Angiolymphoid hyperplasia with eosinophilia in a 27 year old male: A case report in Jos, North Central Nigeria

Abstract

Background: Angiolypmphiod hyperplasia with eosinophilia (AHLE), also known as epithelioid hemangioma or histiocytoid hemangioma  is a very rare vasoproliferative  disorder with an obscure aetiopathogenesis. It mostly affects  the head and neck regions of young  women. It appears as a dark  hyperpigmented or erythemathous nodular subcutaneous  swelling depending on skin colour of the  individual. Histologically it appears as proliferating small to medium sized  blood vessels with epithelioid like endothelial lining cells  within a lymphoid background punctuated by eosinophils.  Even though it is mostly self limiting, surgery is one of the good  modalities  for its treatment. 

Case presentation: A 27 year old male Nigerian presenting  with dark hyperpigmented nodular growths on the right  pinna  and the left posterior auricular area. Had no history of ear  piercing or injury prior to the onset of the growths. The masses  measured about 4 by 2 by 1.5 cm and non tender. No regional  lymphadenopathy felt on palpation or peripheral blood  eosinophilia.  Complete surgical excision of the two masses was  done and specimen taken for histological evaluation. A  diagnosis of ALHE was made.  There was no recurrence of the  growth two years after the surgery. 

Conclusions: AHLE is very rare lesion and might be mistaken  for  other lesions that share gross or histological features with it.  Histological diagnosis of the lesion is pertinent before  definitive treatment.  This will allow choice of preferred  modality by the patient and the clinician. There are several  treatment modalities for this  lesion, but surgical excision is  currently recommended.