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Tidsskrift For Den Norske Laegeforening... Aug 2023Lyme disease after a tick bite often presents as erythema migrans, yet less frequent variants of this disease, such as Borrelia lymphocytoma, multiple erythema migrans...
BACKGROUND
Lyme disease after a tick bite often presents as erythema migrans, yet less frequent variants of this disease, such as Borrelia lymphocytoma, multiple erythema migrans and neuroborreliosis, are also seen occasionally.
CASE PRESENTATION
We report a case of a tick-bitten child who first presented with an indistinct macular erythema around the left eye and a more distinct macular erythema on and around the left ear. The next day, she developed a facial palsy.
INTERPRETATION
The case was interpreted as facial multiple erythema migrans and Borrelia lymphocytoma on the ear, followed by neuroborreliosis. The diagnosis of lymphocytoma was made from clinical findings and PCR of skin biopsy. She recovered quickly after intravenous ceftriaxone and is now healthy.
Topics: Child; Female; Humans; Ear Diseases; Erythema Chronicum Migrans; Facial Dermatoses; Facial Paralysis; Lyme Neuroborreliosis; Pseudolymphoma; Tick Bites; Lyme Disease; Skin Diseases, Bacterial
PubMed: 37589351
DOI: 10.4045/tidsskr.23.0159 -
Respiration; International Review of... 2017Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established first-line invasive modality for mediastinal lymph node staging in...
BACKGROUND
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established first-line invasive modality for mediastinal lymph node staging in lung cancer patients and in the diagnostic workup of patients with mediastinal adenopathy. With the current 21- and 22-gauge (G) EBUS-TBNA needles, the procedure can be limited by the degree of flexibility in the needle and the size of the lumen in tissue acquisition.
OBJECTIVE
We report our initial experience with a first-generation flexible 19-G EBUS-TBNA (Flex 19G; Olympus Respiratory America, Redmond, WA, USA) needle with regards to efficacy and safety.
METHODS
The Flex 19G EBUS-TBNA needle was used in 47 selected patients with enlarged hilar and/or mediastinal lymphadenopathy at 3 centers. The standard Olympus EBUS scope with a 2.2-mm working channel was used in all cases.
RESULTS
The diagnostic yield of the Flex 19G needle according to clinical cytopathology reports was 89% (42/47). The diagnosis and their respective diagnostic yield with the Flex 19G EBUS-TBNA needle were malignancy 24/27 (89%), sarcoidosis 13/14 (93%), and reactive lymph node hyperplasia 5/6 (83%). The mean short axis of the sampled lymph nodes was 19 ± 9 mm. No complications occurred except for 1 instance of moderate bleeding, which did not require intervention beyond suctioning and subsequently resolved. All 13 patients diagnosed with adenocarcinoma by the 19-G needle had sufficient tissue for genetic testing.
CONCLUSION
EBUS-TBNA using the first-generation Flex 19G needle is feasible and safe with promising diagnostic yield while providing a greater degree of flexion with the Olympus EBUS scope. Additional clinical evaluations are warranted.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Aged; Bronchoscopy; Carcinoma, Squamous Cell; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Female; Humans; Lung Neoplasms; Lymph Nodes; Lymphadenopathy; Lymphoma; Male; Mediastinal Neoplasms; Mediastinum; Middle Aged; Needles; Neoplasms; Pseudolymphoma; Retrospective Studies; Sarcoidosis, Pulmonary; Small Cell Lung Carcinoma
PubMed: 28511175
DOI: 10.1159/000475504 -
Journal of the American Academy of... Apr 2022Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available.
Dermatoscopy of nodular/plaque-type primary cutaneous T- and B-cell lymphomas: A retrospective comparative study with pseudolymphomas and tumoral/inflammatory mimickers by the International Dermoscopy Society.
BACKGROUND
Limited data on dermatoscopy of nodular/plaque-type T-/B-cell primary cutaneous lymphomas (PCLs) is available.
OBJECTIVE
To describe dermatoscopic features of nodular/plaque-type PCLs, comparing them with those of clinical mimickers (pseudolymphomas, tumors, and inflammatory lesions) and investigating possible differences according to histologic subtypes.
METHODS
Participants were invited to join this retrospective, multicenter case-control study by submitting histologically/immunohistochemically confirmed instances of nodular/plaque-type PCLs and controls. Standardized assessments of the dermatoscopic images and comparative analyses were performed.
