ABSTRACT
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular neoplasm mainly affecting middle-aged women. Lesions typically affect the head and neck region. ALHE is considered a distinct disease entity different from Kimura's disease, a benign reactive lymphoid proliferation that is predominantly seen in young Asian men although it can affect all ethnic groups. In contrast to ALHE, Kimura's disease is typically associated with peripheral blood eosinophilia, increased serum IgE and lymphadenopathy. Several case reports suggest an overlap between ALHE and Kimura's disease. We review the current literature and discuss whether AHLE and Kimura's disease might represent two extreme variants of the same disease entity.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/classification , Angiolymphoid Hyperplasia with Eosinophilia/diagnosis , Skin/pathology , Diagnosis, Differential , Evidence-Based Medicine , Humans , Syndrome , Terminology as TopicABSTRACT
Classification schemes proposed for vascular lesions are the subjects of significant controversy. Cutaneous epithelioid angiomatous nodule (CEAN) was described in 2004, but there is no agreement as to whether this is a distinct entity or a type of either epithelioid hemangioma or angiolymphoid hyperplasia with eosinophilia. We present a typical case of CEAN and discuss nine other cases from our institution. We then provide two opposing viewpoints concerning its classification.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/pathology , Angiomatosis, Bacillary/pathology , Endothelial Cells/pathology , Granuloma, Pyogenic/pathology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Angiolymphoid Hyperplasia with Eosinophilia/classification , Angiolymphoid Hyperplasia with Eosinophilia/diagnosis , Angiomatosis, Bacillary/classification , Angiomatosis, Bacillary/diagnosis , Child , Dermis/blood supply , Dermis/pathology , Diagnosis, Differential , Female , Follow-Up Studies , Granuloma, Pyogenic/classification , Granuloma, Pyogenic/diagnosis , Humans , Male , Middle Aged , Organ Specificity , Retrospective Studies , Sex Factors , Young AdultABSTRACT
BACKGROUND: There has been considerable controversy about the relation between Kimura's disease and angiolymphoid hyperplasia with eosinophilia (ALHE). OBJECTIVE: We describe the clinical and histopathologic differences between the two diseases. METHODS: We reviewed clinical findings and histopathologic changes in two cases of Kimura's disease and three cases of ALHE. RESULTS: Kimura's disease shows typical lymphoid follicles. It is associated with lymphadenopathy and is always accompanied by peripheral eosinophilia. ALHE shows typical changes in endothelial cells. It is characterized by superficial papules or nodules with no lymphadenopathy and is less frequently accompanied by peripheral eosinophilia. CONCLUSION: Kimura's disease and ALHE are separate entities.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/pathology , Adrenal Cortex Hormones/therapeutic use , Adult , Aged , Angiolymphoid Hyperplasia with Eosinophilia/classification , Angiolymphoid Hyperplasia with Eosinophilia/drug therapy , Cryosurgery , Female , Humans , Male , Middle AgedABSTRACT
The relationship between the disorder known in Japanese and Chinese literature as Kimura's disease and that known in Western literature as angiolymphoid hyperplasia with eosinophilia (ALHE) has been the subject of debate. Many reports have used the terms synonymously. We have reviewed the histological and clinical features of 4 cases, all occurring in Caucasians, 2 of which are typical of Kimura's disease and 2 of ALHE. Analysis of the cases indicates that the histological features of the 2 disorders are sufficiently different to warrant their recognition as 2 distinct entities. The histological and clinical features of Kimura's disease are most consistent with an allergic or autoimmune process in which blood vessels, lymphocytes and eosinophils participate. Those of ALHE suggest a primary, probably neoplastic disorder of vascular endothelium with a variable and secondary inflammatory response. Although there is some clinical overlap between patients with the 2 disorders, the histological features are distinctive, and the 2 terms should not be used synonymously.
Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/pathology , Adult , Angiolymphoid Hyperplasia with Eosinophilia/classification , Angiolymphoid Hyperplasia with Eosinophilia/ethnology , Endothelium, Vascular/pathology , Humans , Male , Middle Aged , Vascular Diseases/pathology , Venules/pathology , White PeopleABSTRACT
A 51-year-old mason presented with a large tumour on his scalp which had developed over the previous 2 years. Histological examination showed the presence of large vessels with muscular coats some of which appeared to be venules and others arterioles. They had markedly swollen cuboidal endothelial cells and a surrounding mononuclear cell infiltrate which in areas formed lymphoid follicles some of which had germinal centers. There was no evidence of tissue or blood eosinophilia. The unusual clinical and histological features of this case are emphasized and the nosology of this rare condition is discussed.
