Angiolymphoid hyperplasia with eosinophilia versus Kimura's disease: a case report and a clinical and histopathological comparison

Abstract Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.

Kimura Disease Involving a Caruncle

A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 x 0.5 x 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.

Kimura Disease Involving a Caruncle

A 35-year-old woman presented with history of a painless, slow-growing nodule in a left eye caruncle over the last 2 months. The visual acuity was 20 / 20 and the ocular movements were in the normal range. The venereal disease research laboratory test, erythrocyte sedimentation rate, serum angiotensin converting enzyme level, and chest radiograph were all normal. An excisional biopsy was done to confirm the diagnosis. A 1.3 x 0.5 x 0.3 cm sized nodule was extracted and sent for histopathologic examination. Hematoxylin-eosin staining showed follicular hyperplasia with perifollicular fibrosis, an eosinophil infiltrate, and proliferation of capillary vessels. The capillaries were lined by normal-appearing, flat, spindle-shaped endothelial cells. On the basis of these histopathologic findings, the diagnosis of Kimura disease in a caruncle was established. This is the first report describing Kimura disease localized to a caruncle. Kimura disease should be suspected and included in the differential diagnosis of a caruncular mass lesion.

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.

Kimura's disease an unusual glandular involvement with blood and tissue esinophilia.

Kimura's disease is a rare cause of a progressive neck swelling associated with blood and tissue esinophilia. Though it is a benign disease, however, its unrelating course and unpredictable response to the therapeutic interventions, poses a great challenge to the treating physician, the patients and the caregiver. Here is one such case of Kimura's disease.

Maladie de Kimura: a propos d'un cas

Introduction : La maladie de Kimura ou lymphogranulome eosinophile est une pathologie inflammatoire chronique tres rare; d'etiologie inconnue. Nous rapportons un cas de maladie de Kimura a localisation parotidienne et a travers une revue de la litterature; rappelons les principales caracteristiques cliniques; paracliniques; therapeutiques et evolutives de cette pathologie. Materiel et methodes : Patient de 17 ans qui a consulte devant l'apparition d'une tumefaction de la region parotidienne gauche evoluant depuis un an et sans paralysie faciale. Resultats : L'echographie cervico-parotidienne a revele une parotide gauche hypertrophiee siege de multiples nodules hypoechogenes. La tomodensitometrie cervico-faciale a mis en evidence une glande parotide gauche augmentee de taille et de structure heterogene nodulaire sans adenopathies cervicales. La cytopontion etait non concluante. Le patient a beneficie d'une parotidectomie exofaciale gauche et l'etude anatomopathologique de la piece operatoire revenue en faveur de la maladie de Kimura. Les suites operatoires etaient simples. Le recul est d'un an sans recidive. Discussion : La Maladie de Kimura se caracterise cliniquement par des nodules sous cutanes de localisation cervicofaciale; une augmentation du volume des glandes salivaires et des adenopathies satellites. Son diagnostic est histologique reposant sur l'identification d'une hyperplasie follicullaire avec des abces a polynucleaires eosinophiles. Le traitement est chirurgical le plus souvent mais dans certains cas la cortico- therapie est proposee. Ce diagnostic doit cependant rester a l'esprit devant toute masse cervico-faciale

Epithelioid hemangioma of the temporal artery: a case report.

Temporal or giant cell arteritis is the most common vasculitis affecting the temporal artery. We encountered an unusual case of involvement of the temporal artery, which showed marked proliferating capillaries admixed with a dense infiltrate of eosinophils affecting all layers of the vessel. It was concluded that these changes were those of an epithelioid hemangioma of the temporal artery.

Kimura's disease--cytodiagnostic pointers: a case report.

Kimura's disease is an entity which is common in Asia with predilection for males. Earliest reports were from China. Kimura et al reported the case in detailfrom Japan 1948. Cytological diagnosis of Kimura's helps in allaying fears of malignancies in clinicians and patients. When all the cytological features are seen, this diagnosis should be borne in mind, and the differential diagnosis should be ruled out. Here we report 2 cases of Kimura's disease diagnosed on cytology and confirmed on biopsy. The etiology of Kimura's is unknown but a hypersensitivity etiology has been proposed.

Hiperplasia Angiolinfoide con Eosinofilia (HALE) / Angiolymphoid Hyperplasia with eosinophilia (HALE)

La Hiperplasia angiolinfoide con eosinofilia (HALE) es una enfermedad angioproliferativa poco frecuente, benigna, de etiología desconocida, aunque la mayoría de las publicaciones la atribuyen a un proceso vascular reactivo. Afecta conmayor frecuencia adultos jóvenes y de sexo femenino. Las lesiones son pápulas únicas o múltiples, de color rojo-violáceas, localizadas preferentemente en cabeza y cuello. Presentamos un caso de una paciente de sexo femenino, que consultó por presentar una lesión pequeña en región retroauricular izquierda, la cual fue tratada con cirugía escisional y márgenes de seguridad, sin recurrencias hasta la fecha.

