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Sarkar N, Dash S, Behera B, Sethy M, Ayyanar P. Exophytic proliferative nodule on the scalp of a child. Pediatr Dermatol 2024. [PMID: 38632830 DOI: 10.1111/pde.15627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/31/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Namrata Sarkar
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Rishikesh, India
| | - Siddhartha Dash
- Department of Dermatology and Venereology, SCB Medical College & Hospital, Cuttack, India
| | - Biswanath Behera
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Madhusmita Sethy
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pavithra Ayyanar
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
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Carvalho Lujan RA, de Melo Mascarenhas DA, de Amorim Aquino M, Costa Menezes A, Pereira de Souza Filho ML, Costa Sampaio Silva F, Godeiro Fernandez M, Silveira Alves CA, Aras Júnior R. Angiolymphoid Hyperplasia With Temporal Artery Eosinophilia: A Case Report. Vasc Endovascular Surg 2024; 58:95-99. [PMID: 37378998 DOI: 10.1177/15385744231184333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Angiolymphoid Hyperplasia with Eosinophilia (ALHE) is a benign vascular proliferative disorder with uncertain etiology and pathogenesis. The aim of this paper is to report a case of ALHE in the temporal artery and discuss the general aspects of this pathology. A 29-year-old female black patient sought the Vascular Surgery Outpatient Service, complaining of bulging in the right temporal region, associated with pain and local discomfort. Physical examination revealed pulsatile bulging in the right temporal region measuring approximately 2.5 × 1.5 cm. Nuclear Magnetic Resonance showed an expansive fusiform lesion in the superficial soft parts of the right temporal region, measuring 2.9 cm in the longest longitudinal axis. Surgical excision proved to be the best therapeutic option for the patient in this case. Histopathological sections showed the proliferation of vessels of different sizes, covered by swollen endothelium, prominent inflammatory infiltrate composed of lymphocytes, plasma cells, eosinophils, and scarce histiocytes. Immunohistochemical analysis of the lesion showed positivity for CD31, corroborating the diagnosis of ALHE.
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Affiliation(s)
- Ricardo Augusto Carvalho Lujan
- Vascular Surgery Division, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Maurício de Amorim Aquino
- Vascular Surgery Division, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Aline Costa Menezes
- Vascular Surgery Division, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Fernanda Costa Sampaio Silva
- Postgraduate Program in Medicine and Health, Faculty of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Carlos Alberto Silveira Alves
- Vascular Surgery Division, Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Roque Aras Júnior
- Postgraduate Program in Medicine and Health, Faculty of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil
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Angiolymphoid hyperplasia with eosinophilia: a case series and literature review. Int Ophthalmol 2023:10.1007/s10792-023-02644-y. [PMID: 36869976 DOI: 10.1007/s10792-023-02644-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/19/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE Angiolymphoid hyperplasia with eosinophilia is an uncommon chronic inflammatory condition of unknown etiology. Orbital and adnexal involvement findings are variable and often nonspecific. METHODS AND RESULT We report six patients with angiolymphoid hyperplasia of the orbit, their clinical and histopathological characteristics, and a review of previously published literature with this diagnosis between 1980 and 2021. CONCLUSION ALHE has definite histopathologic features but inconclusive radiological studies. The ophthalmologic findings of this entity overlap significantly with other similar variants and may be thought as equivalent lesions.
