Unusual presentation of angiolymphoid hyperplasia with eosinophilia treated with intralesional and topic corticosteroid combination therapy

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon angioproliferative benign disorder. A 24- year-old Caucasian female patient presented with multiple itchy reddish pearly nodule.

Comparison between Kimura’s disease and angiolymphoid hyperplasia with eosinophilia: case reports and literature review

Kimura’s disease (KD) is a rare chronic inflammatory or allergic disease. Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular neoplasm. Their relationship has always been debated. This article reports two rare cases, one of each disease. One patient was a 48-year-old female that presented with a mass on her right mandible. She also had oedema erythema and wheals on her lower limbs. She was diagnosed with Kimura’s disease complicated with chronic urticaria. The second patient was a 23-year-old female that presented with multiple nodules of unequal size on the scalp. She was diagnosed with angiolymphoid hyperplasia with eosinophilia. The first patient recovered after being treated with surgical resection, glucocorticosteroids, cyclophosphamide and radiotherapy. The second patient underwent the first stage of surgical excision and is currently being followed-up. Comparison of the clinical and histopathological features of these two cases supports the theory that KD and ALHE are two separate disease entities.

TISSUE DIAGNOSIS OF TWO DISTINCT EOSINOPHIL RICH LESIONS WITH SIMILAR HISTOMORPHOLOGY

Eosinophil rich lesions in histopathology have a wide range of differential diagnosis including conditions arising from inammatory, reactive, immune mediated, drugs, parasitic infestations to neoplasms of both hematopoietic and non-hematopoietic origin (Nutman, 2007). Some of them are yet to be clearly differentiated by histological criteria, though being genetically different, such as Kimura disease and Angiolymphoid hyperplasia with eosinophilia (ALHE) (Googe et al., 1987). Some close mimics of eosinophil rich reactive and clonal lesions need to be differentiated based on the site of involvement, radiological features and appropriate immunohistochemical evaluation on biopsy tissues. We present here two distinct diagnoses of Langerhans cell histiocytosis (LCH) and ALHE which appear similar in terms of eosinophil rich inammatory inltrate on histological examination but have entirely different clinical course. Summary: Langerhans cell histiocytosis is a locally aggressive slow growing neoplasm while Angiolymphoid hyperplasia with eosinophilia is a reactive lesion. Problem arises sometimes in the tissue diagnosis of these two lesions owing to their similarities in a couple of features. Both have a predilection for head and neck region. Both appear as an inammatory lesion with eosinophils being a striking feature in biopsy tissues. Since, both the lesions have an entirely different clinical behaviour and prognosis, it is important to differentiate between the two based on the histopathology, clinical as well as radiological features. This paper emphasizes upon the same.

Angiolymphoid Hyperplasia of the External Auditory Canal; Reconstruction of a Complex Defect

Angiolymphoid hyperplasia (AH) was first described by Wells and Whimster in 1969 as a benign vasoproliferative pathology with a varied infiltrate of eosinophils, lymphocytes, and plasmatic cells. Clinical presentation has been described in the literature as small red-bluish nodules, less than 3 cm in diameter that can bleed in 25% of the cases and be pruritic and painful in 37% and 20% of the cases, respectively. Particularly, AH can appear in the ear; nevertheless, other regions have been affected, including the scalp, lips, tongue, orbit, muscle, and bone. Most of these cases have occurred in adults with an unknown etiology; however, an inflammatory process has been associated in approximately 20% with eosinophilia. No malignancy has been reported.