So-Called "Lipomelanotic Reticulosis" of Pautrier-Woringer

Non-neoplastic histiocytic and dendritic cell disorders in lymph nodes

“…The lymphadenopathy may be generalized or localized. Axillary and inguinal lymph nodes [169, 171] are most frequently involved and a peripheral blood eosinophilia may be present [166, 167, 169, 172].…”

“…Dermatopathic lymphadenopathy occurs at any age, but it is more common in the 5 th and 6 th decades [169, 173] and in males [166, 167, 169, 172]. In their series of 906 consecutive lymph node biopsies, Cooper et al reported an incidence of 4.8% with 15% (6/40) of their cases of dermatopathic lymphadenopathy occurring in patients with mycosis fungoides [169].…”

“…Whilst theories regarding the pathogenesis of dermatopathic lymphadenopathy have centered on an inflammatory reaction with excessive absorption of melanin from the skin due to the underlying skin disorder [166, 167, 170, 172], some lymph nodes may have histologic features of dermatopathic lymphadenopathy in the absence of an associated skin disease [169]. Gould et al, in a study of 1181 lymph nodes from axillary dissections from patients without skin disease, observed varying degrees of dermatopathic-like histologic features, concluding that dermatopathic lymphadenopathy “may represent one end of a normally occurring histologic spectrum that may be found in the absence of a dermatitis” [170, 174].…”

“…Histologically, the architecture of the lymph node is intact, but there is variable expansion of the paracortex by a pale staining proliferation composed of interdigitating dendritic cells, histiocytes and Langerhans cells, which may compress and peripheralize the cortical areas of the node [166, 174, 175] and surround residual atrophic follicles [172]. Mitotic activity may be present.…”

“…At the margins of the proliferation [166, 169], some of the histiocytes contain phagocytized pigment, usually melanin, although some hemosiderin may be present [167, 169]. Phagocytized cytoplasmic lipid may also be evident [169, 172]. The infiltrate contains variable numbers of lymphocytes, plasma cells and eosinophils (Figure 5A–B).…”