hyperplasia with eosinophilia also known as epithelioid hemangioma is a
distinctive vascular lesion which usually occurs during early and mid
adult life (20 - 40 years).
Clinically, this lesion presents as single or multiple pink to red-brown
papules and nodules on the face, scalp and ear.
It is still uncertain whether this lesion is a true neoplasm or a
Some cases appear to be associated with trauma, pregnancy, HIV
infection, pregnancy and oral contraceptives.
Microscopically, these are well circumscribed lesions usually located in
the dermis and subcutis. Angiolymphoid hyperplasia with eosinophilia
consists of vascular and inflammatory cellular components.
The vascular component
displays thick and thin walled vessels lined by plump endothelial cells.
The epithelioid endothelial cells have rounded nuclei abundant
eosinophilic cytoplasm containing occasional vacuoles that represent
primitive vascular lumen formation.
These endothelial cell
protrude into the vessels in a 'tombstone' pattern. Within some
thicker vessels there is intravascular proliferations of the endothelial
The inflammatory component
consists of lymphocytes scattered eosinophils and mast cells within the
stroma. Lymphoid follicle may be present.
In areas the stroma may be myxoid or fibrous in character.
epithelioid angiosarcoma ; injection site
cells are not present).
Kimura's disease is a separate entity which usually affects young
Asian men and is commonly associated with lymphadenopathy.
is a deeper lesion and reactive lymphoid follicles and are present
together with a dense infiltration of eosinophils sometimes forming
Blood vessels are also increased in number but these are lined by flat
the tumour cells are arranged in nests and cords surrounded by hyaline and
myxoid stroma. Well formed blood vessels are usualy not present.
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