Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Diagn Pathol. 2008 May 29;3:22. doi: 10.1186/1746-1596-3-22.
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a vasocentric process characterized by infiltrates of lymphocytes and eosinophils, usually affecting the muscular arteries of the head and neck. Currently it is unclear whether it is a reactive or neoplastic process.
We present a 61-year-old African American male with a twenty year history of superficial skin patches involving the head and neck region. An excisional biopsy of a right submental lymph node revealed an atypical T-cell lymphocytic process, diagnosed as peripheral T-cell lymphoma after immunophenotyping and molecular studies. Three months later the patient underwent a biopsy of a left temporal nodule that was diagnosed as ALHE. Subsequently, at two year follow-up, the patient was diagnosed with Mycosis Fungoides. Polymerase chain reaction for T cell receptor gamma showed the same T-cell receptor gene rearrangement in both the temporal mass and the right submental lymph node.
ALHE with molecular evidence of monoclonality is extremely unusual, as is the association with nodal peripheral T-cell nodal lymphoma. The findings of this case support our hypothesis that ALHE might be an early form of T-cell lymphoma.
血管淋巴样增生伴嗜酸性粒细胞增多症（ALHE）是一种以淋巴细胞和嗜酸性粒细胞浸润为特征的血管中心性疾病，通常影响头颈部的肌肉动脉。目前尚不清楚它是反应性的还是肿瘤性的过程。
我们报告了一例 61 岁的非裔美国男性，他有 20 年的头颈部浅表皮肤斑块史。右颏下淋巴结的切除活检显示为非典型 T 细胞淋巴细胞增生，免疫表型和分子研究后诊断为外周 T 细胞淋巴瘤。三个月后，患者接受了左侧颞部结节的活检，诊断为 ALHE。随后，在两年的随访中，患者被诊断为蕈样霉菌病。T 细胞受体γ的聚合酶链反应显示颞部肿块和右颏下淋巴结的 T 细胞受体基因重排相同。
ALHE 具有分子证据的单克隆性极为罕见，与结外周围 T 细胞淋巴瘤的关联也很罕见。该病例的发现支持我们的假设，即 ALHE 可能是 T 细胞淋巴瘤的早期形式。
