An Unusual Presentation of Angiolymphoid Hyperplasia with Eosinophilia as Postauricular Mass: A case Report

Abstract

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign, reactive vaso-proliferative condition in the dermal and subcutaneous tissues of the head and neck. A 28-year-old female presented with slow-growing painless swelling behind her left ear. FNAC revealed benign soft tissue neoplasm and histopathological examination after surgical excision revealed angiolymphoid hyperplasia with eosinophilia. ALHE origin has been variously attributed to prior trauma, hyperestrogenemia, infectious agents, atopy, reactive hyperplasia, and benign neoplasia. Retroauricular ALHE has been rarely reported. However, on the basis of our case report, it should be a viable differential diagnosis when large subcutaneous tumors of the head and neck are encountered. When big subcutaneous tumors of the head and neck are present, especially in females, a valid differential diagnosis for angiolymphoid hyperplasia with eosinophilia, a rare condition marked by dermal or subcutaneous endothelial cell proliferation, should also be considered.

Keywords: Angiolymphoid hyperplasia with eosinophilia; Epithelioid hemangioma; Kimura Disease; Retroauricular.

Fig. 1

Clinical photograph of the left postauricular swelling

Fig. 2

Intra-operative dissection of the left postauricular swelling

Fig. 3

Intra-operative removal of the left postauricular swelling

Fig. 4

Complete excision of the left postauricular swelling

Fig. 5

Gross appearance of the left postauricular swelling

Fig. 6

Microphotograph showing stroma with numerous small and large blood vessels with endothelial cells, lymphoid aggregates, and eosinophils