Radiotherapy in aggressive cutaneous pseudolymphoma: a case report and review of literature

Abstract

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.

Cutaneous pseudolymphoma—A review on the spectrum and a proposal for a new classification

“…A re‐exposure to the particular cause may incite a recurrence . Progression or a so‐called “aggressive course” of PSL has been rarely reported . From our point of view, a progressive course should lead one to question the original diagnosis.…”

Treatment of Cutaneous Pseudolymphoma: A Systematic Review

“…responses that can result in CPL include responses to contact dermatitis, lichenoid pigmented purpuric dermatosis, lichen sclerosus et atrophicus, the inflammatory stage of morphea, secondary syphilis, lupus panniculitis, arthropod reactions, nodular scabies, viral infections (orf, milker's nodule, herpes simplex/zoster, and molluscum contagiosum), tattoo dye, vaccinations, trauma, jewellery for pierced ears, such as gold, acupuncture, infections with Borrelia burgdorferi or leishmaniasis, and drug reactions (3). Drugs associated with the development of CPL include anticonvulsants, antipsychotics, antihypertensives, cytotoxics, antirheumatics, antibiotics, anxiolytics, antihistamines, antiarrythmics, sex steroids, lipid-lowering agents, and more recently, anti-tumour necrosis factor (TNF)-α agents, tocilizumab, and cyclosporine (1,(4)(5)(6). Although they appear more often in the skin, pseudolymphomas have also been described in other organs, such as the eye, tongue, parotid gland, larynx, gastrointestinal tract, lung, kidney, and breast (4).…”

“…Drugs associated with the development of CPL include anticonvulsants, antipsychotics, antihypertensives, cytotoxics, antirheumatics, antibiotics, anxiolytics, antihistamines, antiarrythmics, sex steroids, lipid-lowering agents, and more recently, anti-tumour necrosis factor (TNF)-α agents, tocilizumab, and cyclosporine (1,(4)(5)(6). Although they appear more often in the skin, pseudolymphomas have also been described in other organs, such as the eye, tongue, parotid gland, larynx, gastrointestinal tract, lung, kidney, and breast (4).…”

Solitary nodule on the back: A diagnostic challenge on cytology

“…Histopathology helps in differentiating LC from a reactive cutaneous inflammation and lymphoma. Pseudolymphoma can be differentiated from a true lymphoma from these basic histological findings [8][9][10][11]. LC cases will show an admixture of B-and T-cells along with macrophages and dendritic cells.…”

“…However, it becomes important to establish the polyclonality of these cells, as it becomes difficult to differentiate these lymphoid cells from lymphoma in a small biopsy [9][10][11][12]. Hence, IHC becomes important in making a definitive diagnosis.…”