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BMJ Case Reports Nov 2023Hepatic reactive lymphoid hyperplasia is an uncommon benign condition, often found incidentally as a solitary liver lesion. The chronic inflammatory reaction associated...
Hepatic reactive lymphoid hyperplasia is an uncommon benign condition, often found incidentally as a solitary liver lesion. The chronic inflammatory reaction associated with autoimmune conditions and malignancies has been postulated as a possible aetiology. The diagnosis is challenging as it often mimics various malignancies radiologically and histologically, hence the diagnosis being made only after surgical resection. Lymphadenopathy is common with primary biliary cholangitis, though rarely reported with reactive lymphoid hyperplasia. We report a case of hepatic reactive lymphoid hyperplasia associated with portacaval lymphadenopathy in a patient with primary biliary cholangitis, diagnosed after surgical resection. We propose lesional biopsy be considered in patients with primary biliary cholangitis found to have a solitary lesion with supporting low-risk clinical and radiological features.
Topics: Humans; Pseudolymphoma; Liver Cirrhosis, Biliary; Liver Neoplasms; Lymphadenopathy; Cholangitis
PubMed: 37967929
DOI: 10.1136/bcr-2023-254963 -
Indian Journal of Dermatology 2023
PubMed: 37822384
DOI: 10.4103/ijd.ijd_645_22 -
Cureus May 2024Cutaneous reactive lymphoid proliferation (CRLP) is a condition that resembles cutaneous lymphoma, and differentiating the two is necessary for proper diagnosis and...
Cutaneous reactive lymphoid proliferation (CRLP) is a condition that resembles cutaneous lymphoma, and differentiating the two is necessary for proper diagnosis and treatment. It can be idiopathic or caused by viruses, drugs, or skin trauma, resulting in reactive lymphoid hyperplasia. Several clinical and histopathological features are helpful for differentiating CRLP from lymphoma, and they must be considered as a whole to reach the correct diagnosis. The number, location, and progression of CRLP lesions are important clinical clues, while the type, size, arrangement, surface markers, and clonality of the cellular infiltrate are key histopathological clues. We present a case in which CRLP arose in the setting of concomitant antidepressant and antihypertensive use, which are both potential causes of CRLP. In this case, excision served as both diagnosis and treatment. The benign presentation and lack of clonality led to the diagnosis of CRLP. While the cause is unknown, drug exposure was a possible inciting factor, and the patient will be monitored for recurrence.
PubMed: 38899272
DOI: 10.7759/cureus.60681 -
Annales de Dermatologie Et de... Mar 2024
Topics: Humans; Patch Tests; Pseudolymphoma; Skin Abnormalities
PubMed: 38306723
DOI: 10.1016/j.annder.2023.103239 -
JAAD Case Reports Apr 2024
PubMed: 38577499
DOI: 10.1016/j.jdcr.2024.02.007 -
JAAD Case Reports May 2024
PubMed: 38576903
DOI: 10.1016/j.jdcr.2024.02.028 -
Radiology Case Reports May 2024A 53-year-old female with primary biliary cholangitis was referred for the evaluation of a hepatic nodule identified during routine imaging. Ultrasonography revealed a...
A 53-year-old female with primary biliary cholangitis was referred for the evaluation of a hepatic nodule identified during routine imaging. Ultrasonography revealed a homogeneous, hypoechoic, 18 mm nodule in segment 3 of the liver. On dynamic CT and MRI, the nodule showed mild enhancement at the hepatic artery-dominant phase. On diffusion-weighted images, the nodule exhibited pronounced hyperintensity with accompanying wedge-shaped perinodular hyperintensity (comet and comet-tail appearance). The nodule showed a portal perfusion defect on CT during arterial portography, and mild enhancement on CT during hepatic arteriography (CTHA). A nodular and wedge-shaped perinodular enhancement (comet and comet-tail appearance) in the CTHA was also clearly observed. The nodule demonstrated abnormal FDG uptake on F-FDG-PET/CT. An excisional biopsy was performed for histopathological diagnosis, and the nodule was diagnosed as reactive lymphoid hyperplasia (RLH). Diagnosing hepatic RLH by imaging is challenging due to its imaging findings overlapping with those of various malignant tumors, especially the nodular type of lymphomas, making differentiation particularly difficult. However, radiologists should note the perinodular early enhancement and the perinodular hyperintensity on diffusion weighted images, which are thought to be key imaging findings of RLH, along with other characteristics such as a single, small, homogeneous nodule with mild early enhancement and marked restricted diffusion. We propose to name the nodular lesion with perinodular early enhancement/hyperintensity on diffusion weighted images as 'comet and comet-tail appearances'.
