Cutaneous Vascular Hyperplasias

Abstract

Angiolymphoid hyperplasia with eosinophilia (AHE) was first described by Wells and Whimster in 1969 (1). These authors considered the process to be a late stage of Kimura’s disease, a disorder described in the Japanese literature 20 years earlier (2). Following this description, the concept that AHE and Kimura’s disease were the same entity was widely accepted. It later became clear that the entities are different, and currently most authors believe that AHE and Kimura’s disease are two separate entities (3–8). To complicate the issue further, different names have been used to describe AHE, to wit: atypical pyogenic granuloma (9), pseudopyogenic granuloma (10), inflammatory angiomatous nodule (10), papular angioplasia (11), inflammatory arteriovenous hemangioma (12), intravenous atypical vascular proliferation (13), cutaneous histiocytoid hemangioma (7,14), and epithelioid hemangioma (15). Many of these terms are confusing and in our opinion it is best not to apply them to this particular entity. Take for example the term histiocytoid hemangioma (14). This term has been used to describe a wide spectrum of vascular proliferations, both benign and malignant, all of which are histopathologically characterized by the presence of endothelial cells with a histiocytoid appearance. Because this term is not specific and does not designate a single entity it is better not to use it. Another confusing term is epithelioid hemangioma (15), since it can be confused with epithelioid hemangioendothelioma, an entirely different clinicopathologic entity.