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Journal of Cutaneous Pathology Mar 2024Syphilis can mimic, clinically and microscopically, many other diseases. By microscopy, typically syphilis presents with plasma cell infiltration, admixed with...
Syphilis can mimic, clinically and microscopically, many other diseases. By microscopy, typically syphilis presents with plasma cell infiltration, admixed with lymphocytes and macrophages, in lichenoid and/or perivascular/perineural distribution pattern. When exuberant, this inflammatory infiltrate can mimic a lymphoproliferative disorder (LPD), notably plasma cell neoplasia or lymphoma. To date, about 12 cases of secondary syphilis, all but one in extraoral location, suggesting initially a LPD, have been published. Here, to our knowledge, we report an unusual case of intraoral primary syphilis initially suggesting LPD, notably lymphoid hyperplasia (pseudolymphoma); however, mucosa-associated lymphoid tissue (MALT) lymphoma and follicular lymphoma could not be disregarded. Polyclonality of plasma cells on immunohistochemistry, in strict clinical correlation, was essential to arrive at the correct diagnosis.
Topics: Humans; Syphilis; Lymphoproliferative Disorders; Lymphoma, B-Cell, Marginal Zone; Lymphocytes; Diagnosis, Differential
PubMed: 38084767
DOI: 10.1111/cup.14567 -
International Journal of Pediatric... Jul 2017Lamotrigine is an anti-epileptic drug often prescribed to children and young females. Side effects include rash, dizziness and diplopia. Over the last twenty years, two... (Review)
Review
Lamotrigine is an anti-epileptic drug often prescribed to children and young females. Side effects include rash, dizziness and diplopia. Over the last twenty years, two cases of lymphadenopathy due to lamotrigine have been reported. We will present the case of a 17-year old female with persistent lymphadenopathy due to lamotrigine. The purpose of this case report is to inform clinicians that lymphadenopathy is a possible side effect of lamotrigine and to highlight the need for further research.
Topics: Adolescent; Anticonvulsants; Female; Humans; Lamotrigine; Lymph Nodes; Lymphadenopathy; Triazines
PubMed: 28583510
DOI: 10.1016/j.ijporl.2017.04.047 -
Journal of Cutaneous Pathology Dec 2022T-cell-rich angiomatoid polypoid pseudolymphoma (TRAPP) and inflammatory lobular hemangioma (ILH) encompass a spectrum of cutaneous vascular lesions in which a prominent... (Comparative Study)
Comparative Study
BACKGROUND
T-cell-rich angiomatoid polypoid pseudolymphoma (TRAPP) and inflammatory lobular hemangioma (ILH) encompass a spectrum of cutaneous vascular lesions in which a prominent lymphoplasmacytic component may impart a pattern highly reminiscent of low-grade cutaneous lymphoma (pseudolymphoma). Epithelioid hemangioma, including its most common variant angiolymphoid hyperplasia with eosinophilia (ALHE), is a distinct entity associated with FOS and/or FOSB expression detected by immunohistochemistry (IHC). These entities can show significant morphological overlap.
METHODS
We performed IHC for FOSB, FOS, and lymphoid markers in a series of TRAPP/ILH and ALHE.
RESULTS
We identified 13 cases of ILH/TRAPP, which showed a predominance in CD8 T-cells (CD8>CD4: 11/13) while FOSB and FOS were expressed in 36% (4/11) and 27% (3/11) of cases, respectively. ALHE (n = 9) showed a predominance in CD4 T-cell (67%) with FOSB and FOS co-expression in 78% (seven of nine) of the cases.
CONCLUSION
We showed, based on FOS and/or FOSB immunohistochemical expression, that there is a possible link between ILH/TRAPP and epithelioid hemangioma/ALHE. The use of FOS and FOSB IHC in the routine diagnostic setting of cutaneous vascular lesions will help to redefine cases of ILH/TRAPP as a subset of these may represent inflammatory variants of epithelioid hemangioma.