RESULTS
A total of 261 lesions were included (121 PCLs and 140 controls). Orange structureless areas were the strongest PCL dermatoscopic predictor on multivariate analysis compared with tumors and noninfiltrative inflammatory dermatoses. On the other hand, a positive association was found between PCLs and either unfocused linear vessels with branches or focal white structureless areas compared with infiltrative inflammatory dermatoses, whereas white lines were predictive of PCLs over pseudolymphomas. Differences in the vascular pattern were also seen between B- and T-cell PCLs and among B-cell PCL subtypes.
LIMITATIONS
Retrospective design and the lack of a dermatoscopic-pathologic correlation analysis.
CONCLUSION
Nodular/plaque-type PCLs display dermatoscopic clues, which may partially vary according to histologic subtype and whose diagnostic relevance depends on the considered clinical differential diagnoses.
Topics: Breast Neoplasms; Case-Control Studies; Dermoscopy; Female; Humans; Lymphoma, B-Cell; Lymphoma, T-Cell, Cutaneous; Pseudolymphoma; Retrospective Studies; Skin Neoplasms
PubMed: 34695527
DOI: 10.1016/j.jaad.2021.10.020 -
Cureus Apr 2023Cutaneous B-cell pseudolymphoma (CBPL) may appear in the face, chest, or upper limbs, and it can be asymptomatic or in the form of nodules, papules, or masses. In most...
Cutaneous B-cell pseudolymphoma (CBPL) may appear in the face, chest, or upper limbs, and it can be asymptomatic or in the form of nodules, papules, or masses. In most cases, it is idiopathic. However, some causes that have been identified are trauma, contact dermatitis, injected vaccinations, bacterial infections, tattoo dyes, insect bites, and certain drugs. Since the histology and clinical presentation of cutaneous pseudolymphoma (CPSL) are similar to those of cutaneous lymphomas, the diagnosis is usually based on an incisional or excisional biopsy. In this paper, a 14-year-old male patient with a two-month-old mass in the right lateral thoracic region is taken as a case study. He had neither symptoms, nor a past medical history, nor a family history. He had an insect bite a month ago and was fully vaccinated. However, the mass was some centimeters away from the insect bite. A biopsy was taken. The products of it were two paraffin cubes and two histological slides (H&E). The diagnosis was cutaneous B-cell pseudolymphoma. The total removal of the mass was decided since, in idiopathic cases like this, CBPL is not usually healed with topical and non-invasive treatments. Follow-up examinations were suggested since a further antigenic reaction is possible. If cutaneous B-pseudolymphoma is early diagnosed and treated, it does not cause serious problems. In some cases, it even resolves on its own.
PubMed: 37223157
DOI: 10.7759/cureus.38003 -
The Journal of Clinical and Aesthetic... Dec 2022
PubMed: 36569526
DOI: No ID Found -
Dermatology Online Journal Apr 2021Palpable migratory arciform erythema (PMAE) is an uncommon T cell pseudolymphoma characterized by erythematous, annular-to-arciform papules and plaques. Although the...
Palpable migratory arciform erythema (PMAE) is an uncommon T cell pseudolymphoma characterized by erythematous, annular-to-arciform papules and plaques. Although the eruption is self-limited in most cases, recurrences are routine. Diagnosis requires attention to clinical history as well as histopathologic analysis, which allow for differentiation from other T cell pseudolymphomas and gyrate erythemas. A common triggering factor has not been identified. We report a 60-year-old man who developed PMAE after IVIg infusion. Interestingly, although the individual eruptions were self-limited and resolved after several weeks, subsequent infusions predictably resulted in recurrence of PMAE, confirming the association. To our knowledge, this is the first reported case of recurrent PMAE in association with IVIg infusions.
Topics: Diagnosis, Differential; Erythema; Humans; Immunoglobulins, Intravenous; Male; Middle Aged; Myasthenia Gravis; Pseudolymphoma; Recurrence; Skin; T-Lymphocytes
PubMed: 33999580
DOI: No ID Found -
JAAD Case Reports Apr 2020
PubMed: 32211493
DOI: 10.1016/j.jdcr.2016.07.008 -
Anais Brasileiros de Dermatologia 2024Primary cutaneous CD4 small/medium-sized pleomorphic T-Cell lymphoproliferative disorder (PC-SMTLD) has been considered as a controversial dermatological disease that...
BACKGROUND
Primary cutaneous CD4 small/medium-sized pleomorphic T-Cell lymphoproliferative disorder (PC-SMTLD) has been considered as a controversial dermatological disease that has been included in cutaneous T-cell lymphoma group, presenting most commonly as a solitary nodule and/or plaque with a specific and characteristic head and neck predilection. Due to the considerable overlap between PC-SMTLD and pseudolymphoma (PL), the differential diagnosis is often challenging. Methylation of DNA at position 5 of cytosine, and the subsequent reduction in intracellular 5-hydroxymethylcytosine (5-hmC) levels, is a key epigenetic event in several cancers, including systemic lymphomas. However, it has rarely been studied in cutaneous lymphomas.
