J Korean Ophthalmol Soc.  2012 May;53(5):712-715.

A Case of Angiolymphoid Hyperplasia with Eosinophilia (ALHE) of the Eyelid

• Yoon JH
• Chi M

Abstract

PURPOSE
The authors of the present study describe a rare case of angiolymphoid hyperplasia with eosinophilia (ALHE) of the eyelid.
CASE SUMMARY
A 63-year-old male who was diagnosed with ALHE based on biopsy of an inguinal mass presented with an eyelid mass of 1 month duration. A light brown, solitary, 1.0 x 0.5 cm-sized mass involved the right upper eyelid. There was no lymphadenopathy, but eosinophilia was present. An excisional biopsy of the mass was performed for diagnosis and management. Macroscopic examination of the excised mass revealed a well-defined, smooth, firm, yellowish-red colored lesion measuring 1.0 x 0.6 x 0.5 cm. Histopathology showed the proliferation of small blood vessels, many of which were lined by enlarged endothelial cells with uniform ovoid nuclei and intracytoplasmic vacuoles. The distinctive endothelial cells were described as having a cobblestone appearance. In addition, a perivascular and interstitial infiltrate composed primarily of lymphocytes and eosinophils was present. ALHE was finally confirmed with clinical and microscopic examination.
CONCLUSIONS
The authors of the present study report a rare case of ALHE of the eyelid and suggest that a differential diagnosis should be considered.

Keyword

Angiolymphoid hyperplasia with eosinophilia; Cobblestone appearance; Enlarged endothelial cell; Eyelid mass; Lymphadenopathy

MeSH Terms

Angiolymphoid Hyperplasia with Eosinophilia
Biopsy
Blood Vessels
Diagnosis, Differential
Endothelial Cells
Eosinophilia
Eosinophils
Eyelids
Humans
Light
Lymphatic Diseases
Lymphocytes
Male
Middle Aged
Vacuoles

Figure

• 

  Figure 1 A relaltively well-demarcated, erythematous, firm, subcutaneous nodule in the upper eyelid.

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  Figure 2 A yellowish red color mass (size 1.0 × 0.6 × 0.5 cm).

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  Figure 3 There is marked proliferation of irregular vascular channels surrounded by perivascular lymphocytic infiltration with eosinophils (H&E, ×200).

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  Figure 4 The vascular channels are lined by round and cuboidal endothelial cells, which have protruded into the lumens of the vessels (H&E, ×200).

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