Pathology of Angiolymphoid Hyperplasia with Eosinophilia [Epithelioid Hemangioma]
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.
is a deeper lesion and reactive lymphoid follicles and are present
together with a dense infiltration of eosinophils sometimes forming
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