Angiolymphoid hyperplasia involving large arteries

Abstract

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferative disorder, which most commonly involves the skin of the head and neck regions. Noncutaneous localization of this pathology is unusual, and its primary localization in large arteries presenting as a pulsatile mass is extremely rare. We report here two cases of ALHE manifested as masses of the occipital and brachial artery. ALHE should be considered in the differential diagnosis of localized peripheral arterial masses in young patients.

Epithelioid hemangioma of brachial artery: report of a case and review of the literature

“…There were no associated skin lesions as in our case and arterial duplex imaging and MRI demonstrated a 1.6 diameter by 2 cm long well defined mass surrounding the brachial artery [12]. …”

“…About 22 cases have been reported, involving in order of decreasing frequency: temporal artery [14–20], radial artery [21–24], brachial artery [11, 12], ulnar artery [25, 26], axillary artery [27, 28], subclavian artery [29], facial artery [30], post-auricular artery [31], popliteal artery [32], common carotid artery [33] and occipital artery [12]. The lesion can grow entirely in the lumen of the blood vessel developing occlusive symptoms (such as weakening of the pulse in peripheral arteries) or it can originate from the vascular wall and developing outside with compression of adjacent structures.…”

“…Large vessels involvement is extremely rare and to date only two cases affecting the brachial artery have been reported in literature [11, 12]. …”

Surgical Treatment of Aneurysms in the Upper Limbs

“…Additionally, there may be heavy inflammatory infiltration of lymphocytes and eosinophils. 16) Occasionally, ALHE leads to peripheral blood eosinophilia. 17) In our ALHE case, the patient revealed with the eosinophilia preoperatively; however, interestingly, the eosinophilia resolved after the resection of ulnar artery pseudoaneurysm.…”

“…Furthermore, ALHE affecting large muscular arteries is extremely rare, and a review of the literature revealed only a few reports of ALHE affecting arteries in the extremities. 16,17) …”