Angiolymphoid Hyperplasia with Eosinophilia or the Kimur’s Disease?
Baráková D.1, Šach J.2, Krásný J.1, Kuchynka P.1, ŘedinováM.1, Kodat V.
1Oční klinika 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, přednosta prof. MUDr. Pavel Kuchynka, CSc. 2Ústav patologie 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice KrálovskéVinohrady, přednosta prof. MUDr. Václav Mandys, CSc. |
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Summary:
Angiolymphoid hyperplasia with eosinophilia (ALHE) and Kimur’s disease are
tworarely occurringandmutually very similar, yet independentnosological units.
For the frequency of similar features these diseases were long considered to be
modifications of one disease. In the last years most authors considered these
diseases to be independent entities with certain specific clinical and morphological
features. The case of a 76-year white man, suffering from occurrence of
subcutaneous tumor formations in various part of the body for the period of six
years, is described. Six years after the first signs of the disease, swelling of eyelids
on the right eye with palpable resistance under the upper temporalmargin of eye
socket developed. A similar finding also developed on the left side eight months
later. The tumors were removed by surgery and subjected to histological examination.
One year later a unilateral relapse developed to be again subjected to
surgical treatment and histological examination. In the first two orbital excisions
the tumor infiltrate was in topical connection with structure of the tear gland, the
third excision did not contain such structures. The histological diagnosis was
established as ALHE in spite of some common features with the Kimur’s disease.
The diagnosis of ALHE was especially supported by absence of the formation of
lymphatic follicles, absent fibrotization in the infiltrate and epithelium-like or even histiocyte-like appearance of proliferating endothelia, which formed minute
vascular lumina. A substantial exceptionality in the occurrence of the Kimur’s
disease in white Europeans further supported the diagnosis of ALHE. Our own
experience indicates that both units mutually overlap even in features considered
to be of distinctly different character.Aquestion arises,whether the strict division
of these two nosological units is really possible in practice with unequivocal
certainty.
Key words:
angiolymphoid hyperplasia with eosinophilia, Kimur’s disease, bilateral
affection of the tear gland, relapse
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