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Ahuja R, Patel V, Dagar S, Khandpur S. An unusual case of benign cutaneous lymphoid hyperplasia masquerading as diffuse Addisonian-like pigmentation with skin infiltration - An atypical presentation. Indian J Dermatol Venereol Leprol 2024; 0:1-4. [PMID: 38899415 DOI: 10.25259/ijdvl_1268_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/03/2024] [Indexed: 06/21/2024]
Affiliation(s)
- Rhea Ahuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Varniraj Patel
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Shivangi Dagar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Khalil S, Donthi D, Gru AA. Cutaneous Reactive B-cell Lymphoid Proliferations. J Cutan Pathol 2022; 49:898-916. [PMID: 35656820 DOI: 10.1111/cup.14264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/14/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
Cutaneous lymphoid hyperplasia (CLH), also known as cutaneous pseudolymphoma, is a spectrum of benign conditions characterized by reactive B- and T-cell cutaneous lymphocytic infiltrates. B-cell lymphoid proliferations are a heterogenous group of non-neoplastic cutaneous diseases that must be histopathologically distinguished from cutaneous B-cell lymphomas. These proliferations can be observed as reactive phenomena to infections, medications, allergens, neoplasms, and more. Further, there are many inflammatory conditions that present with reactive B-cell infiltrates, including actinic prurigo, Zoon balanitis, Rosai-Dorfman, and cutaneous plasmacytosis. This review summarizes multiple cutaneous B-cell lymphoid proliferations within the major categories of reactive and disease-associated CLH. Further we discuss major discriminating features of atypical CLH and malignancy. Understanding the specific patterns of B-cell CLH is essential for the proper diagnosis and treatment of patients presenting with such lesions.
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Affiliation(s)
- Shadi Khalil
- Department of Dermatology, University of California San Diego
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Villalobos-Ayala RA, Espinoza-Gurrola AA, Guevara-Gutiérrez E, Solís-Ledesma G, Ramos-Suárez M, Rodríguez-Castellanos MA, Tlacuilo-Parra A. Lymphocytoma cutis (cutaneous B-cell pseudolymphoma): study of 102 cases with emphasis on the histological characteristics and immunohistochemistry of the miliarial type. Int J Dermatol 2021; 61:316-323. [PMID: 34541667 DOI: 10.1111/ijd.15909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/20/2021] [Accepted: 08/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lymphocytoma cutis (LC) is a benign reactive lymphoproliferative B-cell process. It has two variants: localized type with solitary lesions and miliarial type with numerous lesions. The objective was to investigate the characteristics of LC with emphasis on the miliarial type. METHODS Retrospective study, patients with clinical and histopathological diagnosis of LC were included. Age, sex, evolution time, affected site, and type of treatment were investigated. In miliarial-type LC, the histological and immunohistochemical characteristics were also investigated. RESULTS In an 18-year period, there were 102 patients found with LC: 72 (71%) corresponded to females, the median age was 45 years, the median evolution time was 4 months, and the face was the most predominant affected area in 81 (79%) cases. Localized-type LC corresponded to 88 (86%) cases, and miliarial type in 14 (14%). The most common treatment was surgery, which was used in 32 (31%) patients, all of whom had localized type (P < 0.01). The most frequent treatment for miliarial-type LC was corticosteroids in five (36%, P = 0.32), the predominant histopathological pattern was nodular in 10 (71%) specimens, and immunohistochemistry was performed in 11 (79%), where all were positive for CD20 with polyclonality to kappa and lambda light chains. CONCLUSIONS The importance of LC lies in that it can be clinically and histopathologically confused with cutaneous lymphoma and that it is a rare entity, with its miliarial variant being rarer still. This study provides information on the clinical-histological characteristics of LC and its immunohistochemistry.
