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Differential diagnosis between angiolymphoid hyperplasia with eosinophilia and Kimura disease

Differential diagnosis between angiolymphoid hyperplasia with eosinophilia and Kimura disease
  Angiolymphoid hyperplasia with eosinophilia Kimura disease
Age of onset
  • All ages, peak incidence second to fourth decade
 
Clinical features
Sex
  • No sex predilection
  • Predominantly in males
Ethnicity
  • Any
  • Asian
Body location
  • Head and neck most common
 
Clinical appearance
  • Cutaneous papules and nodules
  • Large subcutaneous mass
Regional lymphadenopathy
  • Rare
  • Common
Systemic involvement
  • None
  • Associated with renal disease in approximately 20% of cases
Clinical course
  • Chronic, persistent
 
Laboratory tests
Peripheral eosinophilia
  • Uncommon (20%)
  • Common
Serum IgE levels
  • Normal
  • Increased
Histopathology
Depth
  • Dermal/subcutaneous
  • Subcutaneous
Main findings
  • Proliferation of blood vessels of varying sizes lined by plump endothelial cells
  • Mild fibrous stromal reaction
  • Florid lymphoid follicles with germinal center formation
  • Hyperplastic small blood vessels lined by flat or cuboidal endothelial cells
  • Prominent stromal fibrosis
Infiltrate
  • Mixed, lymphocytes and variable number of eosinophils
  • Dense inflammatory infiltrate of lymphocytes, plasma cells, histiocytes, eosinophils
  • Eosinophilic microabscesses
Lymph nodes
  • N/A
  • Preserved nodal architecture, follicular hyperplasia with reactive germinal centers, IgE deposition in the germinal centers
IgE: immunoglobulin E.
References:
  1. Guo R, Gavino AC. Angiolymphoid hyperplasia with eosinophilia. Arch Pathol Lab Med 2015; 139:683.
  2. Olsen TG, Helwig EB. Angiolymphoid hyperplasia with eosinophilia. A clinicopathologic study of 116 patients. J Am Acad Dermatol 1985; 12:781.
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