Pathology of epithelioid hemangioma

Introduction

Epithelioid hemangioma is a benign vascular injury of the skin or deeper structures (bone). Has many similarities with angiolymphoids hyperplasia with eosinophilia and some authors believe that they are the same entity. Although eosinophils they are often rich in injury, peripheral Eosinophilia is not a feature.

Histology epithelioid hemangioma

In epithelioid hemangioma, histopathologically there's a proliferation of blood vessels with epithelioid endothelial cells (Figures 1,2). Endothelial cells are thick and abundant. eosinophilic cytoplasm sometimes it resembles histiocytes (Best seen in figure 2.) Because the endothelial cells are so thick, it is sometimes difficult to appreciate the vascular spaces and aggregates it may look like granulomas. Accompanying vascular proliferation are collections of lymphocytes numerous eosinophils (Figures 1,2).

Special studies for epithelioid hemangioma.

None are generally needed. Immunohistochemical markers for CD31, CD34 may be useful in highlighting endothelial cells and the general architecture of the lesion.

Differential diagnosis for elastofibroma

Angiolymphoid hyperplasia with eosinophilia (ALHE): Some authorities believe that it is the same entity. However, in contrast to ALHE, epithelioid hemangioma can affect any part of the body and involve deep Soft fabric and bone. Epithelioid hemangioma is generally an isolated lesion where ALHE often occurs in multiplicity.

Angiosarcoma: Angiosarcoma usually shows greater nuclear atypia and a invader growth pattern

Kimura disease: generally Asian with elevation serum eosinophils and IgE, usually regional lymphadenopathy