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Affiliation(s)
- Romina A Villalobos-Ayala
- Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - América A Espinoza-Gurrola
- Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - Elizabeth Guevara-Gutiérrez
- Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - Guillermo Solís-Ledesma
- Departamento de Histopatología, Instituto Dermatológico de Jalisco, "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - Marina Ramos-Suárez
- Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - Marco A Rodríguez-Castellanos
- Departamento de Dermatología, Instituto Dermatológico de Jalisco "Dr. José Barba Rubio", Secretaría de Salud Jalisco, Zapopan, Jalisco, México
| | - Alberto Tlacuilo-Parra
- División de Investigación Médica, UMAE Hospital de Pediatría CMNO, IMSS, Guadalajara, Jalisco, México
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Mitteldorf C, Kempf W. Cutaneous pseudolymphoma—A review on the spectrum and a proposal for a new classification. J Cutan Pathol 2019; 47:76-97. [DOI: 10.1111/cup.13532] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 05/26/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, Venereology and AllergologyUniversity Medical Center Göttingen Germany
| | - Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik Zürich Switzerland
- Department of DermatologyUniversity Hospital Zurich Zurich Switzerland
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Rosa WSC, Girão RJS, Carvalho IMSD, Vargas LMML. Lymphocytoma cutis on the inguinal region: report of a rare case of benign lymphoproliferative disorder. An Bras Dermatol 2017; 92:98-100. [PMID: 29267460 PMCID: PMC5726691 DOI: 10.1590/abd1806-4841.20175555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/13/2017] [Indexed: 11/22/2022] Open
Abstract
Lymphocytoma cutis, or benign reactive lymphoid hyperplasia, is an inflammatory
skin lesion that mimics clinically and histologically malignant lymphoma. Most
cases are idiopathic, but they may also be triggered by multiple factors, such
as insect bites, tattoos, injections and herpes zoster. Clinically, the lesions
are erythematous, soft papules, plaques or nodules, usually located on the upper
limbs and face. The diagnosis is mainly based on histopathology and
immunohistochemistry. Corticosteroid injections, cryosurgery, PUVA therapy,
radiotherapy and surgery can be therapeutic options in cases requiring immediate
treatment. To demonstrate an atypical presentation of this tumor, a case
lymphocytoma skin on the groin will be reported, describing its diagnosis and
treatment.
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6
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Abstract
The term, cutaneous pseudolymphoma (PSL), refers to a group of lymphocyte-rich infiltrates, which either clinically and/or histologically simulate cutaneous lymphomas. Clinicopathologic correlation is essential to achieve the final diagnosis in cutaneous PSL and to differentiate it from cutaneous lymphomas. A wide range of causative agents (eg, Borrelia, injections, tattoo, and arthropod bite) has been described. Based on clinical and/or histologic presentation, 4 main groups of cutaneous PSL can be distinguished: (1) nodular PSL, (2) pseudo-mycosis fungoides, (3) other PSLs (representing distinct clinical entities), and (4) intravascular PSL. The article gives an overview of the clinical and histologic characteristics of cutaneous PSLs.
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Affiliation(s)
- Christina Mitteldorf
- Department of Dermatology, HELIOS Klinikum Hildesheim, Senator-Braun-Allee 33, Hildesheim 31134, Germany.
| | - Werner Kempf
- Kempf & Pfaltz, Histologische Diagnostik, Seminarstrasse 1, 8057 Zürich, Zurich, Switzerland; Department of Dermatology, University Hospital Zurich, Gloriastrassse 31, 8091 Zürich, Switzerland
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Oliveira EVLD, Badiale GB, Moraes MMFS. Lymphocytoma cutis--case report. An Bras Dermatol 2014; 88:128-31. [PMID: 24346899 PMCID: PMC3875987 DOI: 10.1590/abd1806-4841.20132320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 01/17/2013] [Indexed: 11/21/2022] Open
Abstract
We describe a clinical case involving a 62-year-old white male, diagnosed with lymphocytoma cutis (Spiegler-Fendt sarcoid) in the cephalic segment. The diagnosis was carried out by pathological study and confirmed by immunohistochemical panel: evidence of polyclonality. Phototherapy sessions were suggested as treatment (13 PUVA sessions, with an accumulated dose of 58.65 J/cm2 ). The improvement was partial. Thus, infiltration of triamcinolone was opted for (one intralesional infiltration every 3 weeks). After 5 sessions, satisfactory improvement was observed: regression of nearly all the lesions.
