Cutaneous reactive B‐cell lymphoid proliferations

Abstract

Cutaneous lymphoid hyperplasia (CLH), also known as cutaneous pseudolymphoma, is a spectrum of benign conditions characterized by reactive B‐ and T‐cell cutaneous lymphocytic infiltrates. B‐cell lymphoid proliferations are a heterogenous group of non‐neoplastic cutaneous diseases that must be histopathologically distinguished from cutaneous B‐cell lymphomas. These proliferations can be observed as reactive phenomena to infections, medications, allergens, neoplasms, and more. Furthermore, there are many inflammatory conditions that present with reactive B‐cell infiltrates, including actinic prurigo, Zoon balanitis, Rosai‐Dorfman disease, and cutaneous plasmacytosis. This review summarizes multiple cutaneous B‐cell lymphoid proliferations within the major categories of reactive and disease‐associated CLH. Further we discuss major discriminating features of atypical CLH and malignancy. Understanding the specific patterns of B‐cell CLH is essential for the proper diagnosis and treatment of patients presenting with such lesions.

Intraoral primary syphilis mimicking lymphoproliferative disorder

“…Regarding the oral cavity, only one case with lingual, genital, and skin involvement has been reported, 6 with the current case presenting a solitary lingual lesion and the only case in this series corresponding to primary syphilis. For these LPDs, the diagnoses of lymphoid hyperplasia (pseudolymphoma), cutaneous T‐cell lymphoma, marginal‐zone B‐cell lymphoma, follicular lymphoma, angioimmunoblastic T‐cell lymphoma, and peripheral T‐cell lymphoma, not otherwise specified, were suggested 1–12,18 . In three cases, equal expression of immunoglobulin light chains was observed, 5,10,11 similar to the current case; however, noteworthy, one case reported monoclonality by immunohistochemistry and molecular studies, 1 whereas in two cases 2,6 the diagnosis of syphilis was stablished after starting chemotherapy.…”

“…For these LPDs, the diagnoses of lymphoid hyperplasia (pseudolymphoma), cutaneous T-cell lymphoma, marginal-zone B-cell lymphoma, follicular lymphoma, angioimmunoblastic T-cell lymphoma, and peripheral T-cell lymphoma, not otherwise specified, were suggested. [1][2][3][4][5][6][7][8][9][10][11][12]18 In three cases, equal expression of immunoglobulin light chains was observed, 5,10,11 similar to the current case; however, noteworthy, one case reported monoclonality by immunohistochemistry and molecular studies, 1 whereas in two cases 2,6 the diagnosis of syphilis was stablished after starting chemotherapy. T. pallidum immunostain was relevant for the establishment of diagnosis in four cases 8,[10][11][12] ; nevertheless, recent studies warn about the possibility of false positives.…”

“…When the typical microscopic features of syphilis are exuberant, lymphoid hyperplasia, lymphoma, plasma cell neoplasia, and Epstein-Barr virus-positive (EBV+) mucocutaneous ulcer 14,17,18 should be included in the differential diagnosis. However, this is relevant that F I G U R E 1 Clinical presentation of the ulcerated lesion located on the anterior dorsal surface of the tongue (A).…”

Systemic sclerosis with morphea-like plaques histopathologically mimicking cutaneous B-cell lymphoma

“…These features are typical of benign reactive follicular lymphoid hyperplasia and contrast with the expected findings in neoplastic lymphoid follicles. 7 …”

Cutaneous Reactive Lymphoid Proliferation Arising in the Setting of Concomitant Antidepressant and Antihypertensive Therapy

“…Common causes of drug-induced CRLP are anticonvulsants, antidepressants, antihypertensives, and monoclonal antibodies [ 4 - 5 ]. The most frequent presentation is a solitary papule, nodule, or plaque, but others include multiple or disseminated lesions and even erythroderma [ 2 , 6 ]. B-cell CRLP usually presents above the neck or on the upper thorax, and it is more common in those who are white, male, and under age 40 [ 1 - 2 , 6 ].…”