Angiolymphoid hyperplasia with eosinophils pathology

Author: A/Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2013.

Angiolymphoid hyperplasia with eosinophilia (or eosinophils) is also known as epithelioid or histiocytoid haemangioma. It usually effects young adults and presents as clustered small, translucent nodules on the head and neck.

Histology of angiolymphoid hyperplasia with eosinophils

Sections show an inflamed dermis which shows increased vascularity (figure 1). Higher power examination reveals the endothelial cells lining the vessels are enlarged and epithelioid (figure 2, 3). The infiltrate is composed of lymphocytes which form follicles and numerous eosinophils (figures 2, 3).

Special studies of angiolymphoid hyperplasia with eosinophils

None are generally needed.

Differential diagnosis of angiolymphoid hyperplasia with eosinophils

Kimura disease – Can closely resemble angiolymphoid hyperplasia with eosinophilia. Eosinophilic abscess, eosinophils infiltrating germinal centers and dermal sclerosis are more common in Kimura disease. The vessels of Kimura disease generally lack an epithelioid endothelial lining.

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