Histopathology-India.net  

Soft Tissue Pathology

Path Quiz Case-8   Diagnosis: 

Angiolymphoid Hyperplasiawith Eosinophilia [Epithelioid Hemangioma]

                                                      Dr Sampurna Roy MD

Custom Search

                                       Path Quiz Online :  Case 8 - Case history & images

January 2014 
    DermPath-India

     Site created by

 Dr Sampurna Roy MD

          

http://www.histopathology-india.net/dermpath.htm

Surgical-Pathology.com

Dermatopathology Cases

Histopathology-India.net

diagnostichistopathology. blogspot.com

Pathopedia-India.com

Pathology-India.com

Pancreatic Pathology Online

Gall Bladder Pathology Online

Paediatric Pathology Online

Paraganglioma-Online

Endocrine Pathology Online

Eye Pathology Online

Ear Pathology Online

Cardiac Path Online

Lung Tumour-Online

Mesothelioma-Online

Pulmonary Pathology Online

Nutritional Pathology Online

Environmental Pathology Online

Pathology Quiz Online

Dermpath-India

GI Path Online

Soft Tissue Pathology

Case Index

Infectious Disease Online; INDEX: A-D ; INDEX: E-L ; INDEX: M-P INDEX: Q-Z ; FUNGAL DISEASE ; VIRAL DISEASE.

E-book - History of  Medicine with special reference to India

Basic Pathology Blog.

Vascular tumours

Angiokeratoma

Lobular capillary hemangioma (pyogenic granuloma

Bacillary angiomatosis

  - Verruga Peruana

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

Retiform hemangioendothelioma

Papillary intralymphatic angioendothelioma 

Composite hemangioendothelioma 

Polymorphous  hemangioendothelioma

Kaposi's sarcoma

Epithelioid hemangioendothelioma

Angiosarcoma

Glomus tumour

Hemangiopericytoma

Angiolipoma

Aggressive angiomyxoma

Angiomyofibroblastoma

Angioleiomyoma

Angiomyolipoma

Dermatofibroma (aneurysmal variant)

Spindle cell lipoma (Angiomatoid variant)

Kimura's disease

Myxoid Tumours of Soft Tissue

Classification of Soft Tissue Tumour

Gross examination of soft tissue specimen          

PULMONARY PATHOLOGY:

Congenital Cystic Adenomatoid  Malformation ;

Acute Respiratory Distress Syndrome  ;

Sarcoidosis ;

Bronchiolitis ;

Emphysema ;

Bronchial Asthma ;

Chronic Bronchitis Pulmonary;

Alveolar Proteinosis ;

Lipid Pneumonia ;

Pulmonary Hypertension ;

Pulmonary edema ;

Pulmonary Infection ;

Pneumococcal Pneumonia ;

Haemophilus influenza Infection;

Klebsiella Pneumoniae ;

Mycoplasma Pneumonia ;

 

Path Quiz Image 1  ; Image2  ;  Image3  ;  Image4

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.

                                                              

Abstracts:

Angiolymphoid hyperplasia with eosinophilia associated with pregnancy: a case report and review of the literature. Arch Pathol Lab Med. 2005;129(9):1168-71. (Full Text).

Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the lung: a clinicopathologic and immunohistochemical study of two cases. Am J Clin Pathol. 2005;123(5):762-5.

Cutaneous epithelioid angiomatous nodule: a distinct lesion in the morphologic spectrum of epithelioid vascular tumors. Am J Dermatopathol. 2004;26(1):14-21.

Human herpesvirus-8 is not associated with angiolymphoid hyperplasia with eosinophilia.J Cutan Pathol. 2004 Oct;31(9):612-5.

Epithelioid hemangioma of the penis: a clinicopathologic and immunohistochemical analysis of 19 cases, with special reference to exuberant examples often confused with epithelioid hemangioendothelioma and epithelioid angiosarcoma. Am J Surg Pathol. 2004;28(4):523-33.

Angiolymphoid hyperplasia with eosinophilia: evidence for a T-cell lympho-proliferative origin.Hum Pathol. 2002;33(10):1023-9.

Angiolymphoid hyperplasia with eosinophilia: a classic clinical presentation with histologic features of angiosarcoma.Dermatol Surg. 2002 ;28(8):772-5.

Angiolymphoid hyperplasia with eosinophilia with bilateral involvement of the lacrimal glands. Klin Monatsbl Augenheilkd. 2002;219(5):376-9.

