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Acta Gastro-enterologica Belgica 2017Nodular lymphoid hyperplasia (NLH) is a rare benign condition that is characterized by diffuse hyperplasia of the lymphoid follicles of the gastrointestinal tract (GIT).... (Review)
Review
Nodular lymphoid hyperplasia (NLH) is a rare benign condition that is characterized by diffuse hyperplasia of the lymphoid follicles of the gastrointestinal tract (GIT). During endoscopy, NLH appears as multiple or occasionally innumerable nodules measuring a few millimeters in diameter. NLH occurs mainly in the small intestine, less commonly in the large intestine and rarely involves the stomach. There are multiple associated diseases such as immunoglobulin deficiency syndromes, giardiasis, Helicobacter pylori (H. pylori) infection, HIV and celiac disease. NLH elicits a wide range of symptoms that can range from asymptomatic to chronic diarrhea, weight loss, bleeding from the rectum and, very infrequently, intestinal obstruction. The clinical significance of NLH relies not only on the associated conditions but also on the possible complications. The most important of which are malignant transformation, particularly to gastric carcinoma, and intestinal or extra-intestinal lymphoma. There is no consensus regarding the management and surveillance of NLH. However, surveillance is recommended by most authors, but the intervals and duration have not yet been identified.
Topics: Disease Management; Gastrointestinal Tract; Humans; Intestinal Diseases; Pseudolymphoma
PubMed: 29560671
DOI: No ID Found -
Histopathology Jan 2022This review focuses upon the pragmatic diagnostic approach of suspicious B cell infiltrations in the skin and lists the necessary histopathological and molecular tools... (Review)
Review
This review focuses upon the pragmatic diagnostic approach of suspicious B cell infiltrations in the skin and lists the necessary histopathological and molecular tools for a thorough work-up. We start with the description of different histopathological patterns of cutaneous B cell infiltrations and recommend pattern-dependent immunohistochemical staining algorithms for further differential diagnosis. A summarised description of the current World Health Organisation (WHO) subtypes of primary cutaneous B cell lymphomas highlighting their most relevant clinical, histopathological and molecular features is included. Differential diagnostic clues towards secondary infiltrations by systemic B cell lymphomas, B cell-rich T cell lymphoproliferative disorders and pseudolymphomas are provided. Furthermore, the most important pitfalls also elaborating on rare differential diagnoses are highlighted with helpful hints to solve arising diagnostic difficulties. The clinical work-up and the staging examinations depending on the type of B cell infiltrate are relevant for patient care and a short overview of the main diagnostic standards is given.
Topics: Diagnosis, Differential; Humans; Lymphoma, B-Cell; Skin; Skin Neoplasms
PubMed: 34958501
DOI: 10.1111/his.14556 -
International Journal of Surgery Case... Jul 2023Primary central nervous system (CNS) lymphomas (PCNSLs) comprise a heterogeneous subset of intracranial disorders, predominantly of the intraparenchymal high-grade...
INTRODUCTION AND IMPORTANCE
Primary central nervous system (CNS) lymphomas (PCNSLs) comprise a heterogeneous subset of intracranial disorders, predominantly of the intraparenchymal high-grade non-Hodgkin's lymphoma. Intracranial pseudolymphoma represents an exceedingly rare entity; as few as 3 reports in the English literature. We describe the first multiple large intracranial pseudolymphomata leading to increased intracranial pressure, visual loss, and recurrence during a short while. It also represents the first report of intracranial pseudolymphoma presented as a skull base tumor.
CASE PRESENTATION
We describe a 67-year-old female suffering from left-sided loss of visual acuity, headache, nausea, vomiting, and improper balance. Axial brain computed tomography (CT) scan revealed an isodense anterior interhemispheric mass lesion with surrounding edema in both frontal lobes. T1 and T2 weighted magnetic resonance imaging (MRI) and T1 weighted with gadolinium injection revealed two extra-axial isointense dural-based mass lesions with homogenous enhancement compressing both frontal lobes. The morphologic findings favored B cell pseudolymphoma and meningeal B cell lymphoid hyperplasia. One year later, she developed headaches, disorientation, and progressive meaningless speech lasting 2 months. Subsequent MRI demonstrated the rapid growth of the lesion of the lesser sphenoid wing and recurrence of the lesion at the same site of surgery, thereby undergoing revision surgery in which both tumors were maximally resected using a pterional approach.
