Ear
External ear tumors - benign / nonneoplastic
Angiolymphoid hyperplasia with eosinophilia
Author: Nat Pernick, M.D.
Last author update: 1 October 2013
Last staff update: 16 May 2022
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Angiolymphoid hyperplasia with eosinophilia ear
Table of Contents
Definition / general | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Cytology description | Differential diagnosisCite this page: Pernick N. Angiolymphoid hyperplasia with eosinophilia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earangiolymphoidhyperplasia.html. Accessed June 3rd, 2023.
Definition / general
- Also called epithelioid (histiocytoid) hemangioma
- Rare, benign angiomatous subcutaneous process, usually of auricle and external canal; also elsewhere in head and neck (eMedicine: Angiolymphoid Hyperplasia With Eosinophilia [Accessed 16 May 2022])
- Usually men and women in 20's to 40's, may have history of trauma
- Symptoms: pruritis and bleeding after scratching
Case reports
- 43 year old woman with 20 year history of lesions (Dermatol Online J 2002;8:10)
- 33 year old woman with auricular nodule during pregnancy (Arch Pathol Lab Med 2005;129:1168)
- 89 year old man with angiolymphoid hyperplasia with eosinophilia associated to a squamous cell carcinoma of the ear (Dermatol Surg 2004;30:1367)
Treatment
- 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
Images hosted on other servers:
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
