1.Recalcitrant cutaneous pseudolymphoma in a 14-year-old Filipino male effectively treated with topical fluorouracil: A case report
Patricia Ann F. Cabiedes ; R-jay F. Agbon ; Ma. Lourdes Anna Nerida-Idea
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):28-28
Cutaneous pseudolymphoma is a benign reactive lymphoproliferative skin disorder that can mimic cutaneous lymphoma. Clinical features include papules or indurated plaques that commonly affect the head and neck region and upper extremities. Various causative factors such as infectious agents, insect bites, vaccines, foreign bodies such as tattoos and drugs have been identified. Majority of the cases are idiopathic. Diagnosis is made by clinical assessment and careful histopathologic examination. Topical or intralesional steroids are the first-line therapy for persistent localized lesions.
This is a case of a 14-year-old male who presented with an 8-month persistent solitary violaceous to dusky red indurated plaque on the right distal ventral forearm. No trigger factors were identified. A skin biopsy with immunohistochemical staining (positively staining CD68, CD3 and CD20 T and B cells with no loss of CD7) revealed cutaneous lymphoid hyperplasia. Initial treatment with a topical steroid was unsuccessful, leading to the addition of intralesional steroid to the regimen. This resulted in partial improvement but did not prevent further plaque enlargement. Topical medication was then shifted to compounded 5-Fluorouracil cream which was applied twice daily for a duration of 18 months. In the first six months of treatment, the patient noted further decrease in size and flattening of the lesion with no reported adverse effects. A repeat biopsy after 18 months post- treatment revealed a marked reduction in lymphocytic infiltrates, indicating a favorable response to treatment.
The main goal of treatment in Cutaneous Pseudolymphoma is early disease recognition and prompt intervention. Topical 5- fluorouracil (5-FU) belongs to a class of medications known as anti-metabolites and has been used in the treatment of various recalcitrant benign and malignant skin tumors. Treatment efficacy of this case contributes to anecdotal evidence of topical 5-Fluorouracil in treating pseudolymphoma.
Human ; Male ; Adolescent: 13-18 Yrs Old ; Corticosteroids ; Adrenal Cortex Hormones ; Pseudolymphoma
2.Expression of TOPK/PBK in children with malignant lymphoma or reactive lymphoid hyperplasia.
Xin TIAN ; Xiang-Ling HE ; Xiao-Ye YUAN ; Run-Ying ZOU ; Hui ZOU ; Ya-Lan YOU ; Ke-Ke CHEN ; Cheng-Guang ZHU
Chinese Journal of Contemporary Pediatrics 2018;20(3):214-217
OBJECTIVETo study the difference in expression of TOPK/PBK in lymph nodes between children with malignant lymphoma and those with reactive lymphoid hyperplasia.
METHODSEighty children with malignant lymphoma and twenty children with reactive lymphoid hyperplasia were enrolled as subjects. Immunohistochemistry was used to determine the expression of TOPK/PBK in all the subjects. The expression of TOPK/PBK was compared between the two groups.
RESULTSThe TOPK/PBK-positivity rate was significantly higher in children with malignant lymphoma than in those with reactive lymphoid hyperplasia (P<0.05). There was no significant difference in the TOPK/PBK-positivity rate between the children with Hodgkin's lymphoma and non-Hodgkin's lymphoma (NHL). There were significant differences in the TOPK/PBK-positivity rate among children with different pathological types of NHL (P<0.05): the children with lymphoblastic lymphoma showed the highest TOPK/PBK-positivity rate and those with mature B-cell lymphoma and mature T/NK-cell lymphoma had a similar TOPK/PBK-positivity rate.
CONCLUSIONSThe expression of TOPK/PBK is up-regulated in the lymph nodes of children with malignant lymphoma. The expression level of TOPK/PBK may be related to the pathological type of NHL.
Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Lymph Nodes ; enzymology ; Lymphoma ; enzymology ; Mitogen-Activated Protein Kinase Kinases ; analysis ; Pseudolymphoma ; enzymology
3.Pulmonary Nodular Lymphoid Hyperplasia with Mass-Formation: Clinicopathologic Characteristics of Nine Cases and Review of the Literature
Jongmin SIM ; Hyun Hee KOH ; Sangjoon CHOI ; Jinah CHU ; Tae Sung KIM ; Hojoong KIM ; Joungho HAN
Journal of Pathology and Translational Medicine 2018;52(4):211-218
BACKGROUND: Pulmonary nodular lymphoid hyperplasia (PNLH) is a non-neoplastic pulmonary lymphoid disorder that can be mistaken for malignancy on radiography. Herein, we present nine cases of PNLH, emphasizing clinicoradiological findings and histological features. METHODS: We analyzed radiological and clinicopathological features from the electronic medical records of nine patients (eight females and one male) diagnosed with PNLH. IgG and IgG4 immunohistochemical staining was performed in three patients. RESULTS: Two of the nine patients had experienced tuberculosis 40 and 30 years prior, respectively. Interestingly, none were current smokers, although two were ex-smokers. Three patients complaining of persistent cough underwent computed tomography of the chest. PNLH was incidentally discovered in five patients during examination for other reasons. The remaining patient was diagnosed with the disease following treatment for pneumonia. Imaging studies revealed consolidation or a mass-like lesion in eight patients. First impressions included invasive adenocarcinoma and mucosal-associated lymphoid tissue‒type lymphoma. Aspergillosis was suspected in the remaining patient based on radiological images. Resection was performed in all patients. Microscopically, the lesions consisted of nodular proliferation of reactive germinal centers accompanied by infiltration of neutrophils and macrophages in various degrees and surrounding fibrosis. Ultimately, all nine patients were diagnosed with PNLH and showed no evidence of recurrence on follow-up. CONCLUSIONS: PNLH is an uncommon but distinct entity with a benign nature, and understanding the radiological and clinicopathological characteristics of PNLH is important.
Adenocarcinoma
;
Aspergillosis
;
Cough
;
Electronic Health Records
;
Female
;
Fibrosis
;
Follow-Up Studies
;
Germinal Center
;
Humans
;
Hyperplasia
;
Immunoglobulin G
;
Lymphoma
;
Macrophages
;
Neutrophils
;
Pneumonia
;
Pseudolymphoma
;
Radiography
;
Recurrence
;
Thorax
;
Tuberculosis
4.Cutaneous Pseudolymphoma Derived from Ruptured Milia.
Minseok LEE ; Jemin KIM ; Do Young KIM
Annals of Dermatology 2018;30(6):725-727
No abstract available.
Pseudolymphoma*
5.Multifocal nodular lymphoid hyperplasia of the lung.
Gil Tae LEE ; Eun Kyoung KIM ; Eirie CHO ; Seung Sook LEE ; Seo Yun KIM ; Cheol Hyeon KIM ; Hye Ryoun KIM
Yeungnam University Journal of Medicine 2017;34(1):84-87
Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.
Biopsy
;
Follow-Up Studies
;
Hyperplasia*
;
Lung*
;
Lymphoproliferative Disorders
;
Multiple Pulmonary Nodules
;
Natural History
;
Pseudolymphoma
;
Radiography
;
Thorax
6.Pathologic Evaluation of Routine Nasopharynx Punch Biopsy in the Adult Population: Is It Really Necessary?.
Sami BERCIN ; Gokhan YALCINER ; Togay MUDERRIS ; Fatih GUL ; H Mervan DEGER ; Muzaffer KIRIS
Clinical and Experimental Otorhinolaryngology 2017;10(3):283-287
OBJECTIVES: To retrospectively evaluate the patients who underwent nasopharyngeal biopsy with imaging and biopsy results, who have or don’t have symptoms for nasopharyngeal pathology and to determine the ratio of the nasopharyngeal cancer cases and other pathologic conditions. METHODS: In this retrospective study, 983 patients who underwent endoscopic nasopharyngeal biopsy for symptomatic nasopharyngeal lesions were included. All pathological results, benign or malign was recorded and classified due to the patients’ presenting symptoms such as symptomatic for nasopharyngeal pathology or asymptomatic. Computed tomography (CT) or magnetic resonance imaging (MRI) reports were also recorded separately as group A for malignancy or group B for not malignancy. RESULTS: Forty-five (4.6%) of 983 biopsies were malignant. In this group, there is no statistically significant difference between symptomatic and asymptomatic group. For malignant pathologies, the sensitivity of MRI was found 88.2% and CT was 61.5%. CONCLUSION: For early diagnosis of nasopharyngeal cancer, all patients admitted to Ear, Nose and Throat (ENT) referral clinics should be examined endoscopically irrespective of their complaints and suspicious cases should be investigated by imaging especially by MRI. If MRI report clearly indicates Thornwaldt cyst or reactive lymphoid hyperplasia and this result is compatible with endoscopic findings, biopsy may not be necessary. Apart from these cases, all suspected lesions should be biopsied.
Adult*
;
Biopsy*
;
Ear
;
Early Diagnosis
;
Humans
;
Magnetic Resonance Imaging
;
Multidetector Computed Tomography
;
Nasopharyngeal Neoplasms
;
Nasopharynx*
;
Nose
;
Pathology
;
Pharynx
;
Pseudolymphoma
;
Referral and Consultation
;
Retrospective Studies
7.Multifocal nodular lymphoid hyperplasia of the lung
Gil Tae LEE ; Eun Kyoung KIM ; Eirie CHO ; Seung Sook LEE ; Seo Yun KIM ; Cheol Hyeon KIM ; Hye Ryoun KIM
Yeungnam University Journal of Medicine 2017;34(1):84-87
Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.
