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Indian Journal of Dermatology 2016Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a... (Review)
Review
Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a significant challenge since many inflammatory dermatoses can clinically and/or histopathologically mimic cutaneous lymphomas, coined pseudolymphomas. We conducted a literature review from 1966 to July 1, 2015, at PubMed.gov using the search terms: Cutaneous lymphoma, cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia, simulants/mimics/imitators of cutaneous lymphomas, and cutaneous lymphoid infiltrates. The diagnostic approach to CLIs and the most common differential imitators of lymphoma is discussed herein based on six predominant morphologic and immunophenotypic, histopathologic patterns: (1) Superficial dermal T-cell infiltrates (2) superficial and deep dermal perivascular and/or nodular natural killer/T-cell infiltrates (3) pan-dermal diffuse T-cell infiltrates (4) panniculitic T-cell infiltrates (5) small cell predominant B-cell infiltrates, and (6) large-cell predominant B-cell infiltrates. Since no single histopathological feature is sufficient to discern between a benign and a malignant CLI, the overall balance of clinical, histopathological, immunophenotypic, and molecular features should be considered carefully to establish a diagnosis. Despite advances in ancillary studies such as immunohistochemistry and molecular clonality, these studies often display specificity and sensitivity limitations. Therefore, proper clinicopathological correlation still remains the gold standard for the precise diagnosis of CLIs.
PubMed: 27512181
DOI: 10.4103/0019-5154.185698 -
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 -
International Journal of Surgery Case... 2017Perianal pseudolymphoma is a rare lymphoproliferative disorder that can mimic cutaneous lymphoma. The condition can present acutely with concerns of perianal sepsis. The...
INTRODUCTION
Perianal pseudolymphoma is a rare lymphoproliferative disorder that can mimic cutaneous lymphoma. The condition can present acutely with concerns of perianal sepsis. The purpose of this case review is to review the current literature on perianal pseudolymphoma and emphasise to the surgical community its presentation, suggested aetiology and management.
CASE PRESENTATION
In this case report, we detail the case of a 28-year-old female who presented with perianal pseudolymphoma. Malignant lymphoproliferative diseases required exclusion. Conservative management of this rare condition was successful.
DISCUSSION
We highlight the differential diagnoses, investigations and treatment options for a rare condition. A review of the literature on the limited published data on perianal pseudolymphoma is briefly discussed.
CONCLUSION
The aim of this case report is to highlight the existence of such a rare condition that can imitate an acute surgical presentation and its successful conservative management.
PubMed: 28881336
DOI: 10.1016/j.ijscr.2017.08.014 -
Indian Journal of Dermatology Jul 2014
PubMed: 25071293
DOI: 10.4103/0019-5154.135562 -
Archives of Pathology & Laboratory... Oct 2014Primary cutaneous CD4⁺ small/medium T-cell lymphoma is a provisional and controversial entity with a broad differential diagnosis. Despite being an uncommon lymphoma,... (Review)
Review
CONTEXT
Primary cutaneous CD4⁺ small/medium T-cell lymphoma is a provisional and controversial entity with a broad differential diagnosis. Despite being an uncommon lymphoma, it is a frequent diagnostic consideration in cutaneous biopsies with a dense lymphoid infiltrate because it shows overlapping features with reactive lymphoid hyperplasia (pseudolymphoma) and a variety of other primary cutaneous and systemic lymphomas. However, proper classification of this process is important for determining patient prognosis and treatment options.
OBJECTIVE
To review the clinical, morphologic, immunophenotypic, and genetic features of primary cutaneous CD4⁺ small/medium T-cell lymphoma and contrast those features with entities in the differential diagnosis.
DATA SOURCES
Applicable literature will be reviewed with emphasis on current controversies and distinguishing characteristics.
CONCLUSIONS
Although many consider primary cutaneous CD4⁺ small/medium T-cell lymphoma to be indistinguishable from reactive lymphoid hyperplasia/pseudolymphoma, it can be differentiated from other primary cutaneous and systemic lymphomas. Patients with solitary lesions of primary cutaneous CD4⁺ small/medium T-cell lymphoma generally have an excellent prognosis. Nevertheless, a subset of patients who have been reported to meet criteria for this lymphoma have followed a more-aggressive course; however, those patients show some differing clinical, morphologic, and immunophenotypic features.
