Angiolymphoid hyperplasia with eosinophilia: A report of a rare entity in an elderly male

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign proliferation of blood vessels of uncertain etiology. It primarily affects the head‑and‑neck region. Histologically, it is characterized by the prominent proliferation of plump endothelial cells, and accompanying eosinophilic and lymphocytic infiltration. Herein, we report the case of ALHE in a 65‑year‑old male.

Epithelioid hemangioma of the ascending aorta: A rare case

Cardiac epithelioid hemangioma is extremely rare. Currently, there are only a few described cases of intraluminal hemangiomas of the aorta and the aortic valve and no described cases with extraluminal epithelioid hemangiomas of the ascending aorta. We now present a case of epithelioid hemangioma of the ascending aorta that was an incidental finding during the coronary artery bypass and successfully resected.

INTRAOSSEOUS LESION OF PHALANX: TWO SIMILAR CASES BUT NOT THE SAME

@#Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, the majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at the little finger for six months. The lytic lesions involved the whole middle phalanx with cortical breach sparing the joints. A provisional diagnosis of osteomyelitis was made, although unlikely. Bone biopsy was performed early to plan for definitive treatment and surgery. Patient 1 was diagnosed for intraosseous gout whereas Patient 2 for epithelioid hemangioma. Both were benign destructive bone lesions. Thus, we counselled the patients for curettage of lesion, bone grafting and spanning external fixation in view of extensive lesion. Patient 1 defaulted treatment. Patient 2 had an uneventful surgery. She regained her grip strength. In two years follow up, there was no evidence of infection, recurrence or malignant transformation.

Clinicopathological analysis of 22 cases of cutaneous epithelioid hemangioma / 中华皮肤科杂志

Objective To investigate clinical and histopathological features of cutaneous epithelioid hemangioma (EH).Methods Clinical and histological data were collected from 22 patients with EH and analyzed.Results Of the 22 EH patients,10 were male,and 12 were female.The age at onset ranged from 16 to 62 years,with an average age of 45.91 years.The duration of disease varied from 1 month to 20 years,with an average disease duration of 37 months.Skin lesions most frequently occurred on the scalp in 14 cases (63.6％),followed by the ear in 6 cases (27.3％),the forehead in 2 cases (9.1％),and the thigh in 1 case (4.5％).Lesions affected both the scalp and forehead in 1 case.Histopathological examination of the 22 cases revealed vascular proliferation.The blood vessels were lined with epithelioid endothelial cells,and a large number of lymphocytes and eosinophils infiltrated around the vessels.The dermis were involved in all cases,and subcutaneous tissues were involved in 8 cases (36.4％).Immunohistochemical examination of 6 cases showed positive staining for CD31,CD34 and factor Ⅷ in blood vessel walls.Conclusion EH is an uncommon disease characterized by vascular proliferation and inflammatory infiltration,and clinical manifestations in combination with histopathological examination facilitate its diagnosis.

Epithelioid hemangioma of distal femoral epiphysis in a patientwith congenital talipes equinovarus

Epithelioid hemangioma (EH) is a rare benign vascular lesion of soft tissue and bone, characterized by endothelial cells with epithelioid or histiocytoid appearance. Though tubular bones, flat bones, vertebra and short bones are common sites for this lesion, the epiphyseal involvement is extremely rare. We present an unusual case of EH of the distal femur in a young boy. Case report: A 12-year-old boy who had congenital talipes equinovarus of the right foot presented with progressively increasing pain in the right lower thigh for six months. Physical examination revealed muscular atrophy of the right lower limb and a moderately tender swelling in the medial aspect of the right knee without restriction of knee movement. An X-ray revealed an osteolytic lesion, which appeared iso- and hypointense on T1W and hyperintense on T2W MRI images in the distal epiphysis and adjacent metaphysis of the right femur. A radiological diagnosis of chondroblastoma was entertained. The patient was treated with curettage and bone grafting. Histopathology showed a tumor composed of thin-walled arteriolar capillaries lined by large, polyhedral epithelioid endothelial cells with vesicular nuclei, finely distributed nuclear chromatin, and moderate amount of eosinophilic cytoplasm. The endothelial cells were strongly immunopositive for CD34. Mitotic activity was low and the Ki-67 proliferative rate was <2%. A diagnosis of EH was made. EH is a benign lesion and it should be differentiated from its histologically similar malignant counterparts such as epithelioid hemangioendothelioma and epithelioid angiosarcoma as the lesion can be successfully treated with curettage or resection.

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa.

Angiolymphoid hyperplasia with an eosinophilia (ALHE) is a rare benign entity whose etiology and pathogenesis is under debate. Clinically, it is characterised by cutaneous papules or nodules on the head and neck. Literature reveals very few cases of this entity in the oral mucosa. Here, we report a case of ALHE in a 25 year-old woman, who presented with a painless, 5mm x 5mm, sub mucosal erythematous nodule on left angle of mouth at lower lip. Histological examination of lip biopsy specimens revealed an increase in small vessels. The vascular walls consist of prominent endothelial cells with a histiocytoid appearance, which protruded into the lumen. Many eosinophils and lymphocytes were also seen around the vessels. The diagnosis of ALHE was made from the above findings.