CLINICAL DISCUSSION
Intracranial pseudolymphoma remains exceedingly rare, and despite its benign cellular nature, it may proliferate and recur quickly.
CONCLUSION
Intracranial pseudolymphoma should always be considered a rare but potentially differential diagnosis leading to the intraventricular lesion.
PubMed: 37384957
DOI: 10.1016/j.ijscr.2023.108373 -
The Journal of Dermatology Feb 2022To identify clonal neoplastic cells in skin affected by B-cell lymphoma using skin flow cytometry (FCM) techniques, we investigated light-chain restriction using skin...
To identify clonal neoplastic cells in skin affected by B-cell lymphoma using skin flow cytometry (FCM) techniques, we investigated light-chain restriction using skin FCM with clonality assessed by polymerase chain reaction and light-chain restriction by in situ hybridization (ISH). We retrospectively analyzed 16 cases of B-cell lymphoma with cutaneous involvement: primary cutaneous diffuse large B-cell lymphoma, leg type (pcDLBCL-LT) (n = 7), DLBCL-not otherwise specified (DLBCL-NOS) (n = 6), primary cutaneous follicle center lymphoma (pcFCL) (n = 1), and follicular lymphoma (n = 2), as well as cutaneous B-cell pseudolymphoma (n = 9). Results of skin FCM light-chain restriction analyses were compared with immunoglobulin H (IgH) gene rearrangement and κ/λ ISH findings. Skin FCM detected light-chain restriction in 11 of 14 B-cell lymphoma patients but none of the B-cell pseudolymphoma patients. The sensitivity of skin FCM for distinguishing B-cell lymphoma and B-cell pseudolymphoma was 79%, and the specificity was 100%. Eleven of 13 B-cell lymphoma patients exhibited gene rearrangement (sensitivity 85%), whereas six of seven pseudolymphoma patients were negative (specificity 86%). ISH was positive in three of 16 B-cell lymphoma cases (sensitivity 19%) but none of the B-cell pseudolymphoma cases (specificity 100%). ISH sensitivity was 29% for pcDLBCL-LT, 17% for DLBCL-NOS, and 0% for pcFCL and follicular lymphoma. Skin FCM therefore appears to be more sensitive than ISH in detecting light-chain restriction in DLBCL and follicular lymphoma, and as sensitive as IgH gene rearrangement analysis in detecting clonality. Skin FCM is thus a promising diagnostic tool for identifying monoclonal neoplastic B-cell populations.
Topics: Flow Cytometry; Gene Rearrangement; Humans; Immunophenotyping; Lymphoma, Large B-Cell, Diffuse; Pseudolymphoma; Retrospective Studies
PubMed: 34263482
DOI: 10.1111/1346-8138.16057 -
Dermatologic Therapy Jul 2019To explore and compare the clinical presentations and pathologic features of cutaneous pseudolymphomas (CPL) with primary cutaneous lymphomas. Review literature in order... (Review)
Review
To explore and compare the clinical presentations and pathologic features of cutaneous pseudolymphomas (CPL) with primary cutaneous lymphomas. Review literature in order to improve the treatment of CPL. Six cases of CPLs were collected. The clinical, pathologic, and immunohistochemical features were performed and analyzed in Peking Union Medical College Hospital in 2018. Of six patients, the distributions and clinical manifestations of skin lesions are varied. The pathologic features consisted of atypical prominent lymphocytes infiltration. Of them, two cases imitated mycosis fungoides, one case mimicked primary cutaneous aggressive pidermotropic CD8+ cytotoxic T-cell lymphoma, one case was diagnosed as Jessner-Kanof lymphocyte infiltration and two cases primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. With respect to etiology, one was result from insects bite and the others were on account of drugs. All cases were treated with systemic or local glucocorticoid. The skin lesions and systemic symptoms showed notable improvement after treatment. Follow-up visits were 2 years, half a year, and months, respectively, without relapse. These unique types of CPL were similar to cutaneous lymphomas in clinical manifestation and pathology. They were all sensitive to the treatment of externally or orally using glucocorticoid. The prognosis is generally good but needs long-term follow-up.