PubMed: 38440741
DOI: 10.1016/j.radcr.2024.02.029 -
Journal of Clinical and Experimental... 2024Duodenal type follicular lymphoma (DFL), a rare entity of follicular lymphoma (FL), is clinically indolent and is characterized by a low histological grade compared with...
Duodenal type follicular lymphoma (DFL), a rare entity of follicular lymphoma (FL), is clinically indolent and is characterized by a low histological grade compared with nodal follicular lymphoma (NFL). Our previous reports revealed that DFL shares characteristics of both NFL and mucosa-associated lymphoid tissue (MALT) lymphoma in terms of clinical and biological aspects, suggesting its pathogenesis may involve antigenic stimulation. In contrast to NFL, the genomic methylation status of DFL is still challenging. Here, we determined the methylation profiles of DNAs from patients with DFL (n = 12), NFL (n = 10), duodenal reactive lymphoid hyperplasia (D-RLH) (n = 7), nodal reactive lymphoid hyperplasia (N-RLH) (n = 5), and duodenal samples from normal subjects (NDU) (n = 5) using methylation specific PCR of targets previously identified in MALT lymphoma (CDKN2B/P15, CDKN2A/P16, CDKN2C/P18, MGMT, hMLH-1, TP73, DAPK, HCAD). DAPK1 was frequently methylated in DFL (9/12; 75%), NFL (9/10; 90%), and D-RLH (5/7; 71%). CDKN2B/P15 sequences were methylated in six DFL samples and in only one NFL sample. Immunohistochemical analysis showed that p15 expression inversely correlated with methylation status. Genes encoding other cyclin-dependent kinase inhibitors (CDKN2A/P16, CDKN2C/P18) were not methylated in DFL samples. Methylation of the genes of interest was not detected in DNAs from D-RLH, except for DAPK1, and the difference in the extent of methylation between NDU and D-RLH was statistically significant (P = 0.013). Our results suggest that D-RLH serves as a reservoir for the development of DFL and that methylation of CDKN2B/P15 plays an important role in this process.
Topics: Humans; Lymphoma, Follicular; Death-Associated Protein Kinases; DNA Methylation; Male; Pseudolymphoma; Female; Middle Aged; Cyclin-Dependent Kinase Inhibitor p15; Aged; Duodenal Neoplasms; Adult
PubMed: 38925973
DOI: 10.3960/jslrt.24020 -
Cureus Mar 2024Benign lymphoid polyps of the rectum, also termed "Rectal tonsil" or "Pseudolymphoma," are submucosal tumor-like growths with localized hyperplasia of the lymphoid...
Benign lymphoid polyps of the rectum, also termed "Rectal tonsil" or "Pseudolymphoma," are submucosal tumor-like growths with localized hyperplasia of the lymphoid follicles and are often discovered incidentally during colonoscopy. Its diagnosis and differentiation from other submucosal tumors pose challenges owing to their similar endoscopic features. A 72-year-old woman presented with a positive fecal occult blood test, which led to the discovery of a 10-mm lower rectal tumor resembling a neuroendocrine tumor during colonoscopy. Upon closer examination, the lesion had a yellow submucosal appearance with dilated capillaries. Endoscopic submucosal resection with a ligation device (ESMR-L) was performed because the patient preferred immediate removal. Histopathological examination revealed lymphocytic infiltration with germinal center-containing lymphoid follicles, confirming the diagnosis of benign lymphoid polyp. Benign lymphoid polyps are often difficult to differentiate from carcinoid tumors and malignant lymphomas because the endoscopic findings are similar. Although preoperative endoscopic ultrasonography aids localization and characterization, definitive differentiation remains elusive and necessitates complete lesion resection. ESMR-L is a viable approach for diagnostic accuracy and therapeutic intervention, offering advantages in terms of procedural efficiency and patient care, particularly in cases involving submucosal rectal lesions.
PubMed: 38469365
DOI: 10.7759/cureus.55921 -
Journal of the European Academy of... Feb 2024
The unexpected guest: Cytotoxic, pseudolymphoma-like reaction at the site of primary cutaneous follicle centre B-cell lymphoma in a patient receiving secukinumab for psoriasis.
PubMed: 38334200
DOI: 10.1111/jdv.19845