engleski

Angiolymphoid hyperplasia with eosinophilia (epitheloid hemangioma) of the orbit

Background: Angiolymphoid hyperplasia with eosinophilia (ALHE) is the same condition as epitheloid hemangioma. It is an uncommon vascular tumor that occurs in the orbit extremely rarely. The main differential diagnosis is Kimura's disease (KD). We present a case of an ALHE of the orbit and discuss main differences between ALHE and KD. Case Presentation: An 83-year-old patient presented with a subcutaneous mass of the left lower eyelid. Magnetic resonance imaging revealed a tumor in the left orbit and lower eyelid. An inferior orbitotomy was performed with tumor excision. Histopathological evaluation revealed a lobulated tumor measuring 2.5x2x0.8 cm, composed of proliferated blood vessels of varying caliber, lined by plump endothelial cells with large cytoplasmic vacuoles. The stroma contained numerous lymphatic follicles with prominent germinal centers and large proportion of eosinophils. The diagnosis of ALHE was made. Discussion: ALHE was first characterized by Wells and Whimster and the term epitheloid hemangioma was introduced by Enzinger and Weiss. ALHE shares some features with KD. However, they can be distinguished microscopically: ALHE has swollen, vacuolated endothelial cells ; endothelial cells in KD are attenuated, without cytoplasmic vacuoles. Moreover, KD has systemic manifestations. ALHE is treated with surgical excision with approximately 33% recurrence rate.

Angiolymphoid hyperplasia; eosinophilia

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