Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the lung: A clinicopathologic and immunohistochemical study of two cases

Two cases of primary angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) (ALHE/EH) of the lung are described. Both patients are white, a 60-year-old man and a 27-year-old woman. One patient had a long-standing history of asthma, and the other had symptomatology related to the pulmonary mass. Wedge resections were performed in both cases, and both lesions shared similar histopathologic changes, mainly the presence of a tumor mass with a marked presence of eosinophils in the background, lymphoid hyperplasia, and marked proliferations of small-caliber vessels. Immunohistochemical studies using leukocyte common antigen, L-26, and UCHL-1 nicely stained the lymphoid component of the lesion, and CD31 clearly outlined the vascular component of the process. Clinical follow-up demonstrated that the woman died of status asthmaticus, and the man was alive and well 1 year after surgical resection of the lesion. Both cases highlight the ubiquitous distribution of ALHE/EH and underscore the importance of keeping these lesions in the differential diagnosis of vascular and lymphoid lesions of the lung.