BACKGROUNDThis is a rare cause of an axillary artery aneurysm in a young patient and brings together dermatology, rheumatology and vascular surgery. CASE PRESENTATIONA man in his late 20s presented with a painless swelling in his left axilla. He also had a long history of nocturnal sweating with no history of weight loss or fatigue. On examination, there was a large, well circumscribed lump measuring 3 × 2.5 cm within the apex of the left axilla. The mass was pulsatile, fi rm and non-tender. General examination was otherwise unremarkable; in particular, there were neither skin lesions nor palpable lymphadenopathy. INVESTIGATIONSBiochemical and haematological investigations were normal apart from a mildly raised eosinophil count of 0.5 × 10 9 /l (upper limit of normal 0.4 × 10 9 /l).Doppler ultrasound confi rmed a 2.9 cm long × 1.8 cm wide aneurysm of the distal axillary artery with evidence of an irregular thrombus present within. DIFFERENTIAL DIAGNOSISAngiolymphoid hyperplasia with eosinophilia (ALHE) has been known by a variety of different names, such as epithelioid haemangioma, pseudopyogenic granuloma, infl ammatory angiomatous nodule, papular angioplasia, subcutaneous angioblastic lymphoid hyperplasia with eosinophilia and lymphofolliculosis, intravenous atypical vascular proliferation and histiocytoid haemangioma. 1 This extensive list of nomenclature refl ects the spectral variation in microscopic presentations of ALHE encountered by past investigators and, not least, the divided opinion as to whether the pathogenesis of the lesion is truly neoplastic or a reactive phenomenon.There has been controversy over the exact relationship between Kimura's disease (KD) and ALHE, where the two terms have been used interchangeably in many articles. KD was fi rst described by Chinese authors Kimm and Szeto 2 in 1937 and later made widely recognised by Kimura in 1947. KD is a chronic infl ammatory disease of unknown aetiology usually presenting as solitary or multiple subcutaneous nodules in the head and neck region, often involving the parotid or submandibular salivary glands. KD is associated with regional lymphadenopathy; this may become generalised in longstanding disease, 3 and systemic eosinophilia with raised IgE levels. It is most prevalent in Asians with 85% of cases occurring in males.Although KD has been thought to be integral to the spectrum of ALHE in the past, histological features show that these conditions represent two separate disease entities. 4 KD is characterised by lymphoid nodules with germinal centres which may extend from the dermis to the underlying fascia and muscles. Lesions show a distinct eosinophilic infi ltrate with microabscesses. Vascular proliferation is not always present; however, when seen, there are many canalised capillaries lined by fl at endothelial cells. Systemic eosinophilia is almost always present, seen in approximately 98% of cases in comparison to 20% in ALHE. 5 In contrast to KD, ALHE lesions are superfi cial containing blood vessels of varying luminal sizes, some of w...

Primary localized genitourinary amyloid deposition is a rare disease that can be confused with cancer. Amyloid tumours of the urethra are exceptionally rare, with only 40 cases having been reported in the literature since 1909. A case is presented herein, with a full review of the presenting features, coexisting conditions and pathology and recommendations for treatment, based on the findings in previously reported cases.

Despite its increasing use in the management of symptomatic benign prostatic hyperplasia, the long-term complications after potassium-titanyl-phosphate photoselective vaporization of the prostate are poorly reported. We describe a rare complication of this technology-calculi formation in the prostatic urethra. All patients presented with visible hematuria and variable lower urinary tract symptoms up to 5 years after the original surgery. In all cases, the calculi were successfully removed endoscopically. Possible causes for this unusual complication are discussed, and the importance of warning patients about this potential long-term complication are highlighted.