Dermatopathic Lymphadenopathy: Is Our Diagnostic Approach Correct?

Correlation Between Clinical and Histological Features of Dermatopathic Lymphadenopathy: Analysis of 39 Lymph Nodes

“…7,9 It has also been reported that dermatopathic lymphadenopathy is more common in patients with extensive skin involvement. 3 In a large series of consecutive lymph node biopsy specimens, dermatopathic lymphadenopathy was detected in 4.8% of specimens with a male predominance; in the study, most of the patients had a skin disease, while 12% of the patients had no findings of a skin disease. 9 In another study evaluating 1000 axillary lymph nodes from 50 consecutive radical mastectomy specimens performed in women with breast cancer, 15% of the lymph nodes showed mild to moderate dermatopathic changes, with only 1 patient having a cutaneous disease (contact dermatitis).…”

“…Although macrophages are a minor component, they are characteristic due to the cytoplasmic pigment (mostly melanin, some hemosiderin) that they contain. 3,11 The histological differentiation of dermatopathic lymphadenopathy from lymphoproliferative disorders is crucial. 4 Differential diagnosis of dermatopathic lymphadenopathy includes Hodgkin lymphoma, mycosis fungoides/Sezary syndrome, infectious lymphadenopathy including bacterial and viral and melanoma.…”

“…2 Dermatopathic lymphadenopathy is a well-defined histological entity with an underestimated prevalence in the general population. 3 It is commonly associated with chronic skin diseases, presented as enlarged lymph nodes with paracortical hyperplasia, however in some cases the lymph nodes may remain at a normal size and may not be associated with other system disorders rather than skin diseases. [3][4][5] Recently, the immunophysiology underlying the histological features of dermatopathic lymphadenopathy has been studied.…”

“…3 It is commonly associated with chronic skin diseases, presented as enlarged lymph nodes with paracortical hyperplasia, however in some cases the lymph nodes may remain at a normal size and may not be associated with other system disorders rather than skin diseases. [3][4][5] Recently, the immunophysiology underlying the histological features of dermatopathic lymphadenopathy has been studied. Antigen-presenting dendritic cell subsets are found in both healthy and chronically inflamed skin, as well as in skin draining lymph nodes, suggesting that cutaneous Langerhans cells and other types of dendritic cells migrate to the T-cell-rich areas of regional lymph nodes where they mediate an appropriate immune response.…”

Adenopatía dermatopática simulando quiste branquial

“…En cuanto a la patología benigna se incluyen lesiones congénitas como los quistes branquiales, lingangiomas, etc., pero también adenopatías de procesos granulomatosos como sarcoidosis, tuberculosis u otras infecciones (VIH, toxoplasmosis, mononucleosis infecciosa). En cuanto a la patología maligna, hay que considerar los procesos linfoproliferativos y las metástasis de neoplasias sólidas de cabeza y cuello 3 . En ocasiones, éstas pueden tener una apariencia quística tanto en la exploración física como en las pruebas de imagen que dificulta distinguirlas de patología benigna.…”