pruritic, frequently bleed after minor trauma, and may be associated with peripheral eosinophilia and regional lymphadenopathy. On rare occasions, the disease may masquerade as a salivary-gland tumor, cause stenosis of the external auditory canal, or present as an osseous lesion of the skull. Extrafacial tumors are uncommon. Excision is the most frequent form of therapy; however, local irradiation, corticosteroids, electrodessication with curettage, and chemotherapy have also had varying degrees of success.

Angiolymphoid Hyperplasia With Eosinophilia‐acquired Port‐wine‐stain–like Lesions: Attempt at Treatment With the Argon Laser

“…hemangi om a , or persist ent reactio n to insect bi t e s,~,I Il, J.I ,2 5 , ;J(i , 4 !J . 55 Th e flat, red lesion s. as our pa tie nt presented, should be differ entiat ed from port-wine sta in , sa rcoidosis, lupus ery t hern utosus . an d n on-Hodgkin lym ph oma such as mycosis Iu ngoides.…”

Angiolymphoid hyperplasia with eosinophilia in the shoulder

“…The most common site of ALHE occurring outside the head and neck is the hand, with four cases having been described 3,6–8 . Other reported locations include two cases in the legs, 2,4 one on the chest, 2 and two with widespread eruptions on the trunk and limbs 2,5 . Single lesions were seen in four cases, 2,6 , 8 and multiple lesions in five cases 2–5,8 .…”

“…The occurrence of ALHE outside the head and neck region is extremely rare. Only nine cases of ALHE outside the head and neck region have previously been reported 2,3 , 4,5 , 6,7 , 8 . The most common site of ALHE occurring outside the head and neck is the hand, with four cases having been described 3,6–8 .…”

Angiolymphoid Hyperplasia with Eosinophilia of the External Ear (Kimura’s Disease)

“…There are only a few reports on AHE in ENT literature [14][15][16][17][18][19][20], although the lesion has been recognized as a distinct clinical and pathological entity. Most frequently localized on the face and mainly in the periauricular region, the lesion may affect the skin else where, e.g.…”