2016 Volume 62 Issue 2 Pages 63-72
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare idiopathic condition that manifests in adults as deep-red papules and nodules in the skin of the head and neck. We herein present the case of a 29-year-old man who was admitted with a pulsatile parotid tumor. A CT scan showed that an expanded small blood vessel carried through the tumor was enhanced at the same level of the blood vessel. MRA showed that a branch of the superficial temporal artery flowed into the tumor. According to these findings, the preoperative diagnosis was an aneurysm. In the intraoperative findings, the tumor was located in the deep lobe and a blood vessel flowed into the tumor. The tumor was composed of a proliferation of thick or thin-walled blood vessels lined by plump epithelioid endothelial cells, accompanied by fibrous stroma and infiltration of eosinophils. Immunohistochemically, these plump endothelial cells were positive for CD31 and CD34. Therefore, the postoperative diagnosis was ALHE. We herein review the current understanding of ALHE and discuss how to differentiate it from Kimura's disease.