Biopsy
;
Follow-Up Studies
;
Hyperplasia
;
Lung
;
Lymphoproliferative Disorders
;
Multiple Pulmonary Nodules
;
Natural History
;
Pseudolymphoma
;
Radiography
;
Thorax
8.Lymphocytoma cutis: diagnostic enigma for the maxillofacial surgeon.
Tejraj P KALE ; Arjun Gurmeet SINGH ; Pushpak SHAH
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2016;42(6):379-382
Cutaneous lymphoid hyperplasia (CLH) is a cutaneous pseudolymphoma with a worldwide distribution, equally affecting all races and ethnic groups. Due to its vast array of characteristics, it is most often missed in the differential diagnosis of firm to soft lumps on the head and neck. A systematic approach to the workup and diagnosis along with treatment of such lesions is discussed in this article. A 20-year-old Asian Indian female presented to our Oral and Maxillofacial unit with a lump on the left side of her forehead for 1 month. Local examination revealed a 2.5×3.0 cm², well circumscribed swelling over the left para median region that was firm to doughy and non-tender. There was no other significant finding on general examination. Excisional biopsy of the lesion was performed, followed by histopathologic processing. The general etiology, pathogenesis, clinical presentation, differential diagnosis, clinical course, prognosis, treatment, and prevention have been discussed in line with the recent modalities of diagnosis and treatment of CLH. Due to the overlapping clinical and histological characteristics of CLH with many other lesions, it is important to consider this lesion in the differential diagnosis of cutaneous lesions.
Asian Continental Ancestry Group
;
Biopsy
;
Continental Population Groups
;
Diagnosis
;
Diagnosis, Differential
;
Ethnic Groups
;
Female
;
Forehead
;
Head
;
Humans
;
Hyperplasia
;
Neck
;
Oral and Maxillofacial Surgeons*
;
Prognosis
;
Pseudolymphoma*
;
Young Adult
9.Radiotherapy in aggressive cutaneous pseudolymphoma: a case report and review of literature.
Deepa JOSEPH ; Monica Malik IRUKULLA ; Syed Fayaz AHMED ; Deepthi VALIYAVEETTIL ; Syed AKRAM
Radiation Oncology Journal 2016;34(1):76-80
Pseudolymphoma is a nonspecific disease characterized by lesions with lymphomatous-appearing but benign accumulation of inflammatory cells. They generally present as small ulcero-nodular lesions confined to skin which often respond to local therapies. We describe an unusual presentation of an extensive and locally aggressive cutaneous pseudolymphoma in a 21-year-old male patient who presented with extensive cutaneous eruptions gradually progressing over 6 years to involve the entire circumference of his left arm. Magnetic resonance imaging scans of his left arm showed a lesion deeply infiltrating into the soft tissue reaching up to the humerus with intense periosteal reaction. He was successfully treated with radiotherapy after many failed attempts with surgery and chemotherapy.
Arm
;
Drug Therapy
;
Humans
;
Humerus
;
Magnetic Resonance Imaging
;
Male
;
Pseudolymphoma*
;
Radiotherapy*
;
Skin
;
Young Adult
10.Reactive Lymphoid Hyperplasia Treated with Radiofrequency Ablation.
Seo Hwa PARK ; Eun Gyu KANG ; Min Wook KIM ; Hyun Soo KIM ; Jeong Kwon KIM
Korean Journal of Medicine 2015;88(2):177-181
Reactive lymphoid hyperplasia (RLH) is a rare benign liver mass that is characterized by proliferation of non-neoplastic lymphocytes extranodally. To date, only 43 cases have been reported in the English literature and 2 cases in the Korean literature. We report a case of hepatic RLH in a 36-year-old woman who had been diagnosed two years previously with an intrahepatic tumor that measured 0.6 x 1.0 cm on abdominal ultrasonography. Her medical history was otherwise unremarkable. On follow-up ultrasonography, the hepatic mass had increased in size. We biopsied the liver mass and the histopathologic findings confirmed reactive lymphoid hyperplasia. Radiofrequency ablation (RFA) was performed instead of surgical resection. The patient is currently doing well with no sign of relapse 1 year and 8 months after the RFA.
Adult
;
Catheter Ablation*
;
Female
;
Follow-Up Studies
;
Humans
;
Liver
;
Lymphocytes
;
Pseudolymphoma*
;
Recurrence
;
Ultrasonography


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