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Affiliation(s)
| | | | - Margarida M F S Moraes
- University of São Paulo, Medical School, Pathological Anatomy department, Ribeirão PretoSP, Brazil
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Marchesi A, Parodi PC, Brioschi M, Marchesi M, Bruni B, Cangi MG, Vaienti L. Tattoo ink-related cutaneous pseudolymphoma: a rare but significant complication. Case report and review of the literature. Aesthetic Plast Surg 2014; 38:471-8. [PMID: 24570180 DOI: 10.1007/s00266-014-0287-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 01/31/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND The demand for decorative tattoos is steadily growing worldwide, and in the US it is estimated that up to 24% of adults has one or more tattoos. Subsequently, the number of tattoo-related complications is increasing. Among these, lymphoproliferative disorders play a minor but important role. The aim of this article is to arouse the awareness of plastic surgeons and dermatologists about this rare but serious complication and to stimulate stricter clinical control of their tattooed patients. METHODS We report a new case of tattoo-related cutaneous pseudolymphoma (CPL) and perform a review of the last 30 years of literature on the topic in PubMed. RESULTS Apart from this new case, only 18 cases of CPL have been reported in PubMed so far. In contrast to the classic knowledge, the T cell was the predominant phenotype in 68% of cases. Red is confirmed to be the most involved ink. Topical and intralesional steroids, laser therapy, and surgery were used for treatment of CPL. CONCLUSIONS Even if CPL is a very rare and benign complication, we should not forget that in rare cases pseudolymphoma may evolve into a true lymphoma. Diagnosis is still difficult and is based on anamnestic, clinical, and histopathological data. From the review of the literature, the T cell predominance suggests a reclassification of tattoo-induced CPL and there is not a gold standard treatment yet. Finally, once a pseudolymphoma is diagnosed, there must be a long follow-up because of the possibility to transform into a malignancy. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Andrea Marchesi
- Dipartimento di Chirurgia Plastica Ricostruttiva, I.R.C.C.S. Policlinico San Donato, Università degli Studi di Milano, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy,
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Colucci R, Galeone M, Arunachalam M, Berti S, Pinzi C, Bellandi S, Moretti S. Red nodule on the breast. Indian J Dermatol 2012; 57:387-9. [PMID: 23112361 PMCID: PMC3482804 DOI: 10.4103/0019-5154.100496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 63-year-old woman living in the countryside referred to our department with a 2-month history of a red nodule localized on the right breast. Histological examination, immunohistochemical analyses and serologic evaluation conducted with ELISA and Western blot were performed. Clinical diagnosis of borrelial lymphocytoma was not possible solely on the clinical presentation of a classical nodular form without lymphoadenopathy. An absence of a referred prior tick bite and a previous or concomitant erythema migrans at clinical presentation rendered a more challenging diagnosis. The fact that the patient lived in the countryside, the appearance of the breast nodule in September, and serologic, histologic, and immunohistochemical analysis facilitated the diagnosis of borrelial lymphocytoma. We report this case to highlight the importance of an investigation of Lyme borreliosis when a patient living in the countryside presents with a red nodule of the nipple and areola.
