Custom Search

           

Pathology of Angiolymphoid Hyperplasia with Eosinophilia [Epithelioid Hemangioma]

Dr Sampurna Roy MD

 

Path Quiz Case 8 - Pathology case history and images

Diagnosis: Angiolymphoid Hyperplasia with Eosinophilia [Epithelioid Hemangioma]

 

 February 2016

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

 

 

Vascular tumours

Angiokeratoma

Lobular capillary hemangioma

Masson's Tumour

Acro-angiodermatitis / pseudo-Kaposi's sarcoma

Reactive angioendotheliomatosis

Infantile Hemangioma

Glomeruloid hemangioma

Acquired tufted angioma

Verrucous hemangioma

Cherry angioma/senile angioma

Arteriovenous hemangioma 

Microvenular hemangioma

Targetoid hemosiderotic hemangioma

Spindle cell  hemangioma

Kaposiform hemangioendothelioma 

Retiform hemangioendothelioma 

Papillary intralymphatic angioendothelioma

Composite hemangioendothelioma

10 Microscopic Features of Acute Febrile Neutrophilic Dermatosis (Sweet's Syndrome)

Pseudoxanthoma Elasticum can kill you! 10 important lessons about Pseudoxanthoma Elasticum

Angiolymphoid  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 reactive process.
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 cells.

        

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.


Differential diagnosis:  Kimura's  disease ; epithelioid hemangioendothelioma; epithelioid angiosarcoma ; injection site granuloma (epithelioid cells are not present).            

Kimura's  disease is a separate entity which usually affects young Asian men and is commonly associated with lymphadenopathy.

Kimura's disease is a deeper lesion and reactive lymphoid follicles and are present together with a dense infiltration of eosinophils sometimes forming eosinophilic abscesses.
Blood vessels are also increased in number but these are lined by flat endothelial cells.

In
Epithelioid hemangioendothelioma
the tumour cells are arranged in nests and cords surrounded by hyaline and myxoid stroma. Well formed blood vessels are usualy not present.  Path Quiz Image 1  ; Image2  ;  Image3  ; Image4

Visit: Cutaneous Epithelioid Angiomatous Nodule

                                                                

Further reading:

Angiolymphoid hyperplasia with eosinophilia associated with pregnancy: a case report and review of the literature.

Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the lung: a clinicopathologic and immunohistochemical study of two cases.

Cutaneous epithelioid angiomatous nodule: a distinct lesion in the morphologic spectrum of epithelioid vascular tumors.

Human herpesvirus-8 is not associated with angiolymphoid hyperplasia with eosinophilia.

Angiolymphoid hyperplasia with eosinophilia: evidence for a T-cell lympho-proliferative origin.

Angiolymphoid hyperplasia with eosinophilia: a classic clinical presentation with histologic features of angiosarcoma.

Angiolymphoid hyperplasia with eosinophilia with bilateral involvement of the lacrimal glands.

Differential diagnosis of tumorous space-occupying lesions of the parotid gland: angiolymphoid hyperplasia with eosinophilia and Kimura disease.

 

Histopathology-India.net

 

Pathopedia-India.com

 

Surgical Pathology.com

 

Pathology-India.com

 

Dermpath-India

 

Gallbladder Pathology Online

 

Pathology Quiz Online 

 

Paediatric Pathology Online

 

Pancreatic Pathology Online

 

Paraganglioma-Online

 

Endocrine Pathology Online

 

Eye Pathology Online

 

Ear Pathology Online

 

Cardiac Path Online

 

Pulmonary Pathology Online

 

Lung Tumour Online

 

Mesothelioma-Online

 

Nutritional Pathology Online

 

Environmental Pathology Online

 

Soft Tissue Tumour Online

 

GI Path Online-India

 

Case Index

 

E-book - History of Medicine  

 

Microscope - Seeing the Unseen

 

 

 

Disclaimer

Privacy Policy  

Advertising Policy

Copyright 2016  histopathology-india.net