안검에 발생한 호산구 증가증을 동반한 혈관림프증식증 1예
A Case of Angiolymphoid Hyperplasia with Eosinophilia (ALHE) of the Eyelid
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목적: 안검에 발생한 호산구 증가증을 동반한 혈관림프증식증(angiolymphoid hyperplasia with eosinophilia, ALHE) 1예를 경험하여이를 보고하고자 한다. 증례요약: 63세 남자환자가 1개월 전 우연히 발견된 우상안검의 결절로 내원하였다. 환자는 우상안검 비측부 피부에 약 1.0×0.5 cm 크기의 연갈색의 단독성 결절이 있었다. 전신검사상 림프절비대 소견은 없었으며 혈액검사상 호산구 증가증을 보였다. 이에 저자들은정확한 진단 및 치료를 위하여 상안검 결절에 대한 절제 생검을 시행하였다. 수술 후 얻은 조직은 크기 1.0×0.6×0.5 cm의 표면이매끄러운 황적색 결절이었다. 현미경 검사상 크기가 증가된 혈관 내피세포로 이루어진 다수의 모세혈관과 이를 둘러싸고 침윤되어있는 림프구 및 호산구가 관찰되었다. 위의 소견을 종합하여 최종적으로 호산구 증가증을 동반한 혈관림프증식증으로 진단되었다. 결론: 상안검의 결절을 주소로 내원한 환자에서 호산구 증가증을 동반한 혈관림프증식증을 감별 진단으로 고려하여야 할 것으로 생각되며 안검을 침범한 드문 증례를 보고하는 바이다.
Abstract
Purpose: The authors of the present study describe a rare case of angiolymphoid hyperplasia with eosinophilia (ALHE) of the eyelid. Case summary: A 63-year-old male who was diagnosed with ALHE based on biopsy of an inguinal mass presented with an eyelid mass of 1 month duration. A light brown, solitary, 1.0 × 0.5 cm-sized mass involved the right upper eyelid. There was no lymphadenopathy, but eosinophilia was present. An excisional biopsy of the mass was performed for diagnosis and management. Macroscopic examination of the excised mass revealed a well-defined, smooth, firm, yellowish-red colored lesion measuring 1.0 × 0.6 × 0.5 cm. Histopathology showed the proliferation of small blood vessels, many of which were lined by enlarged endothelial cells with uniform ovoid nuclei and intracytoplasmic vacuoles. The distinctive endothelial cells were described as having a cobblestone appearance. In addition, a perivascular and interstitial infiltrate composed primarily of lymphocytes and eosinophils was present. ALHE was finally confirmed with clinical and microscopic examination. Conclusions: The authors of the present study report a rare case of ALHE of the eyelid and suggest that a differential diagnosis should be considered.
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