External ear tumors - benign / nonneoplastic

Angiolymphoid hyperplasia with eosinophilia

Last author update: 1 October 2013
Last staff update: 16 May 2022

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PubMed Search: Angiolymphoid hyperplasia with eosinophilia ear

Nat Pernick, M.D.
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Cite this page: Pernick N. Angiolymphoid hyperplasia with eosinophilia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earangiolymphoidhyperplasia.html. Accessed June 3rd, 2023.
Definition / general
Case reports
  • Local excision or laser desiccation are usually curative
Gross description
  • Pink / red / brown cutaneous papules or subcutaneous nodules up to 1 cm
  • May coalesce to form plaque like lesions
Gross images

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Papule on ear

Microscopic (histologic) description
  • Unencapsulated but circumscribed
  • Dermal, nodular proliferation of granulation type tissue with haphazard, small caliber, irregularly shaped blood vessels with epithelioid endothelial cells containing hyperchromatic nuclei
  • Patchy lymphocytes, eosinophils and histiocytes
Cytology description
  • Vascular structures, eosinophils, lymphocytes and clusters of cuboidal cells with vacuoles in abundant acidophilic cytoplasm (Diagn Cytopathol 1998;18:227)
  • No evidence of malignancy
Differential diagnosis
  • Angiosarcoma:
    • Anastomosing vascular channels lined by pleomorphic cells with increased mitotic activity, no inflammatory infiltrate
  • Hemangioma:
    • No epithelioid endothelial cells, no inflammatory infiltrate
  • Kimura disease:
    • Large, deep, subcutaneous plaques in young Asian men, often regional lymphadenopathy, peripheral blood eosinophilia and elevated serum IgE levels
    • Prominent lymphoid follicles and fibrosis with less prominent capillary proliferation, no aggregates of noncanalized endothelial cells
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