Subcutaneous angiolymphoid hyperplasia with eosinophilia.

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SUMMARY.— Persistent subcutaneous nodules on the head and neck with distinctive histological features of angiolymphoid hyperplasia with eosinophilia are reported in nine patients. They were all young adults and had one or more lesions ranging from 1 to 10 cm. in diameter. Apart from blood eosinophilia, there were no systemic manifestations. While some lesions persisted for several years, the condition appears to be benign. The nodules lie mainly in the sub-cutis but sometimes extend into the overlying dermis and deeply into muscle or fascia. They are composed of unencapsulated masses of angiolymphoid hyperplasia with the following components: 1. Exuberant proliferation of capillary vessels, often with imperfectly canalized masses of endothelium. 2. Massive infiltration with eosinophils and an excess of mast cells. 3. Reticulin formation but little collagenous fibrosis. 4. Lymphoreticular hyperplasia, increasing with the duration of the lesion and leading to lymphoid follicle formation in lesions of one year or more duration. The clinical and histological features suggest enough common ground for regarding subcutaneous angiolymphoid hyperplasia with eosinophilia as a distinct pathological entity. Its relation to Kimura's disease as described in Japan is discussed.