Johnson Nathan M, Thomas Raj J, Grider Douglas J
Department of Internal Medicine, Dermatology Division, Carilion Clinic and Virginia Tech Carilion School of Medicine, Roanoke, VA; and Edward Via College of Osteopathic Medicine, Blacksburg, VA.
Am J Dermatopathol. 2019 Sep;41(9):680-683. doi: 10.1097/DAD.0000000000001407.
Extramedullary hematopoiesis is the process of blood cell synthesis occurring outside the medulla of the bone marrow. During fetal development, extramedullary hematopoiesis is considered physiological; however, it is considered pathologic when occurring outside the neonatal period. Angiolymphoid hyperplasia with eosinophilia (ALHE) describes a lesion characterized histologically by plump endothelial cells associated with a mixed inflammatory infiltrate of lymphocytes, plasma cells, mast cells, and eosinophils. This report describes an adolescent boy with an isolated preauricular facial lesion. After excision, histopathology confirmed a diagnosis of ALHE with the additional finding of trilineage extramedullary hematopoiesis. To the authors' knowledge, this is the first reported case of extramedullary hematopoiesis in ALHE.