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Affiliation(s)
- Roberta Colucci
- Division of Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
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Wu JM, Vonderheid E, Gocke CD, Moresi JM, Liegeois N, Borowitz MJ. Flow cytometry of lesional skin enhances the evaluation of cutaneous B-cell lymphomas. J Cutan Pathol 2012; 39:918-28. [DOI: 10.1111/j.1600-0560.2012.01975.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2010] [Revised: 07/31/2011] [Accepted: 04/22/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Julie Michelle Wu
- Department of Pathology; Cedars Sinai Medical Center; Los Angeles; CA; USA
| | - Eric Vonderheid
- Department of Dermatology; Johns Hopkins University; Baltimore; MD; USA
| | | | - Jean Margaret Moresi
- Department of Pathology; Johns Hopkins Bayview Medical Center; Baltimore; MD; USA
| | - Nanette Liegeois
- Department of Oncology; Johns Hopkins University; Baltimore; MD; USA
| | - Michael J. Borowitz
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore; MD; USA
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11
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Cutaneous pseudolymphoma localized to black tattoo. J Am Acad Dermatol 2011; 65:e155-7. [PMID: 22000890 DOI: 10.1016/j.jaad.2011.06.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 06/19/2011] [Accepted: 06/23/2011] [Indexed: 11/21/2022]
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12
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CD123-Positive Plasmacytoid Dendritic Cells in Primary Cutaneous Marginal Zone B-Cell Lymphoma: A Crucial Role and a New Lymphoma Paradigm. Am J Dermatopathol 2010; 32:194-6. [DOI: 10.1097/dad.0b013e3181aff9b3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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CD123-positive Plasmacytoid Dendritic Cells in Primary Cutaneous Marginal Zone B-cell Lymphoma. Am J Surg Pathol 2009; 33:1307-13. [DOI: 10.1097/pas.0b013e3181a6ae1e] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Abstract
From the Eskimo in Greenland to the tribes in Polynesia-the whole world knows the art of tattoo. Despite their wide popularity the relation between the skin diseases and the tattooed pictures aren't studied in depth. With the appearance of professional tattoo studios, the risk of infectious complications was reduced. Simultaneously, on a global scale there has been an increase in pseudolymphoma and allergic reactions caused by the introduction of an exogenous pigment into the dermis. The results of our clinical and therapeutic research and review of literature on the subject outline the major problems related to tattoos, i.e. clinical complications. The summarized data showed infectious diseases transmitted through the process of tattooing and many allergic reactions, granulomas and tumors as complications of a tattoo.
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Affiliation(s)
- Jana Kazandjieva
- Department of Dermatology, Medical University-Sofia, 1431 Sofia, Bulgaria.
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Dionyssopoulos A, Mandekou-Lefaki I, Delli FS, Kourtis D, Nikolis A, Dionyssopoulou E, Nikopoulos K. T- and B-cutaneous pseudolymphomas treated by surgical excision and immediate reconstruction. Dermatol Surg 2007; 32:1526-9. [PMID: 17199667 DOI: 10.1111/j.1524-4725.2006.32368.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander Dionyssopoulos
- Division of Skin Oncologic Surgery-Plastic Surgery, 1st Department of Dermatology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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T- and B-Cutaneous Pseudolymphomas Treated by Surgical Excision and Immediate Reconstruction. Dermatol Surg 2006. [DOI: 10.1097/00042728-200612000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Abstract
Immunologic and molecular genetic studies greatly contributed to a better understanding and interpretation of the distinct clinico-pathologic features of primary cutaneous B-cell lymphomas (CBCL), which are the basis for the consensus WHO-EORTC classification. There is increasingly accumulating evidence that these well defined clinico-pathologic entities of CBCL have specific immunologic and molecular features, which further support their nosologic categorization as well as either interesting similarities with other extranodal B-cell lymphomas or definite peculiarities as compared to nodal B-cell lymphomas of similar histotype (specifically, follicle center lymphoma and diffuse large B-cell lymphoma).
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Affiliation(s)
- Nicola Pimpinelli
- Department of Dermatological Sciences, University of Florence Medical School, Florence, Italy.
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Lozzi GP, Fargnoli MC, Peris K. A 72-year-old woman with papules and nodules at the site of previous mastectomy. Arch Pathol Lab Med 2005; 129:e167-8. [PMID: 15974829 DOI: 10.5858/2005-129-e167-aywwpa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Gian Piero Lozzi
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
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