Skin nonmelanocytic tumor
Vascular tumors
Hemangioma variants
Epithelioid hemangioma / angiolymphoid hyperplasia with eosinophils
Author: Christopher S. Hale, M.D.
Topic Completed: 1 July 2012
Minor changes: 16 April 2019
Copyright: 2003-2019, PathologyOutlines.com, Inc.
PubMed search: epithelioid [title] hemangioma skin
Table of Contents
Definition / general | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Hale CS. Epithelioid hemangioma / angiolymphoid hyperplasia with eosinophils. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocytichemangiomaepithelioid.html. Accessed August 3rd, 2020.
Definition / general
- Also called histiocytoid hemangioma, angiolymphoid hyperplasia with eosinophilia (ALHE)
- All racial groups
- Head and neck nodules, often periauricular
- Benign in skin
- May be reactive
- May occur in bone
- No / rare regional lymphadenopathy
- Normal serum eosinophils, IgE
Case reports
- 51 year old male with 8 × 6 cm subcutaneous mass in right cheek (Int J Surg Case Rep 2011;2:258)
Gross description
- Small, superficial, dermal papulonodules, frequently erythematous, with bleeding
Microscopic (histologic) description
- Proliferation of blood vessels with epithelioid endothelial cells exhibiting abundant eosinophilic cytoplasm with variable cytoplasmic vacuoles resembling intracytoplasmic lumina and large vesicular nuclei with variable atypia
- Usually heavy infiltrate of eosinophils and lymphocytes with germinal centers
- May have lobular solid pattern
Microscopic (histologic) images
Images hosted on PathOut server:
Images hosted on other servers:
Courtesy of Dr. Mark R. Wick
Images hosted on other servers:
Aggregate of lymphoid tissue
Blood vessels lined by cuboidal endothelial cells
Differential diagnosis
- Epithelioid angiosarcoma: marked atypia
- Epithelioid hemangioendothelioma: usually not cutaneous
- Kimura's disease: usually Asians with elevated serum eosinophils and IgE, usually regional lymphadenopathy
- Lobular pyogenic granuloma: no epithelioid endothelial cells