Topics: Humans; Angiolymphoid Hyperplasia with Eosinophilia; Biomarkers; CD8-Positive T-Lymphocytes; Granuloma, Pyogenic; Hemangioma; Immunohistochemistry; Proto-Oncogene Proteins c-fos; Pseudolymphoma
PubMed: 36008878
DOI: 10.1111/cup.14317 -
Dermatology Practical & Conceptual Jan 2019
PubMed: 30775141
DOI: 10.5826/dpc.0901a04 -
Scientific Reports Jul 2020Aluminium hydroxide is a well-known adjuvant used in vaccines. Although it can enhance an adaptive immune response to a co-administered antigen, it causes adverse...
Aluminium hydroxide is a well-known adjuvant used in vaccines. Although it can enhance an adaptive immune response to a co-administered antigen, it causes adverse effects, including macrophagic myofasciitis (MMF), subcutaneous pseudolymphoma, and drug hypersensitivity. The object of this study is to demonstrate pediatric cases of aluminium hydroxide-induced diseases focusing on its rarity, under-recognition, and distinctive pathology. Seven child patients with biopsy-proven MMF were retrieved from the Seoul National University Hospital (SNUH) pathology archives from 2015 to 2019. The medical records and immunisation history were reviewed, and a full pathological muscle examination was carried out. The mean age was 1.7 years (8.9-40 months), who had records of vaccination against hepatitis B, hepatitis A, and tetanus toxoid on the quadriceps muscle. The chief complaints were muscle weakness (n = 6), delayed motor milestones (n = 6), instability, dysarthria, and involuntary movement (n = 1), swallowing difficulty (n = 1), high myopia (n = 1), and palpable subcutaneous nodules with skin papules (n = 1). Muscle biopsy showed MMF (n = 6) and pseudolymphoma (n = 1) with pathognomic basophilic large macrophage infiltration, which had distinctive spiculated inclusions on electron microscopy. The intracytoplasmic aluminium was positive for PAS and Morin stains. Distinctive pathology and ultrastructure suggested an association with aluminium hydroxide-containing vaccines. To avoid misdiagnosis and mistreatment, we must further investigate this uncommon condition, and pharmaceutical companies should attempt to formulate better adjuvants that do not cause such adverse effects.
Topics: Adjuvants, Immunologic; Aluminum Hydroxide; Child, Preschool; Drug Hypersensitivity; Fasciitis; Female; Hepatitis A; Hepatitis B; Humans; Infant; Macrophages; Male; Muscle Weakness; Myositis; Pseudolymphoma; Subcutaneous Tissue; Tetanus; Vaccination; Viral Vaccines
PubMed: 32678281
DOI: 10.1038/s41598-020-68849-8 -
Ophthalmic Plastic and Reconstructive... 2020
Topics: Diagnosis, Differential; Eyelids; Humans; Hyperplasia; Pseudolymphoma
PubMed: 31261162
DOI: 10.1097/IOP.0000000000001407 -
Indian Journal of Dermatology 2015Cutaneous pseudolymphomas are benign lymphoproliferative processes mimicking lymphomas clinically and histologically. One of the precipitating factors for pseudolymphoma...
Cutaneous pseudolymphomas are benign lymphoproliferative processes mimicking lymphomas clinically and histologically. One of the precipitating factors for pseudolymphoma is drugs like anticonvulsants, antidepressants and angiotensin-converting enzyme inhibitors. According to existing literature phenytoin-induced cutaneous pseudolymphomas are usually T-cell predominant. Most often withdrawal of the drug with or without short-course systemic steroids can attain a cure. Rarely malignant transformation has been reported years later despite withdrawal of the offending drug, which necessitates a long-term follow up of the affected. We report an 80-year-old male patient who was receiving phenytoin sodium and who presented with diffuse erythema and infiltrated skin lesions which histologically resembled cutaneous B-cell lymphoma. Substituting phenytoin with levetiracetam achieved resolution of symptoms. Further evaluation was suggestive of a reactive process. A detailed drug history is of paramount importance in differentiating drug-induced pseudolymphoma from lymphoma. Searching literature we could not find any previous reports of phenytoin-induced cutaneous B-cell pseudolymphoma.