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Luzar B, Ieremia E, Antonescu CR, Zhang L, Calonje E. Cutaneous intravascular epithelioid hemangioma. A clinicopathological and molecular study of 21 cases. Mod Pathol 2020; 33:1527-1536. [PMID: 32094426 PMCID: PMC8360210 DOI: 10.1038/s41379-020-0505-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/09/2022]
Abstract
Pure intravascular growth of epithelioid hemangioma (EH) is exceptional. Herein, we report a series of 21 intravascular EHs, representing a potential serious diagnostic pitfall by mimicking malignant vascular neoplsms with epithelioid morphology. The tumors developed in 12 males and 4 females, aged from 11 to 71 years (mean age 40.2 years) with a predilection for the extremities (13 of 21, 61.9%), followed by the head and neck (8 of 21, 38.1%). Lesions ranged in size from 2 to 30 mm (mean size 13 mm). The most common presenting feature was a slowly growing nodule. Most neoplasms were solitary (13 of 16 patients, 81.2%) but three patients developed more than one intravascular EH (3 of 16, 18.8%). Treatment consisted of complete surgical excision and was generally curative. Follow-up was available for 13 lesions that had developed in ten patients (range 4-72 months, mean 27.3 months). No recurrences or development of additional tumors were observed. All 21 lesions developed in subcutaneous veins. Two morphological patterns of intravascular epithelioid endothelial cell proliferation were observed: (1) a lobular capillary hemangioma-like proliferation with variable formation of open vascular lumina and (2) a solid proliferation generally lacking open vascular spaces. A lobular capillary hemangioma-like pattern was the sole pattern in nine lesions, a mixed lobular hemangioma-like pattern, and solid pattern in eight and a pure solid pattern in four intravascular EHs. Mitotic activity in epithelioid endothelial cells ranged from 0 to 7 mitoses per 10 high-power field (mean 2.1 mitoses per 10 HPFs). Six lesions displayed brisk mitotic activity of five or more mitoses per 10 HPF (6 of 21, 28.5%). The number of mitoses was usually more prominent in areas with solid growth. Atypical mitoses were not observed. No intratumoral necroses were seen. Cytological atypia was mild (20 out of 21 cases). By immunohistochemistry, all tumors were positive for CD31 (14 out of 14) and ERG (5 out of 5). While all tested cases were FOS negative by immunohistochemistry (6 out of 6), one out of six cases (case 6) displayed FOSB nuclear positivity in about 30% of the lesional endothelial cells. Eight cases were analysed by FISH for the presence of FOS and FOSB gene rearrangements. While all cases were negative for FOSB rearrangements, a single case proved positive for FOS gene break-apart. In conclusion, intravascular growth of EH is not associated with adverse biological behavior. Solid intravascular proliferations of endothelial cells can mimic a malignant vascular tumor with epithelioid morphology. Nevertheless, intravascular EHs display mild cytological atypia coupled with low mitotic activity, and a lack of atypical mitoses, pronounced nuclear atypia, multilayering or tumor necrosis. Finally, the FOS gene is infrequently rearranged, and there are no FOSB gene abnormalities in this subset of EHs, suggesting a potential distinct pathogenesis than most classic EHs.
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Affiliation(s)
- Boštjan Luzar
- Institute of Pathology, Medical Faculty, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia
| | - Eleni Ieremia
- Department of Pathology, Oxford University Hospital, Oxford, United Kingdom
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lei Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eduardo Calonje
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas's Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
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Papke DJ, Hornick JL. What is new in endothelial neoplasia? Virchows Arch 2019; 476:17-28. [DOI: 10.1007/s00428-019-02651-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/30/2019] [Accepted: 08/13/2019] [Indexed: 12/22/2022]
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Hypervascular Pseudonodular Plaque-Like Ultrasound Morphology in Angiolymphoid Hyperplasia. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Oka N, Nishimura S, Tanaka H, Hashimoto K, Kakinoki R, Akagi M. Angiolymphoid hyperplasia with eosinophilia in a hand treated with a reverse digital island flap and artificial skin: a case report. J Med Case Rep 2019; 13:87. [PMID: 30914066 PMCID: PMC6436222 DOI: 10.1186/s13256-019-2021-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Angiolymphoid hyperplasia with eosinophilia is a rare nodular skin tumor characterized by eosinophilic invasion and vascular proliferation. Previous reports suggested that irritation and inflammation are the causative factors of this disease. Most cases of angiolymphoid hyperplasia with eosinophilia occur around the auricle, forehead, and scalp; the hand is rarely affected. Moreover, the tumor seldom presents as multiple nodules. CASE PRESENTATION A 67-year-old Japanese woman presented with a complaint of skin masses on her left thumb and index finger, which had gradually grown in size over the past few months. A biopsy was performed confirming a diagnosis of angiolymphoid hyperplasia with eosinophilia. The aponeurosis on her index finger was resected and tissue was reconstructed using a reverse palmar digital island flap harvested from the base of her index finger. The thumb lesion was also resected and covered with collagen-based artificial skin. Gradual progression of skin epithelialization followed by healing was noted 2 months after the surgery. CONCLUSION Angiolymphoid hyperplasia with eosinophilia is a rare tumor; it is seldom seen in the hands. It is generally treated by surgical resection. It is important to resect a sufficiently large area of the tissue due to the possibility of relapse in some cases. Furthermore, appropriate reconstruction is mandatory after wide margin tumor resection.
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Affiliation(s)
- Naohiro Oka
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Shunji Nishimura
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Hiroki Tanaka
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Kazuhiko Hashimoto
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Ryosuke Kakinoki
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Masao Akagi
- Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
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Oral lymphoid lesions: a 47-year clinicopathological study in a Brazilian population. Med Mol Morphol 2018; 52:123-134. [PMID: 30382358 DOI: 10.1007/s00795-018-0210-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/25/2018] [Indexed: 01/25/2023]
Abstract
We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior.
