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Ruifeng Guo1, Alde Carlo P Gavino

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Angiolymphoid hyperplasia with eosinophilia (ALHE), also known as epithelioid hemangioma (EH), is a benign vascular tumor. Complete surgical excision is crucial to prevent recurrence, as it occurs in up to one-third of cases.

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Area of Science:

  • Vascular Tumors
  • Dermatopathology
  • Surgical Oncology

Background:

  • Angiolymphoid hyperplasia with eosinophilia (ALHE), or epithelioid hemangioma (EH), is an inflamed vascular lesion of uncertain origin.
  • It presents as a proliferation of histiocytoid endothelial cells with significant lymphocytic and eosinophilic infiltration.
  • While generally benign, ALHE/EH can recur in approximately one-third of cases if not completely surgically removed.

Purpose of the Study:

  • To review the pathogenesis, histological characteristics, and treatment of Angiolymphoid hyperplasia with eosinophilia (ALHE)/epithelioid hemangioma (EH).
  • To emphasize the importance of complete surgical excision for managing ALHE/EH.
  • To discuss the controversial aspects of ALHE/EH pathogenesis.

Main Methods:

  • Literature review of Angiolymphoid hyperplasia with eosinophilia (ALHE)/epithelioid hemangioma (EH).
  • Analysis of histological features differentiating ALHE/EH from other vascular neoplasms.
  • Evaluation of treatment strategies and recurrence rates.

Main Results:

  • ALHE/EH is characterized by plump endothelial cell proliferation and inflammatory infiltrate, including eosinophils, lymphocytes, and lymphoid follicles.
  • Potential pathogenetic factors include trauma response and arteriovenous shunting.
  • Complete surgical excision is the primary treatment, though recurrence rates remain significant.

Conclusions:

  • Angiolymphoid hyperplasia with eosinophilia (ALHE)/epithelioid hemangioma (EH) requires complete surgical excision due to potential for recurrence.
  • Understanding the unique histological features aids in differentiating ALHE/EH from other vascular lesions.
  • Further research into pathogenesis may refine treatment strategies for this vascular tumefaction.