Introduction: Rosai-Dorfman disease is a rare disease that manifests with painless cervical lymphadenopathy, fever, anemia, an elevated erythrocyte sedimentation rate (ESR), and hypergammaglobulinemia. Extranodal lesions occur in 1/3 of patients, and the skin is involved in more than 10% of cases. Purely cutaneous disease is uncommon and only about more than 100 cases have been reported. Cutaneous Rosai-Dorfman Disease (CRDD) appears to be a distinct entity with different age and race predilection from cases with lymph node involvement. Case report: This is a case of a 40-year-old Filipino female who presented with multiple erythematous papules and plaques with pustules on the cheeks. Skin punch biopsy showed a dense dermal infiltrate of polygonal histiocytes with abundant cytoplasm and vesicular nuclei. Emperipolesis was also present. The histiocytes were highlighted by the immunohistochemical stains S-100 and CD68 and was CD1a negative. Complete blood count and ESR were normal. Cervical lymphadenopathy was absent. Findings were consistent with Cutaneous Rosai-Dorfman disease. The patient was started on methotrexate at 15mg/week with folic acid supplementation. Mild soap, benzoyl peroxide 5% gel and tretinoin 0.05% cream once daily were maintained during the treatment course. There was significant decrease in erythema and size of existing lesions after 2 months. The patient was referred to a hematologist for monitoring of possible future systemic involvement. Conclusion Because of its rarity, clinicopathological correlation is always mandatory to establish a diagnosis of CRDD. Immu- nohistochemical stains are required to differentiate this entity form other forms of Langerhans cell histiocytosis. Multidisci- plinary referral is required to rule out concomitant systemic involvement.
Lymphadenopathy

No abstract available.
Immunoblastic Lymphadenopathy*

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

No abstract available.
Graves Disease* ; Immunoblastic Lymphadenopathy*

Humans ; Erythema Infectiosum ; Lymphadenopathy

Humans ; Immunoglobulin G ; Lymphadenopathy ; Diagnosis, Differential

Primary follicular immunoblastic lymphoma (FIBL) is an extremely rare lymphoma. The positive expression of CD10 suggests the lymphoma originating from germinal centers (GC) and CD138-positive expression generally indicates plasmablastic or plasmacytic differentiation. We report such a rare case in a Chinese female patient and analyze the clinicopathologic and immunohistochemical features of this disease. PET-CT examination was performed to detect signs of systemic lymph node metastasis. We also discussed the differential diagnosis of FIBL from follicular lymphoma (FL) and reactive follicular hyperplasia (RFH). As a rare variant of human follicular lymphoma, FIBL is featured by a neoplastic overgrowth of intrafollicular immunoblasts. Compared with FL, FIBL has a greater chance to evolve into diffuse large B-cell lymphoma with therefore a poorer prognosis.
Adult ; Female ; Humans ; Immunoblastic Lymphadenopathy ; pathology ; Lymphoma, Follicular ; pathology

The purpose of our study is to evaluate the diagnostic performance of radiomics in multi-class discrimination of lymphadenopathy based on elastography and B-mode dual-modal ultrasound images. We retrospectively analyzed a total of 251 lymph nodes (89 benign lymph nodes, 70 lymphoma and 92 metastatic lymph nodes) from 248 patients, which were examined by both elastography and B-mode sonography. Firstly, radiomic features were extracted from multimodal ultrasound images, including shape features, intensity statistics features and gray-level co-occurrence matrix texture features. Secondly, three feature selection methods based on information theory were used on the radiomic features to select different subsets of radiomic features, consisting of conditional infomax feature extraction, conditional mutual information maximization, and double input symmetric relevance. Thirdly, the support vector machine classifier was performed for diagnosis of lymphadenopathy on each radiomic subsets. Finally, we fused the results from different modalities and different radiomic feature subsets with Adaboost to improve the performance of lymph node classification. The results showed that the accuracy and overall 1 score with five-fold cross-validation were 76.09%±1.41% and 75.88%±4.32%, respectively. Moreover, when considering on benign lymph nodes, lymphoma or metastatic lymph nodes respectively, the area under the receiver operating characteristic curve of multi-class classification were 0.77, 0.93 and 0.84, respectively. This study indicates that radiomic features derived from multimodal ultrasound images are benefit for diagnosis of lymphadenopathy. It is expected to be useful in clinical differentiation of lymph node diseases.
Elasticity Imaging Techniques ; Humans ; Lymph Nodes ; Lymphadenopathy ; Retrospective Studies ; Ultrasonography

Occult Breast Carcinomas (OBCs) are rare. History and physical examination alone may lead to misdiagnosis hence inappropriate investigative and treatment modalities. Diagnosis is difficult without tissue biopsy and extensive immunohistochemical staining. Presented here is a 74-year-old Filipino male with a 2-month history of axillary mass with erythematous skin, initially assessed as hidradenitis suppurativa failing to resolve with antibiotics. An excision biopsy revealed adenocarcinoma within the lymph nodes. Immunohistochemical stains confirmed a breast primary. Radiologic imaging showed no breast lesions and no distant metastasis. Axillary node dissection done showed metastasis to 5 in 14 nodes harvested, classifying him as OBC Stage IIIA (cT0pN2M0). He completed whole breast radiotherapy and chemotherapy. No tumor recurrence was documented thereafter. Although misdiagnosis is common, OBC is a condition to consider in male patients presenting with axillary lymphadenopathy.

Peripheral T-cel1 lymphoma(PTCL) encompasses histopathologically and clinically various spectra of cutaneous T-cell lymphoma(CTCL). In this report, we describe two cases of PTCL showing diRerent clinical courses according to EBV(Epstein-Barr virus) positivity. The chnical course of case 1 with EBV-associated PTCL was rapidby fatal and refractory to intensive chcmotherapy. However, in case 2, EBV genomes were not found in her lesional tissues and she showed an indolent clinical course withoaat systemic symptoms. Accordingly, serological and immunohistochemical investigations for EBV might be mandatory in cutaneous PTCL to evaluate clinical prognosis.
Genome ; Herpesvirus 4, Human* ; Immunoblastic Lymphadenopathy* ; Lymphoma* ; Lymphoma, T-Cell, Peripheral ; Prognosis ; T-Lymphocytes