OBJECTIVES
The authors aimed to explore the role of differential 5-hmC immunostaining as a useful marker to distinguish PC-SMTLD from PL.
METHODS
Retrospective case series study with immunohistochemical and immunofluorescence analysis of 5-hmC was performed in PL and PC-SMTLD.
RESULTS
Significant decrease of 5-hmC nuclear staining was observed in PC-SMTLD when compared with PL (p < 0.0001). By semi-quantitative grade integration, there were statistical differences in the final 5-hmC scores in the two study groups. The IF co-staining of 5-hmC with CD4 revealed a decrease of 5-hmC in CD4 lymphocytes of PC-SMTLD.
STUDY LIMITATIONS
The small clinical sample size of the study.
CONCLUSIONS
The immunorreactivity of 5-hmC in CD4 lymphocytes was highly suggestive of a benign process as PL. Furthermore, the decrease of 5-hmC nuclear staining in PC-SMTLD indicated its lymphoproliferative status and helped to make the differential diagnosis with PL.
Topics: Humans; Retrospective Studies; CD4-Positive T-Lymphocytes; Lymphoma, T-Cell, Cutaneous; Skin Neoplasms; Pseudolymphoma
PubMed: 37657958
DOI: 10.1016/j.abd.2023.01.003 -
Journal of Cancer Research and... 2015Large lymphoid proliferations are usually regarded as synonymous with lymphomas. However, lymphoma-like lesions. (LLLs) of the cervix are amongst the exception. We... (Review)
Review
Large lymphoid proliferations are usually regarded as synonymous with lymphomas. However, lymphoma-like lesions. (LLLs) of the cervix are amongst the exception. We report a 46-year-old woman who complained of irregular menses and was found to have superficial erosion in cervix, which on biopsy showed clusters of large atypical appearing lymphoid cells admixed with smaller reactive lymphoid cells. On immunohistochemistry, these large cells were strongly positive for CD20 and CD30 and the background cells were reactive to CD3. Based on the superficial nature of infiltrate and absence of a mass-forming lesion, a diagnosis of LLL of cervix was made. Despite a benign diagnosis, a hysterectomy was done on patient's insistence and only a focus of lymphoid cells similar to biopsy was seen on the operated specimen. Patient is free of disease on follow-up.
Topics: Biomarkers, Tumor; Cervix Uteri; Diagnosis, Differential; Female; Humans; Hysterectomy; Immunoenzyme Techniques; Middle Aged; Prognosis; Pseudolymphoma; Uterine Cervical Neoplasms
PubMed: 26881638
DOI: 10.4103/0973-1482.155979 -
International Journal of Surgery Case... 2018Pseudolymphoma of the liver is a very rare disease. It is usually resected and pathologically diagnosed because of the difficulty of discrimination from the malignant...
INTRODUCTION
Pseudolymphoma of the liver is a very rare disease. It is usually resected and pathologically diagnosed because of the difficulty of discrimination from the malignant neoplasm. For this reason, few cases which were observed for several years have been reported. We present a case of this disease observed and slightly enlarged for two years.
PRESENTATION OF CASES
The patient was a 46-year-old woman who underwent laparoscopic partial nephrectomy for right renal cell carcinoma two years ago. The preoperative computed tomography (CT) showed the mass 7 mm in diameter with localized parenchymal atrophy of the liver (segment Ⅵ). Two years later, CT showed enlarged mass from 7 to 11 mm in diameter. We performed laparoscopic partial hepatectomy because the patient desired definite diagnosis by surgery. The resected specimen showed white and solid mass. The lymphocyte and plasma cells are histologically observed. Immunohistological staining showed CD10 positive, Bcl-2 negative, and cyclin D1 negative. The pathological diagnosis was pseudolymphoma of the liver.
DISCUSSION
Pseudolymphoma is rarely observed in the liver. It is reported that chronic hepatitis, collagen diseases, and malignant diseases were often accompanied, but detail pathogenesis has been unknown. She had the history of renal carcinoma, but the lesion was not vanished regardless of clearance of renal neoplasm. Surgical resection is usually performed because discrimination with malignant neoplasm is difficult. The present case is probably the first one, which is followed for long term duration.
CONCLUSION
The present case may contribute to clarify the pathophysiology of this entity.
PubMed: 30005366
DOI: 10.1016/j.ijscr.2018.06.033