Topics: Adolescent; Adult; Aged, 80 and over; Female; Glucocorticoids; Humans; Lymphoma, T-Cell, Cutaneous; Male; Middle Aged; Pseudolymphoma; Skin Neoplasms
PubMed: 30589489
DOI: 10.1111/dth.12807 -
Anais Brasileiros de Dermatologia 2022
Topics: Humans; Pseudolymphoma; Skin Diseases; Skin Neoplasms
PubMed: 35853772
DOI: 10.1016/j.abd.2020.11.019 -
Cureus Mar 2023Pseudolymphoma (PSL) of the orbit is a benign lymphoid hyperplasia (LH). It is a rare disease with an extensive range of known causative agents. LH is further classified...
Pseudolymphoma (PSL) of the orbit is a benign lymphoid hyperplasia (LH). It is a rare disease with an extensive range of known causative agents. LH is further classified into "reactive" (RLH) and "atypical" (ALH) types. It clinically presents as a single or a few plaques and/or nodular lesions, particularly on the head, neck, and upper trunk. It must be differentiated from orbital malignant lymphoma. In this report, we present a case of a 58-year-old Pakistani female with an asymptomatic recurrent right periorbital swelling for three years. It was clinically diagnosed as an angiotensin-converting enzyme (ACE) inhibitor-induced angioedema as it responded to stopping the ACE inhibitor; however, after four months, the patient again started to develop right periorbital swelling. An incisional biopsy revealed perivascular and periadnexal infiltration of lymphocytes, plasma cells, and a few neutrophils along with pigmentary incontinence. The formation of multiple lymphoid follicles and infiltration by monomorphic lymphoid cells in deeper skeletal muscle fibers were also observed. Immunohistochemistry (IHC) showed polyclonality and low Ki-67 labeling (20%), corresponding to periorbital RLH. Our objective in this study is to highlight the importance of considering PSL as a differential diagnosis in periorbital swelling. We also suggest that recurrent angioedema may lead to PSL.
PubMed: 37073202
DOI: 10.7759/cureus.36270 -
Journal of Clinical Neuroscience :... Aug 2020Intracranial pseudolymphoma is a rare entity. We report the case of a 44 year old female who presented with headaches and was noted to have a right lateral ventricular...
Intracranial pseudolymphoma is a rare entity. We report the case of a 44 year old female who presented with headaches and was noted to have a right lateral ventricular lesion on a background history of Burkitt's lymphoma. She underwent biopsy of said lesion and was found to have benign reactive lymphoid tissue. This is the third reported case in literature of intracranial pseudolymphoma and the first reported intraventricular lesion.
Topics: Adult; Biopsy; Burkitt Lymphoma; Cerebral Ventricles; Diagnosis, Differential; Female; Humans; Pseudolymphoma
PubMed: 32417128
DOI: 10.1016/j.jocn.2020.04.082 -
Italian Journal of Dermatology and... Apr 2024Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being... (Review)
Review
INTRODUCTION
Over the few last decades, dermoscopy has become an invaluable and popular imaging technique that complements the diagnostic armamentarium of dermatologists, being employed for both tumors and inflammatory diseases. Whereas distinction between neoplastic and inflammatory lesions is often straightforward based on clinical data, there are some scenarios that may be troublesome, e.g., solitary inflammatory lesions or tumors superimposed to a widespread inflammatory condition that may share macroscopic morphological findings.
EVIDENCE ACQUISITION
We reviewed the literature to identify dermoscopic clues to support the differential diagnosis of clinically similar inflammatory and neoplastic skin lesions, also providing the histological background of such dermoscopic points of differentiation.
