A Clinicopathologic Study of 15 Cases of Angiolymphoid Hyperplasia with Eosinophilia

Choi, Yoon Jin; Roh, Mi Ryung; Lee, Min Geol

Abstract

BACKGROUND: Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon distinctive vascular lesion characterized by proliferation of endothelial cells. Because of its rarity, the clinical and pathological aspects of ALHE have not been fully studied in Korea.
OBJECTIVE
The purpose of our investigation was to describe the clinical and pathological characteristics of ALHE.
METHODS
We reviewed the medical records, clinical photographs and histological slides of 15 patients who were diagnosed as ALHE at Severance hospital.
RESULTS
Of the 15 patients, 60% were men and 40% women. The average onset age of men was 53.7 years, women 33.2 years. Overall average onset age was 45.5 years. The scalp was the most frequently involved site in ALHE. Pruritus was the most common symptom. Two of four patients demonstrated peripheral blood eosinophilia and one patient showed elevation of serum IgE. The essential microscopic features of the fifteen lesions of ALHE were epithelioid proliferation of endothelial cells and perivascular inflammatory infiltration with eosinophils and lymphocytes. Four patients underwent surgery as their sole treatment modality and there were no recurrences. Other treatment modalities were topical steroid, intralesional injection of triamcinolone, systemic steroid, and 5% imiquimod cream.
CONCLUSION
The clinical and pathological features of patients in this survey differ from previous studies in the age of onset, gender distribution, and anatomical distribution. Men were more affected (60%) than woman (40%), and the average age of onset was 45.5 years. The scalp and extremities were the most frequently involved sites. Surgery was the treatment of choice in ALHE. However, the clinical findings of ALHE need to be further evaluated in larger groups of patients.