Angiolymphoid hyperplasia with eosinophilia (alhe): a rare entity for otolaryngologist.

A case of angiolymphoid hyperplasia with eosinophilia (ALHE) is reported. It is a rare and new disease for an otolaryngologist. The difference between the Kimura's disease and ALHE has been discussed. Though it is rare, ALHE should be kept in differential diagnosis for an auricular swelling.

Hiperplasia angiolinfoide con eosinofilia: a propósito de dos casos / Angiolymphoid hyperplasia with eosinophilia: a propos of two cases

La Hiperplasia Angiolinfoide con Eosinofilia (HALE) es una proliferación vascular benigna, poco frecuente, que se caracteriza por nódulos localizados preferentemente en el cuero cabelludo, región periauricular y cuello, en adultos jóvenes. La histopatología muestra proliferación de vasos sanguíneos con endotelio prominente, acompañada de un infiltrado inflamatorio que incluye eosinófilos y linficitos. El tratamientos de elección es la resección quirúrgica; sin embargo, las recurrencias son frecuentes. Se presentan dos casos clínicos, se revisa la literatura y se discute la relación entre HALE y enfermedad de Kimura.

Kimura's Disease Involving Thoracic and Abdominal Lymph Nodes in a Hemodialysis Patient

We report the first observed case of Kimura's disease occurring during hemodialysis, involving the thoracic and abdominal lymph nodes, which spontaneously resolved nearly completely after two months. Early diagnosis and recognition of Kimura's disease may spare both the patient and doctor from the need for unnecessary invasive diagnostic procedures. Therefore, we emphasize that we need to have a high index of suspicion regarding Kimura's disease.

Hiperplasia angiolinfoide con eosinofilia: sobre 4 observaciones / Angiolymphoid hyperplasia with eosinophilia

La hiperplasia angiolinfoide con eosinofilia es una patología infrecuente de origen desconocido, que se caracteriza clínicamente por presentar nódulos ubicados en cabeza o cuero cabelludo de adultos jóvenes. Presentamos cuatro casos clínicos, tres de ellos con lesiones múltiples y uno solitario

Hiperplasia angiolinfoide con eosinofilia: casos clínicos y revisión de la literatura / Angiolymphoid hyperplasia with eosinophilia: report of 2 cases and a review of the literature

La hiperplasia angiolinfoide con eosinofilia (HALE) es una entidad clínica benigna, infrecuente, que se manifiesta con nódulos subcutáneos únicos o múltiples localizados de preferencia en la cabeza y cuello de adultos jóvenes. Se caracteriza en su histopatología por células endoteliales prominentes y un infiltrado inflamatorio con predominio de linfocitos, eosinofilos e histiocitos. La observación de dos pacientes con HALE, nos permite precisar la clínica, características histopatológicas e inmunología

Enfermedad de Kimura-HAE / HAE-Kimura's disease

Se presenta el caso de un paciente de sexo masculino con enfermedad de Kimura. A propósito del mismo se recuerdan las principales características clínico-patológicas de la enfermedad de Kimura y la hiperplasia angiolinfoide con eosinofilia, destacando en este paciente la necesidad de descartar distintos tipos de paniculitis

Hiperplasia angiolinfoide con eosinofilia: presentación de dos casos / Angiolymphoid hyperplasia with eosinophilia: two cases

Presentan dos casos de hiperplasia angiolinfoide con eosinofilia (HAE). Pacientes de sexo femenino de 79 y 35 años de edad, la primera con una lesión tumoral en cuero cabelludo y la segunda con pápulas y nódulos en pabellón auricular. El diagnóstico se confirmó por histopatología. El objetivo de este trabajo es comentar las características principales de esta entidad, destacar sus diferencias con la enfermedad de Kimura y plantear la fotocoagulación con láser de CO2 como alternativa terapéutica de interés

Angiolymphoid hyperplasia with eosinophilia and Kimura's disease: a clinicopathological study

In this work, the clinical and histopathological features of 10 cases of angiolymphoid hyperplasia with eosinophilia and 5 cases of Kimura's disease are described and a comparison between the features of the two lesions is presented. Angiolymphoid hyperplasia showed exuberant proliferation of vessels lined by plump endothelial cells with irregular nuclei and cytoplasmic vacuoles, together with fibromyxiod matrix and inflammatory cells infiltrate containing eosinophils. Involvement of muscular coat of blood vessels or even growth entirely within a vessel was a common feature. It occurred in the skin and subcutaneous tissue. Kimura's disease occurred in the parotid gland and the subcutaneous tissues. It was characterized by florid lymphoid infiltrate with prominent lymphoid follicle, vascularization of germinal centres, germinal centre necrosis with eosinophilic material [folliculolysis], and marked eosinophilia with or without eosinophil abscess formation