A Rare Case of Angiolymphoid Hyperplasia without Eosinophils, with Review of the Literature

James Ko,Zachary P Nahmias,Andras Schaffer,Kara Blackwell,Patrick S Phelan,Sabra Abner

doi:10.25251/skin.4.5.15

Abstract

The epithelioid hemangioma, more commonly termed angiolymphoid hyperplasia with eosinophils, is a pathologic vascular proliferation characterized by a distinctive eosinophil-rich mixed inflammatory infiltrate. A nonspecific accompanying infiltrate has only rarely been reported, and may confound the diagnosis of this benign process with malignant mimics. We present such a case of angiolymphoid hyperplasia without eosinophils, and consider its diagnosis and pathogenesis within the spectrum of related entities.

Highlights

A 44-year-old female with a past medical history of a basal cell carcinoma was initially seen for a rapidly growing lesion located on the neck that was present for two months
Known as “epithelioid hemangioma,” ALHE may be accompanied on the histiocytoid hemangioma spectrum by such conditions as Kimura disease, pseudopyogenic or atypical pyogenic granuloma, papular angioplasia, inflammatory hemangioma, inflammatory angiomatoses, and atypical vascular proliferation with inflammation, among others.[4]
-called pseudolymphomatous angiokeratoma features endothelial cell proliferation with morphology that has been likened to highendothelial venules (HEVs).[6]

Summary

Introduction

A 44-year-old female with a past medical history of a basal cell carcinoma was initially seen for a rapidly growing lesion located on the neck that was present for two months. Physical examination revealed a 6-mm red papule on the neck, yielding a differential diagnosis of a pyogenic granuloma versus basal cell carcinoma (Figure 1).

Results

Conclusion