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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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Biro A, Ternyik L, Czoma V, Hegedűs G, Bálint I, Tóth D, Káposztás Z. Epithelioid hemangioma of liver-The first reported case. INDIAN J PATHOL MICR 2021; 64:S143-S145. [PMID: 34135157 DOI: 10.4103/ijpm.ijpm_148_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Epithelioid hemangioma, otherwise known as angiolymphoid hyperplasia with eosinophilia, is a rare benign vasoproliferative disease with an unknown etiology. We report the case of a 42-year-old man with routine bloods test showing mildly elevated serum bilirubin level. CT scan revealed a lesion in the left liver lobe not typical of FNH. PET/CT scan and a dynamic liver MRI were consistent with a malignant mass. Surgical resection was performed. Histopathology of the 45 mm mass reported well-defined, slightly lobular proliferations of capillary-sized vessels around several central muscular vessels. Although the endothelial cells revealed a "hobnail" appearance, none of them showed pleomorphism or mitotic activity. Endothelial cells showed reactivity for the endothelial markers (CD34, CD31) and smooth muscle was detected in the blood vessel walls via immunohistochemistry. Despite its benign nature, epithelioid hemangioma of the liver can lead to a diagnostic and therapeutic dilemma due to the malignant looking features on imaging modalities.
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Affiliation(s)
- Adrienn Biro
- Department of Surgery, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400; Doctoral School of Clinical Medicine of University of Debrecen, Debrecen, 1. Egyetem Square, Debrecen 4032, Hungary
| | - László Ternyik
- Department of Surgery, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400, Hungary
| | - Veronika Czoma
- Department of Pathology, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400, Hungary
| | - Géza Hegedűs
- Department of Pathology, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400, Hungary
| | - István Bálint
- Department of Surgery, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400, Hungary
| | - Dezső Tóth
- Department of Surgery, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, 72-76. Szentpéteri Gate, Miskolc 3526, Hungary
| | - Zsolt Káposztás
- Department of Surgery, Moritz Kaposi General Hospital, Kaposvár, 20-32. Tallián Gy. Street, Kaposvár 7400, Hungary
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Bastos JTD, Rocha CRMD, Silva PMCE, Freitas BMPD, Cassia FDF, Avelleira JCR. Angiolymphoid hyperplasia with eosinophilia versus Kimura's disease: a case report and a clinical and histopathological comparison. An Bras Dermatol 2018; 92:392-394. [PMID: 29186256 PMCID: PMC5514584 DOI: 10.1590/abd1806-4841.20175318] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/15/2016] [Indexed: 11/22/2022] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor
whose etiology remains uncertain. It clinically presents itself by angiomatous
papules or nodules located on the head and neck. Many controversies in the
literature are found in relation to angiolymphoid hyperplasia with eosinophilia
and Kimura's disease - its main differential diagnosis - due to their clinical
and histopathological similarities. However, currently, most studies agree that
they are distinct diseases. The present case illustrates a characteristic
description of angiolymphoid hyperplasia with eosinophilia and also highlights
the main differences with Kimura's disease.
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Esteves P, Barbalho M, Lima T, Quintella L, Niemeyer-Corbellini JP, Ramos-E-Silva M. Angiolymphoid Hyperplasia with Eosinophilia: A Case Report. Case Rep Dermatol 2015; 7:113-6. [PMID: 26120306 PMCID: PMC4478319 DOI: 10.1159/000381843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Angiolymphoid hyperplasia with eosinophilia is a rare disease considered as being a vascular malformation resulting from a subjacent arteriovenous shunt. It affects mostly the head of women between 20 and 40 years old and may present spontaneous involution.
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Affiliation(s)
- Paola Esteves
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcella Barbalho
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tiago Lima
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Quintella
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Manton RN, Itinteang T, de Jong S, Brasch HD, Tan ST. Angiolymphoid hyperplasia with eosinophilia developing within a port wine stain. J Cutan Pathol 2015; 43:53-6. [PMID: 26010041 DOI: 10.1111/cup.12539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 05/08/2015] [Accepted: 05/17/2015] [Indexed: 01/20/2023]
Abstract
A 19-year-old male with a port wine stain on the base of his neck presented with a 5-month history of gradual thickening of the involved skin which interfered with clothing and caused repeated bleeding. The lesion was excised and histopathologic examination revealed angiolymphoid hyperplasia with eosinophilia (ALHE) arising from the pre-existing port wine stain - a rare finding with only one previously reported case. Additionally the lesion was associated with elevated serum renin levels which virtually normalized following excision of the lesion. We further demonstrated the expression of angiotensin converting enzyme and angiotensin II receptors 1 and 2 by the lesion and discuss the possible role of the renin-angiotensin system in this condition.
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Affiliation(s)
- Robert N Manton
- Centre for the Study & Treatment of Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand
| | | | - Sophie de Jong
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | - Helen D Brasch
- Gillies McIndoe Research Institute, Wellington, New Zealand.,Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - Swee T Tan
- Centre for the Study & Treatment of Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand.,Gillies McIndoe Research Institute, Wellington, New Zealand
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Sotiriou E, Apalla Z, Patsatsi A, Devliotou Panagiotidou D, Ioannides D. Angiolymphoid hyperplasia with eosinophilia: good response to photodynamic therapy. Clin Exp Dermatol 2009; 34:e629-31. [DOI: 10.1111/j.1365-2230.2009.03348.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Concomitant occurrence of kimura disease and mycosis fungoides in a Lebanese woman: significance and response to rituximab. Am J Dermatopathol 2009; 31:814-8. [PMID: 19786854 DOI: 10.1097/dad.0b013e3181acedf8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Kimura disease (KD) is a rare condition that predominantly affects young middle-aged Asian men. It is classically characterized by tumors in the head and neck region with associated eosinophilia and elevated serum immunoglobulin E levels. The exact pathogenesis of this condition remains unknown. Although some regard it as a reactive condition, others believe that it is a T-cell-mediated disease. T-cell clonality has been recently demonstrated in a few cases. We report a 37-year-old Lebanese woman who had both KD and mycosis fungoides (MF). T-cell receptor gene rearrangement studies using 2 different techniques did not detect any clonality for T-cell receptor in both KD and MF lesions. Due to the presence on histology of lymphoid follicles and the persistent high serum immunoglobulin E levels, we elected to attempt treatment with rituximab. Although the KD lesions persisted, they became softer and less nodular. As for the MF lesions, they flared transiently and then exhibited a sustained improvement over a follow-up period of 1 year.
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Varshney MK, Kumar A, Khan SA, Yadav CS. Kimura disease of extremity: Unusual manifestation in a long bone. Joint Bone Spine 2008; 75:492-4. [DOI: 10.1016/j.jbspin.2007.07.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Accepted: 07/17/2007] [Indexed: 11/30/2022]
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Filho RRDC, de Almeida HL. Angiolymphoid hyperplasia with eosinophilia: excellent response to intralesional triamcinolone. Braz J Otorhinolaryngol 2008; 74:160. [PMID: 18392522 PMCID: PMC9450576 DOI: 10.1016/s1808-8694(15)30771-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2006] [Accepted: 11/08/2006] [Indexed: 11/03/2022] Open
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