Polymerase chain reaction (PCR) for human herpesvirus 8 and heteroduplex PCR for clonality assessment in angiolymphoid hyperplasia with eosinophilia and Kimura's disease. J Cutan Pathol. 2001;28(7):363-7.

Traumatic pseudoaneurysm: a possible early lesion in the spectrum of epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia. Am J Dermatopathol. 1998;20(2):113-7.

Differential diagnosis of tumorous space-occupying lesions of the parotid gland: angiolymphoid hyperplasia with eosinophilia and Kimura disease. Laryngorhinootologie. 1997;76(2):110-5.

Angiolymphoid hyperplasia with eosinophilia and vascular tumors of the head and neck. Am J Otolaryngol. 1996;17(4):240-5.

Multiple angiolymphoid hyperplasia with eosinophilia of the hand: report of a case and review of the literature.Cutis. 1996;58(5):345-8

Kimura's disease and angiolymphoid hyperplasia with eosinophilia: new observations from immunohistochemical studies of lymphocyte markers, endothelial antigens, and granulocyte proteins. J Cutan Pathol. 1995;22(4):319-26.

Microcirculatory segments identified with monoclonal antibody against alpha-smooth muscle actin: comparison between Kimura's disease and angiolymphoid hyperplasia with eosinophilia. Acta Derm Venereol. 1995;75(1):15-8.

Kimura's disease and angiolymphoid hyperplasia with eosinophilia: clinical and histopathologic differences.J Am Acad Dermatol. 1992;27(6 Pt 1):954-8.

Estrogen receptors and the response to sex hormones in angiolymphoid hyperplasia with eosinophilia.Arch Dermatol. 1992;128(6):825-8.

The histiocytoid hemangiomas and other controversies. Pathol Annu.1992;27 Pt 2:51-87.

Observations concerning the pathogenesis of epithelioid hemangioma (angiolymphoid hyperplasia). Mod Pathol. 1991;4(4):449-55

Orbital angiolymphoid hyperplasia with eosinophilia. Presentation as chalazion. Ophthal Plast Reconstr Surg. 1991;7(3):208-21.

Angiolymphoid hyperplasia with eosinophilia of the hand. A case report.J Dermatol Surg Oncol. 1991;17(9):731-4

[Angiolymphoid hyperplasia with eosinophilia--report of a case with reference to the vascular changes and cell infiltrates in this disease].Nippon Hifuka Gakkai Zasshi. 1990;100(9):935-46.

A clinicopathological study of Kimura's disease and epithelioid hemangioma . Yonsei Med J. 1990;31(3):205-11.

Histiocytoid hemangioma: a disease spectrum. Report of a case with simultaneous cutaneous and bone involvement limited to one extremity. J Am Acad Dermatol. 1989;21(2 Pt 2):404-9.

Fine-needle aspiration cytology of angiolymphoid hyperplasia with eosinophilia: a case report with electron microscopy and immunohistochemistry.Diagn Cytopathol. 1989;5(1):88-94.

Epithelioid haemangioma (angiolymphoid hyperplasia with eosinophilia) and Kimura's disease in Chinese.Histopathology. 1989;15(6):557-74.

Kimura's disease. Involvement of regional lymph nodes and distinction from angiolymphoid hyperplasia with eosinophilia.Am J Surg Pathol. 1988;12(11):843-54.

Epithelioid hemangioma versus Kimura's disease. A comparative clinicopathologic study.Am J Surg Pathol. 1987;11(10):758-66.

Kimura's disease and angiolymphoid hyperplasia with eosinophilia: two distinct histopathological entities. J Cutan Pathol. 1987;14(5):263-71.

Oral angiolymphoid hyperplasia with eosinophilia.Oral Surg Oral Med Oral Pathol. 1986;61(1):73-9.

Renin in angiolymphoid hyperplasia with eosinophilia. Its possible effect on vascular proliferation. Arch Pathol Lab Med. 1986;110(12):1131-5.

Angiolymphoid hyperplasia with eosinophilia. A clinicopathologic study of 116 patients.J Am Acad Dermatol. 1985 ;12(5 Pt 1):781-96


               Disclaimer  Privacy Policy  ; Advertising Policy  ;  E-mail  .   

 Copyright 2014 histopathology-india.net
          All rights reserved