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Turkiye Parazitolojii Dergisi Mar 2019Pseudolymphoma, also known as Jessner’s lymphocytic infiltration, is a benign but usually chronic, T-cell infiltrating disease with erythematous papules and plaques...
Pseudolymphoma, also known as Jessner’s lymphocytic infiltration, is a benign but usually chronic, T-cell infiltrating disease with erythematous papules and plaques usually seen on the skin of the face, neck, and back. The use of leech therapy also known as hirudotherapy has increased in recent years. Here, we report a 52-year-old male patient who had undergone hirudotherapy in his neck and developed infiltrating plaques after four months. A skin biopsy confirmed the diagnosis of Jessner’s lymphocytic infiltration. In parallel with the increasing use of hirudotherapy in recent years, the side-effect reports will likely to increase. Indications and contraindications of hirudotherapy, which is being used officially in hospitals, should be taken into consideration.
Topics: Diagnosis, Differential; Humans; Leeching; Male; Middle Aged; Neck; Pseudolymphoma; Skin Diseases
PubMed: 30938141
DOI: 10.4274/tpd.galenos.2018.6037 -
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 -
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 -
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 -
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 -
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 -
Anais Brasileiros de Dermatologia 2022
Topics: Humans; Pseudolymphoma; Skin Diseases; Skin Neoplasms
PubMed: 35853772
DOI: 10.1016/j.abd.2020.11.019 -
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 -
Dermatology Practical & Conceptual Jan 2019
PubMed: 30775141
DOI: 10.5826/dpc.0901a04 -
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