Angiolymphoid hyperplasia with eosinophilia of the tongue: report of a case and review of the literature

Angiolymphoid hyperplasia with eosinophilia in a hand treated with a reverse digital island flap and artificial skin: a case report

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.

Epithelioid hemangioma in the oral mucosa: A clinicopathological study of seven cases and review of the literature

To investigate the clinicopathological characteristics and biologic behavior of epithelioid hemangioma in oral mucosa, the clinical features and pathological findings of seven cases of epithelioid hemangioma were reviewed, and all sections were examined by immunohistochemistry. There were 4 males and 3 females ranged from 8 to 65 years (mean 39.7 years). Sites of origin included the tongue (n = 4), lips (n = 2), and palates (n = 1). Five lesions presented as a solitary mass. Three patients had history of minimal trauma. Histopathologically, well-formed but often immature vessels lined by plump epitholid endothelial cells with prominent inflammatory components were observed. Immunohistochemical staining revealed that tumour cells were positive for Vimentin, FVIIIRAg and CD34. All the cases were negative to S-100 protein and EMA. One case recurred after surgical excision, while none of them metastasized. Epithelioid hemangioma is a benign vascular anomaly, and has close relationship with local trauma. The differential diagnosis is usually based upon histopathological findings.

A case of angiolymphoid hyperplasia with eosinophilia (ALHE) of the upper lip

Angiolymphoid hyperplasia with eosinophilia (ALHE) is clinically characterized by intradermal or subcutaneous papules and/or nodules usually occurring in young adults. Lesions in the oral mucosa are extremely rare. We report a case and review the literature of ALHE cases involving the oral mucosa. A 40-year-old man presented with a painless, 20 x 20 mm, submucosal nodule on the upper lip. Histological examination of lip biopsy specimens revealed an increase in many small vessels. The vascular walls consisted of prominent endothelial cells with a histiocytoid appearance, which protruded into the lumen. Many eosinophils and lymphocytes were also seen around the vessels. The diagnosis of ALHE was made from the above findings.

Epithelioid hemangioma: Morphological presentation on aspiration smears

Epithelioid hemangioma (EH) or angiolymphoid hyperplasia with eosinophilia is an uncommon but distinctive lesion seen principally in the skin and subcutaneous tissue. The histopathology of this disease is very characteristic, but error in diagnosis is possible on cytopathology. There are very few case reports describing the cytomorphology of this lesion. We describe the findings of fine-needle aspiration of two cases of EH both arising in the subcutaneous tissue of the head and neck. Both the cases were misdiagnosed on cytology with one case being misinterpreted for an epithelioid sarcoma and the other for a reactive lymph node. The cytological findings of these cases are described and the problems encountered in the diagnosis of this entity are highlighted in this case report.

Angiolymphoid hyperplasia with eosinophilia of the tongue: report of a case and review of the literature

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon disorder manifested as solitary or multiple nodules in dermis and subcutaneous tissue of head and neck region. ALHE affecting tongue is very rare. We report a 56-year-old man with ALHE of the tongue and review the previously reported cases of ALHE of the tongue.

Angiolymphoid hyperplasia with eosinophilia: report of a lesion mimicking soft tissue tumor of extremely long duration

We present a large sized lesion of the right upper arm in which characteristics of the angiolymphoid hyperplasia with eosinophilia (ALHE) intermingled with those of Kimura's disease (KD). The laboratory findings, the prominent vascular proliferation and the features of endothelial cells were suggestive of ALHE. However, the long duration of the disease, the site of involvement, the abundant lymphoid component forming lymph follicles with germinal centers and the fibrosis are features of KD. In agreement with other reports, our case shows that clinicopathologically there is an overlap between ALHE and KD.

Epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) in the oral mucosa. A case report and review of the literature

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign uncommon entity whose aetiology and pathogenesis is under debate. Clinically, it is characterised by cutaneous papules or nodules. Cases of this entity reported in the oral mucosa are very rare. We describe such a case, discuss the problems of histological differential diagnosis between ALHE and other diseases of the region and review the literature.

Traumatic pseudoaneurysm: a possible early lesion in the spectrum of epithelioid hemangioma/angiolymphoid hyperplasia with eosinophilia

We describe a vascular lesion that develops secondary to trauma (pseudotraumatic aneurysm) and study its relation to epithelioid hemangioma (EH)/angiolymphoid hyperplasia with eosinophilia (ALHE). Four lesions are described, all with a distinct history of trauma to the site from which they arose. They presented with masses in the subcutaneous tissue of the head. They were studied by immunohistochemical methods to identify their component cells. The lesions all demonstrated marked thickening of the wall of small and medium-sized arteries, with capillary vascular proliferations. One lesion demonstrated increased eosinophils. Myxoid changes were noted in all lesions. We hypothesize that these lesions may represent an early form of EH/ALHE.

Angiolymphoid hyperplasia with eosinophilia in the colon: a novel cause of rectal bleeding

Angiolymphoid hyperplasia with eosinophilia (epithelioid haemangioma) is an uncommon but distinctive lesion seen principally in the skin. A case of severe gastrointestinal haemorrhage in a 63 year old male is reported, which necessitated a right hemicolectomy. A lobulated nodule was seen macroscopically that had the histological appearance of angiolymphoid hyperplasia with eosinophilia, with sheets of lymphocytes and eosinophils associated with many vessels showing plump and pleomorphic endothelial cells. This is the first reported case of this entity in the large intestine.

Eosinophilic ulcer of the oral mucosa

BACKGROUND

The eosinophilic ulcer is a rare lesion of the oral mucosa that has been infrequently described in the literature.

OBJECTIVE

We attempted to characterize the history, demographics, clinical features, histologic features, pathogenesis, and treatment of the eosinophilic ulcer.

METHODS

We observed three new cases of eosinophilic ulcer and reviewed the English-language literature.

RESULTS

Eosinophilic ulcer occurs in any age group, without sex preference. The most common site in the oral cavity is the tongue, and the average size at diagnosis is 1.6 cm2. These lesions are often ulcerated, may be tender, and are sometimes multiple. The histologic features are characteristic but likely represent a spectrum of related disorders. Most eosinophilic ulcers will resolve spontaneously within a month. Recurrences are uncommon (< 15%).

CONCLUSION

The eosinophilic ulcer is a benign, self-limited, reactive process of the oral mucosa of unknown origin. Its histologic features are characteristic but may be confused with atypical histiocytic granuloma and angiolymphoid hyperplasia with eosinophilia or, more importantly, lymphoma. This condition most likely represents a spectrum of related disorders with overlapping clinical and histologic features. After the diagnosis has been histologically confirmed, conservative management is suggested.