Epithelioid Hemangioma Involving Three Contiguous Bones: a Case Report with a Review of the Literature

An epithelioid hemangioma involving three contiguous bones in continuity has, to the best of our knowledge, not been reported in the literature. A case of a 48-year-old man presented with radiating pain to the lower thoracic region for two years. A radiograph and CT scan revealed both permeative osteolytic and multiple trabeculated lesions involving the left posterior part of the 10th rib as well as the 9th and 10th vertebral bodies in continuity and was misled as a malignant or infectious lesion. The histopathology and immuno-histochemistry of the lesion confirmed the diagnosis of an epithelioid hemangioma. The lesion was still stable as of three years after surgery.

Angiolymphoid Hyperplasia with Eosinophilia on the Palm

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon dermal angioproliferating tumor, characterized by red to brown papules or nodules on the head and neck, though also occurring in the mouth, trunk, extremities and inguinal area. The palm is a very unusual site for ALHE, and there have been very few cases reported globally thus far. ALHE can be pruritic and painful and histopathologic findings show vascular proliferation with infiltration of eosinophils and lymphocytes in the dermis. Plump endothelial cells protrude into the lumen. We report a case of ALHE occurring at an unusual site, the right palm, in a 62-year-old man, who had suffered from a solitary pinkish-colored, central depressed round hyperkeratotic plaque on his palm for 4 years. On the basis of clinical and histopathologic data, a diagnosis of ALHE was made. To our knowledge, this is the first report of ALHE on the palm in Korean dermatologic literature.

Epithelioid Hemangioma of Nasal Tip

Epithelioid hemangioma was firstly described by Enzinger and Weiss. It belongs to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration and synonymous with angiolymphoid hyperplasia with eosinophilia(ALHE). Histopathologically, the lesion is characterized by localized, marginated and relatively symmetrical proliferation of capillaries around a medium-sized vessel with an epithelioid hyperplasia of endothelial cell and marked infiltration of inflammatory cells, eosinophils and lymphocytes. The lesion occurs usually in the dermal and subcutaneous tissue of the head and neck area. We report a case of epithelioid hemangioma occuring on the nasal tip in a 72-years-old man. Microscopically, the lesion consisted of a proliferating vessels surrounded by inflammatory infilatration predominantly composed of eosinophils and lymphocytes. But vessels were lined by conventional-appearing endothelial cells.

Epithelioid Hemangioma Associated with Nevus Flammeus / 대한피부과학회지

Epithelioid hemangioma, the term which was first used by Enzinger and Weiss, is synonymous with angiolymphoid hyperplasia with eosinophilia. It defines a lesion occurring usually in the dermal and subcutaneous tissue of the head and neck, characterized by localized, marginated and relatively symmetrical proliferation of the capillaries around a medium-sized vessel with an epithelioid hyperplasia of endothelial cell. There is a marked inflammatory reaction composed of lymphocytes and eosinophils. We report a case of epithelioid hemangioma associated with nevus flammeus in a 53-year-old male. Histology revealed typical feature of epithelioid hemangioma that proliferation of dilated vessels with prominent endothelial cells surrounded by dense lymphoid cell infiltrates but no eosinophils were identified.

Two cases of epithelioid hemangioma / 대한피부과학회지

Epithelioid hemangiomo, is belong to a group of unusual vascular proliferation accompanying prominent eosinophilic infiltration. It is usually classificed as a subset of angiolymphoid hyperplasia with eosinophilia despite of its peculiar endothelial morphology(i.e., vacuolization and hobnail appearance etc.). Histopathologically, the lesion was characterized by exuberant. proliferation of capillaries, epithelioid-appearing erdothelial cell, endothelial cytoplasmic vacuolization, solid sheets of endothelial cells, massive eosinophilic infiltration and lymphoreticular hyperplasia. The lesions are most common in he head-neck region and are characterized by single or multiple smooth-top papules or plnqu s of varying colors. We report two cases of epithelioid hemangioma occurring on the left auricle and scalp. The chiet complaints were pruritus and they have been early bleeding even in trivial trauma. Microscopically, the lesions were consisted of a prolifration of small to medium-sized blood vessels surraunded by inflammatory infiltrates predominantly composed of lymphocytes, histiocytes and eosinophils. The vessels were lined by epithelioid-appearing endothelial cells haveing enlarged round nuclei and abundant easinophilic or clear cytoplasm. Some vessels showed luminal obliteration by proliferating epithelioid endothelial cells. Occasionally, blood vessels were lined by hobnailor scallop-shaped endothelial cells. In immunohistochemical finolings, the epithelioid endothelial cells or proliferated capillaries were immunoreactive to factor VII-related antigen and negative to lysozyme.

A clinicopathological study of Kimura's disease and epithelioid hemangioma

The clinicopathological features of 9 cases of Kimura's disease and 5 cases of epithelioid hemangioma(EH) were reviewed. Patients with Kimura's disease presented with multiple or solitary large tumors occurring in the thigh, arms as well as parotid gland. Histologically, the lesions were characterized by numerous lymphoid follicles with proliferation of post-capillary venules lined by plump endothelium and a marked eosinophilic infiltration. Patients with EH were older than those with Kimura's disease and presented papular nodular lesions, less than 1 cm in size. Microscopically, there was proliferation of blood vessels lined by epithelioid endothelium with infiltration by lymphocytes and eosinophils. Although there may occasionally be clinicopathological overlap between Kimura's disease and EH, we consider that these two disorders can be recognized as separate entities.