Topics: Biomarkers, Tumor; Biopsy; CD4 Antigens; Diagnosis, Differential; Gene Expression Regulation, Neoplastic; Humans; Immunoblastic Lymphadenopathy; Lymphoma, B-Cell, Marginal Zone; Lymphoma, T-Cell, Cutaneous; Mycosis Fungoides; Prognosis; Pseudolymphoma; Skin; Skin Neoplasms
PubMed: 25268194
DOI: 10.5858/arpa.2014-0299-CC -
Dermatopathology (Basel, Switzerland) Aug 2021The term "pseudomalignancy" covers a large, heterogenous group of diseases characterized by a benign cellular proliferation, hyperplasia, or infiltrate that resembles a... (Review)
Review
The term "pseudomalignancy" covers a large, heterogenous group of diseases characterized by a benign cellular proliferation, hyperplasia, or infiltrate that resembles a true malignancy clinically or histologically. Here, we (i) provide a non-exhaustive review of several inflammatory skin diseases and benign skin proliferations that can mimic a malignant neoplasm in children, (ii) give pathologists some helpful clues to guide their diagnosis, and (iii) highlight pitfalls to be avoided. The observation of clinical-pathological correlations is often important in this situation and can sometimes be the only means (along with careful monitoring of the disease's clinical course) of reaching a firm diagnosis.
PubMed: 34449607
DOI: 10.3390/dermatopathology8030042 -
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 -
Asian Journal of Surgery Jan 2017We report a case of pseudolymphoma of the liver in a 49-year-old woman without an underlying disease except for liver hemangioma. A 20-mm nodule was incidentally found... (Review)
Review
We report a case of pseudolymphoma of the liver in a 49-year-old woman without an underlying disease except for liver hemangioma. A 20-mm nodule was incidentally found in segment 2 of the liver by abdominal ultrasonography during a regular follow-up of the hepatic hemangioma. After a series of radiological examinations, a left lateral sectionectomy was performed because malignant hepatic tumor could not be excluded. The patient was discharged uneventfully 7 days after the operation. The pathology examination revealed a pseudolymphoma. No recurrence of the tumor was found 5½ years after the operation. To the best of our knowledge, only 46 cases of pseudolymphoma of the liver have been reported to date. A review of the literature showed that pseudolymphomas occur predominantly in females (89.4%), usually occur as a single tumor (80.4%), are no more than 20 mm in size (90.6%), and are frequently associated with either autoimmune disease or chronic liver disease. Because an accurate diagnosis is difficult to establish, vigilant follow-up is indicated, and surgical intervention is the choice of treatment once the suspiciousness of malignancy has been raised.
Topics: Female; Humans; Liver Diseases; Middle Aged; Pseudolymphoma
PubMed: 23978426
DOI: 10.1016/j.asjsur.2013.07.013 -
Modern Pathology : An Official Journal... Feb 2010Hepatic pseudolymphoma is a rare and controversial condition, the clinicopathological characteristics of which have not been well documented. In this study, we... (Review)
Review
Hepatic pseudolymphoma is a rare and controversial condition, the clinicopathological characteristics of which have not been well documented. In this study, we retrospectively examined clinical and pathological features of five patients (two males and three females, 40-81 years old) with hepatic pseudolymphoma. Two patients had multiple lesions (two lesions each). Three patients had histories of chronic liver disorders, including primary biliary cirrhosis, nonalcoholic steatohepatitis, and chronic viral hepatitis B. Tumor sizes ranged from 0.5 to 5.5 cm in diameter (average, 2.1 cm). Histologically, hepatic pseudolymphoma consisted of tumorous infiltrates of mature lymphocytes with multiple lymph follicles or clusters of epithelioid histiocytes. Lymphocytes characteristically extended into nearby portal tracts. Ductal structures positive for cytokeratin 7 were entrapped in the peripheral parts of nodules. In situ hybridization of immunoglobulin light chains revealed B lymphocytes and plasma cells to be polyclonal. In addition, clonal rearrangements of immunoglobulin heavy chains could not be shown in any cases using PCR. Two patients were diagnosed by needle biopsy. Interestingly, their nodules spontaneously diminished in size without any treatment. Malignant transformation was not observed in any cases during the follow-up periods. In conclusion, this study revealed that hepatic pseudolymphoma had benign behavior. The diagnosis of hepatic pseudolymphoma can be challenging especially with biopsied specimens, but could be aided by a characteristic growth pattern, in situ hybridization, analyses of gene rearrangements, or a follow-up based on images.
Topics: Adult; Aged; Aged, 80 and over; Female; Gene Rearrangement; Genes, Immunoglobulin Heavy Chain; Humans; Immunoglobulin Light Chains; Immunohistochemistry; In Situ Hybridization; Liver Diseases; Male; Middle Aged; Polymerase Chain Reaction; Pseudolymphoma
PubMed: 19915525
DOI: 10.1038/modpathol.2009.165 -
Journal of the European Academy of... Jan 2022
Topics: Antibodies, Viral; COVID-19; COVID-19 Vaccines; Humans; Pseudolymphoma; SARS-CoV-2; Vaccines, Synthetic; mRNA Vaccines
PubMed: 34547136
DOI: 10.1111/jdv.17680