EVIDENCE SYNTHESIS
Dermoscopic differentiating features were identified for 12 relatively common challenging scenarios, including Bowen's disease and basal cell carcinoma vs. psoriasis and dermatitis, erythroplasia of Queyrat vs. inflammatory balanitis, mammary and extramammary Paget's disease vs. inflammatory mimickers, actinic keratoses vs. discoid lupus erythematosus, squamous cell carcinoma vs. hypertrophic lichen planus and lichen simplex chronicus, actinic cheilitis vs. inflammatory cheilitis, keratoacanthomas vs. prurigo nodularis, nodular lymphomas vs. pseudolymphomas and inflammatory mimickers, mycosis fungoides vs. parapsoriasis and inflammatory mimickers, angiosarcoma vs granuloma faciale, and Kaposi sarcoma vs pseudo-Kaposi.
CONCLUSIONS
Dermoscopy may be of aid in differentiating clinically similar inflammatory and neoplastic skin lesions.
Topics: Dermoscopy; Humans; Diagnosis, Differential; Skin Neoplasms; Dermatitis; Skin Diseases; Psoriasis
PubMed: 38650495
DOI: 10.23736/S2784-8671.24.07825-3 -
Histopathologic Spectrum of Findings Associated With Tattoos: Multicenter Study Series of 230 Cases.The American Journal of Dermatopathology Aug 2021Reactions to tattoo may simulate common dermatosis or skin neoplasms. Histopathology allows diagnosis and helps determining the level and degree of inflammation...
IMPORTANCE
Reactions to tattoo may simulate common dermatosis or skin neoplasms. Histopathology allows diagnosis and helps determining the level and degree of inflammation associated, consequently orientating treatment.
OBJECTIVE
To describe the histological features found in biopsies of cutaneous reactions to tattoo.
DESIGN
This study was designed as a multicenter case series.
SETTING
All consecutive histopathological samples of tattoos referred from 1992 to 2019 to the Hospital General de Catalunya, Hospital Germans Trias i Pujol, and a private practice, all in Barcelona, Spain, and from the Kempf und Pfaltz Histologische Diagnostik in Zurich, Switzerland were retrieved from the files.
PARTICIPANTS AND EXPOSURE
The inclusion criteria were all cosmetic/permanent makeup, artistic/professional, and traumatic tattoos associated with either inflammatory reactions alone and/or with tumors and/or infections. Exclusion criteria were cases without any associated pathologic finding in the place of the ink, amalgam tattoos, and medical or temporary tattoos.
MAIN OUTCOMES AND MEASURES
In all patients, clinical features (age, sex, location, tattoo color, and presentation) were recorded. Histological features evaluated included ink color, associated tumors or infections, and inflammatory reaction pattern. Inflammation was graded in low to moderate or severe.
RESULTS
From 477 biopsies diagnosed as tattoos, 230 cases from 226 patients met the inclusion criteria. Samples corresponded to 107 male and 120 female subjects and 3 of unknown gender. Median age was 39 years (ranging from 9 to 84 years). Fifty-three samples were referred from centers in Spain and 177 from the center in Switzerland. The series was analyzed in 2 parts: tattoos associated only with inflammatory reactions (117/230) and tattoos associated with tumors or infections (113/230). The most common form of inflammatory pattern associated with tattoo was the fibrosing reaction (79/117, 68%), followed by granulomatous reaction (56/117, 48%), lichenoid reaction (33/117, 28%), epithelial hyperplasia (28/117, 24%), pseudolymphoma (27/117, 23%) and spongiotic reaction (27/117, 23%). Combined features of 2 or more types of inflammatory patterns were seen in 64% cases.
CONCLUSIONS AND RELEVANCE
Our series confirms that cutaneous reactions to tattoos are polymorphous. Inflammation tends to present with combined patterns. Infections are tending to decline, and pathologic findings are not specific to ink color or clinical features.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Color; Coloring Agents; Dermatitis; Female; Granuloma; Humans; Ink; Lichenoid Eruptions; Male; Middle Aged; Pseudolymphoma; Skin; Skin Diseases, Infectious; Skin Neoplasms; Tattooing; Young Adult
PubMed: 34276026
DOI: 10.1097/DAD.0000000000001695