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Year : 1992  |  Volume : 58  |  Issue : 2  |  Page : 125-127

Subcutaneous angiolymphoid hyperplasia with eosinophilia (kimura’s disease)

Correspondence Address:
H R Chandrashekar

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A case of angiolymphoid hyperplasia with eosinophilia, presenting as a subcutaneous mass over the face in a 25-years-old woman is presented. The lesion was treated by surgical excision. There was no recurrence after a follow up of 2 months.

Keywords: Angiolymphoid hyperplasia, Eosinophilia, Kimura′s disease

How to cite this article:
Chandrashekar H R, Kumar P, Shashikala P, Pra. Subcutaneous angiolymphoid hyperplasia with eosinophilia (kimura’s disease). Indian J Dermatol Venereol Leprol 1992;58:125-7

How to cite this URL:
Chandrashekar H R, Kumar P, Shashikala P, Pra. Subcutaneous angiolymphoid hyperplasia with eosinophilia (kimura’s disease). Indian J Dermatol Venereol Leprol [serial online] 1992 [cited 2020 Oct 20];58:125-7. Available from:

  Introduction Top

Angiolymphoid hyperplasia with eosinophilia is a rare and peculiar disease, characterised by solitary or multiple subcutaneous or dermal nodules. It was first described by Kimura et al in 1948, under the term "eosinophilic lymphoid granuloma". [1] Since then the lesion has been described under different names such as angiolymphoid hyperplasia, pseudopyogenic granuloma, atypical pyogenic granuloma and Kimura's disease. [2],[3] Rosai and coworkers, suggest that it has to be included under "histiocytoid haemangiomas". [4] The lesion is as extraordinar y in its behaviour, as it is in its histologic feature and its rarity in Indian literature prompted the present report.

  Case Report Top

A 25 year-old-woman was admitted for evaluation of unilateral facial swelling of 6 years duration [Figure - 1]. The lesion was painless and had enlarged progressively.

Examination revealed a solitary subcutaneous swelling, on the left side of the face, measuring 6x4 cms, soft to firm in consistency, nontender and movable. Systemic examination was unremarkable, chest X-ray was normal. Total WBC count was 6050 cells MM 3 with 26 percent eosinophils. The lesion was excised. There was no recurrence after a followup of 2 months.

Macroscopically, it was an irregular fibrofatty mass with grey white cut surface, measuring 6x4x2 cms. Light microscopy showed a subcutaneous lesion consisting of fibrofatty tissue with angiolymphoid hyperplasia. There was a striking proliferation of blood vessels lined by plump endothelial cells in a background of eosinophils, lymphocytes, plasma cells, histiocytes and lymphoid follicles [Figure - 2][Figure - 3]. PAS stain was negative for fungus. Gomori's silver stain showed a delicate network of reticulin enclosing the vascular lumen and perivascular cells.

  Comments Top

Angiolymphoid hyperplasia with eosinophilia is a disease of unknown aetiology. It generally occurs as a solitary lesion in the head and neck, but multiple lesions on the trunk and extremities are also described.[3],[5],[6],[7] The histologic features in our case correspond to those described as characteristic of angiolymphoid hyperplasia with eosinophilia. Age of the patient, size and location are also in accordance with previous findings. [2],[3],[6],[9] Histologically, the lesion is characterised by prominent vascular changes with endothelial proliferation and marked inflammatory infiltrate of lymphocytes, plasma cells, histiocytes and eosinophils. [2] Peripheral blood eosinophilia is occasionally present. [5] These lesions are designated as histiocytoid haemangiomas based on the common histological features of the proliferation of blood vessels lined by plump endothelial cells, the composition of associated inflammatory response being highly variable. [4],[8] In the active phase, the lesion has many cytologic features of malignancy and may be misdiagnosed as angiosarcoma, but it is essentially benign and surgical excision results in cure. [3] Lesions also respond to corticosteroid and radiation therapy. [3] Spontaneous remission and local recurrence are also reported. [3],[2]

  References Top

1.Henry PG, Burnett JW. Angiolymphoid hyperplasia with Eosinophilia. Arch Dermatol 1979; 115: 205-7.  Back to cited text no. 1    
2.Kindblom LG, Fassna AS. Angiolymphoid hyperplasia with eosinophilia of skin. Acta Path Microbiol Scand Sect A 1981; 89 271-83.  Back to cited text no. 2    
3.Reed RJ, Terazakis N. Subcutaneous angioblastic lymphoid hyperplasia with eosinophilia (Kimura's disease). Cancer 1972; 29 : 489 - 97.  Back to cited text no. 3  [PUBMED]  
4.Rosai J, Gold J., Landry R. The histiocytoid haemangiomas : A unifying concept embracing several previously described entities of the skin, soft tissue, large vessels, bone and heart. Human Pathology 1979; 10 707-30.  Back to cited text no. 4    
5.Grimwood R, Swinehart JM, Aeling JL. Angiolymphoid hyperplasia with eosinophilia. Arch Dermatol 1979; 115: 205-7.  Back to cited text no. 5  [PUBMED]  
6.Moesner J, Pallesen R, Sorensen B. Angiolymphoid hyperplasia with eosinophilia (Kimura's disease). Arch Dermatol 1981; 117 : 650-3.  Back to cited text no. 6  [PUBMED]  
7.Singh G, Subramanya H, Pant GC, et al. Angiolymphoid hyperplasia with eosinophilia. Indian J Pathol Microbiol 1990; 33 : 272-3.  Back to cited text no. 7    
8.Buratt BA, Barr RJ, King DF. Cutaneous histiocytoid haemangioma. Arch Dermatol 1982; 118: 166.  Back to cited text no. 8    
9.Ramalakshmi PVB, Rao SS, Venkataratnam G. Cutaneous histiocytoid haemangioma. Indian J Pathol Microbiol 1987; 30: 333-5.  Back to cited text no. 9    


[Figure - 1], [Figure - 2], [Figure - 3]


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