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Yoon and Chi: A Case of Angiolymphoid Hyperplasia with Eosinophilia (ALHE) of the Eyelid
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(5): 712-715.

Published online: 16 May 2012

DOI: https://doi.org/10.3341/jkos.2012.53.5.712

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

Je Hwan Yoon, MD, Mijung Chi, MD, PhD

Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.

Address reprint requests to Mijung Chi, MD, PhD. Department of Ophthalmology, Gachon University Gil Hospital, #21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-3364, Fax: 82-32-460-3358, cmj@gilhospital.com

Received 25 April 2011       Accepted 24 March 2012

Copyright © 2012 The Korean Ophthalmological Society

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 × 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 × 0.6 × 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.

Keywords: Angiolymphoid hyperplasia with eosinophilia, Cobblestone appearance, Enlarged endothelial cell, Eyelid mass, Lymphadenopathy

Figures and Tables

Figure 1
A relaltively well-demarcated, erythematous, firm, subcutaneous nodule in the upper eyelid.
jkos-53-712-g001
Figure 2
A yellowish red color mass (size 1.0 × 0.6 × 0.5 cm).
jkos-53-712-g002
Figure 3
There is marked proliferation of irregular vascular channels surrounded by perivascular lymphocytic infiltration with eosinophils (H&E, ×200).
jkos-53-712-g003
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).
jkos-53-712-g004

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