PubMed: 26538730
DOI: 10.4103/0019-5154.164437 -
Pathology Aug 2022
Topics: Histiocytes; Histiocytosis; Humans; Immunoglobulin G; Lymphoma
PubMed: 34916070
DOI: 10.1016/j.pathol.2021.09.015 -
Cancers Oct 2022Primary cutaneous follicular B-cell lymphoma (PCFBCL) represents an indolent subtype of Non-Hodgkin's lymphomas, being clinically characterized by slowly growing tumors...
BACKGROUND
Primary cutaneous follicular B-cell lymphoma (PCFBCL) represents an indolent subtype of Non-Hodgkin's lymphomas, being clinically characterized by slowly growing tumors of the skin and common cutaneous relapses, while only exhibiting a low propensity for systemic dissemination or fatal outcome. Up to now, only few studies have investigated underlying molecular alterations of PCFBCL with respect to somatic mutations.
OBJECTIVES
Our aim was to gain deeper insight into the pathogenesis of PCFBCL and to delineate discriminatory molecular features of this lymphoma subtype.
METHODS
We performed hybridization-based panel sequencing of 40 lymphoma-associated genes of 10 cases of well-characterized PCFBCL. In addition, we included two further ambiguous cases of atypical B-cell-rich lymphoid infiltrate/B-cell lymphoma of the skin for which definite subtype attribution had not been possible by routine investigations.
RESULTS
In 10 out of 12 analyzed cases, we identified genetic alterations within 15 of the selected 40 target genes. The most frequently detected alterations in PCFBCL affected the , , and genes. Our analysis unrevealed novel mutations of the gene in PCFBCL. All patients exhibited an indolent clinical course. Both the included arbitrary cases of atypical B-cell-rich cutaneous infiltrates showed somatic mutations within the gene. As these mutations have previously been designated as subtype-specific recurrent alterations in primary cutaneous marginal zone lymphoma (PCMZL), we finally favored the diagnosis of PCMZL in these two cases based on these molecular findings.
CONCLUSIONS
To conclude, our molecular data support that PCFBCL shows distinct somatic mutations which may aid to differentiate PCFBCL from pseudo-lymphoma as well as from other indolent and aggressive cutaneous B-cell lymphomas. While the detected genetic alterations of PCFBCL did not turn out to harbor any prognostic value in our cohort, our molecular data may add adjunctive discriminatory features for diagnostic purposes on a molecular level.
PubMed: 36358692
DOI: 10.3390/cancers14215274 -
Current Medical Imaging 2022Pseudolymphoma of the liver (Reactive Lymphoid Hyperplasia) (RLH) is a rare condition. It is usually asymptomatic and detected incidentally on radiological imaging....
BACKGROUND
Pseudolymphoma of the liver (Reactive Lymphoid Hyperplasia) (RLH) is a rare condition. It is usually asymptomatic and detected incidentally on radiological imaging. Imaging features are similar to hepatic adenoma, hepatocellular carcinoma, cholangiocarcinoma, and malignant lymphoma and are not specific for pseudolymphoma of the liver. Percutaneous core biopsy is insufficient to distinguish pseudolymphoma of the liver from low-grade malignant lymphoma and extranodal marginal lymphomas.
CASE DESCRIPTIONS
In this article, we present a case of hepatic RLH of a patient who was presented with a skin rash on the leg and was detected incidentally on radiological imaging.
CONCLUSION
Preoperative definitive diagnosis of hepatic RLH using various imaging methods, including MRI with hepatocellular agents, is highly difficult.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Lymphoma; Pseudolymphoma
PubMed: 33949938
DOI: 10.2174/1573405617666210504120142