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Wortsman X, Yagnam M, Carreño L. Hypervascular Pseudonodular Plaque-Like Ultrasound Morphology in Angiolymphoid Hyperplasia. ACTAS DERMO-SIFILIOGRAFICAS 2018; 110:303-307. [PMID: 30301512 DOI: 10.1016/j.ad.2017.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/13/2017] [Accepted: 09/23/2017] [Indexed: 11/20/2022] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular proliferation characterized by solitary or multiple angiomatous lesions. It is most common in young or middle-aged women, and the lesions typically affect the head and neck, showing a particular predilection for the periauricular region. The differential diagnosis in patients with ALHE is broad and includes both benign and malignant conditions. We report on a series of cases of periauricular ALHE in which ultrasound imaging revealed an hypervascular, pseudonodular and plaque-like morphology with clinical and histologic correlations. It also evidenced vascular communication between lesions that appeared to be separate on clinical examination. Familiarity with such ultrasound presentations could help to improve diagnostic accuracy and facilitate disease monitoring in patients with ALHE.
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Affiliation(s)
- X Wortsman
- Instituto de Investigación y Diagnóstico por Imágenes en Piel y Tejidos Blandos-IDIEP, Santiago, Chile; Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
| | - M Yagnam
- Departamento de Dermatología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Carreño
- Sección de Dermatopatología, Departamento de Anatomía Patológica, Hospital Clínico Universidad de Chile, Universidad de Chile, Santiago, Chile
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Bahloul E, Amouri M, Charfi S, Boudawara O, Mnif H, Boudawara T, Turki H. Angiolymphoid hyperplasia with eosinophilia: report of nine cases. Int J Dermatol 2017; 56:1373-1378. [DOI: 10.1111/ijd.13800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 07/25/2017] [Accepted: 09/14/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Emna Bahloul
- Department of Dermatology; Hedi Chaker Hospital; Sfax Tunisia
| | - Meriem Amouri
- Department of Dermatology; Hedi Chaker Hospital; Sfax Tunisia
| | - Slim Charfi
- Department of Anatomopathology; Habib Bourguiba Hospital; Sfax Tunisia
| | - Ons Boudawara
- Department of Anatomopathology; Habib Bourguiba Hospital; Sfax Tunisia
| | - Hela Mnif
- Department of Anatomopathology; Habib Bourguiba Hospital; Sfax Tunisia
| | - Tahya Boudawara
- Department of Anatomopathology; Habib Bourguiba Hospital; Sfax Tunisia
| | - Hamida Turki
- Department of Dermatology; Hedi Chaker Hospital; Sfax Tunisia
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Rodríguez-Lomba E, Avilés-Izquierdo JA, Molina-López I, Parra-Blanco V, Lázaro-Ochaita P, Suárez-Fernández R. Dermoscopic features in 2 cases of angiolymphoid hyperplasia with eosinophilia. J Am Acad Dermatol 2016; 75:e19-21. [PMID: 27317536 DOI: 10.1016/j.jaad.2016.02.1145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Irene Molina-López
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Verónica Parra-Blanco
- Department of Histopathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Pablo Lázaro-Ochaita
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Epidemiology and treatment of angiolymphoid hyperplasia with eosinophilia (ALHE): A systematic review. J Am Acad Dermatol 2015; 74:506-12.e11. [PMID: 26685720 DOI: 10.1016/j.jaad.2015.10.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/18/2015] [Accepted: 10/12/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Current knowledge of angiolymphoid hyperplasia with eosinophilia (ALHE) derives from retrospective reports and case series, leading to a nonevidence-based treatment approach. OBJECTIVE We sought to systematically review the literature relating to cutaneous ALHE to estimate its epidemiology and treatment outcomes. METHODS A literature search of PubMed, EMBASE, Web of Science, and Google Scholar was conducted. Articles detailing cases of histologically confirmed cutaneous ALHE were included. RESULTS In all, 416 studies were included in the review, representing 908 patients. There was no sex predominance among patients with ALHE. Mean age at presentation was 37.6 years. There was a significant association between presence of multiple lesions and pruritus, along with bleeding. Surgical excision was the most commonly reported treatment for ALHE. Treatment failure was lowest for excision and pulsed dye laser. Mean disease-free survival after excision was 4.2 years. There were higher rates of recurrence postexcision with earlier age of onset, longer duration of disease, multiple lesions, bilateral lesions, pruritus, pain, and bleeding. LIMITATIONS Potential for publication bias is a limitation. CONCLUSIONS Surgical excision appears to be the most effective treatment for ALHE, albeit suboptimal. Pulsed dye and other lasers may be effective treatment options. More studies are needed to improve the treatment of ALHE.
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