Differentiation between lymphadenosis benigna cutis and primary cutaneous follicular center cell lymphomas a comparative clinicopathologic study of 57 patients

Abstract

The authors report the clinical and histologic features of 22 cases of lymphadenosis benigna cutis (LBC) and 35 cases of primary cutaneous follicular center cell (FCC) lymphoma. The differential diagnostic accuracy of criteria generally used for differentiating between benign and malignant cutaneous lymphoid infiltrates was evaluated. The clinical and histologic findings in these two groups showed many similarities. Except for a characteristic clinical presentation of patients with a primary cutaneous FCC lymphoma on the trunk, there was no single clinical or histologic criterion that reliably differentiated between both conditions in all cases. Follow-up data showed that only a small number of patients of the malignant group developed (four of 35 cases) or died of (two of 35 cases) systemic lymphoma. The favorable prognosis of this type of cutaneous lymphoma implies that lack of systemic lymphoma after a five-year follow-up cannot be used as a diagnostic criterion in retrospective studies.

A study of histologic and immunophenotypical staining patterns in cutaneous lymphoid hyperplasia

“…8 A relatively common subset of CLH (or PSL), which demonstrates reactive B-cell follicles, has been termed CLH (or PSL) with follicular growth pattern. 5,[14][15][16] This variant has also been previously called lymphocytoma cutis, lymphadenosis benigna cutis, cutaneous lymphoplasia, and pseudolymphoma of Spiegler-Fendt. 7 A clear distinction of CLH with follicular growth pattern from follicle center cell lymphoma (FCCL) may be difficult.…”

“…12,14 The presence of eosinophils and epithelioid cell granulomas also favors CLH because they are infrequently observed in cutaneous B-cell lymphoma (CBCL). 7,16,17 Absence of clonality, as demonstrated by polyclonal K and L light chain stains and negative TCR and immunoglobulin heavy (IgH) gene rearrangements studies, are also considered to be supportive of CLH. 3,6,7 None of the aforementioned criteria, however, is discriminative by itself, and the diagnosis is based on a constellation of several findings.…”

“…14,18 The presence of eosinophils and clusters of epithelioid histiocytes may be helpful in the differential diagnosis because they are less frequently observed in CBCL. 7,16,17 Negative gene rearrangement studies are usually supportive of CLH, although there are rare reported cases that progressed into cutaneous lymphoma despite the lack of clonality. 15 The remaining 8 CLH cases in our series did not reveal GC clusters, although in 2 cases there were 1 or more small aggregates of blast-like B cells that failed to stain for any of the GC markers.…”

Primary cutaneous B-cell lymphoma: A clinically homogeneous entity?

“…The only reliable tool is the demonstration of B-cell monoclonality by immunohistochemistry and/or molecular analysis by Southern blotting and the polymerase chain reaction. 18,[22][23][24][25][26][27][28] The conclusion that most primary and rare/undefined types. 33 Primary cutaneous FCC lymphoma and IC, which affect more than 90% of all patients with a definite diagnosis of primary CBCL, share a good response to radiotherapy and a generally excellent prognosis that is much better than morphologically similar lymphomas in lymph nodes.…”

Infiltrados Linfocitários Cutâneos Simuladores de Linfoma

“…A elevada actividade proliferativa evidenciada pela marcação com Ki67superior a 90% é uma pista diagnóstica importante. 30,31 O linfocitoma cutis (também conhecido como linfadenose benigna cutis, linfoplasia cutânea benigna, hiperplasia linfóide cutânea, ou pseudolinfoma de Spiegler-Fendt) é uma entidade de apresentação clínica variada (pápulas ou nódu-los não ulcerados, solitários ou agrupados, eritematosos ou hiperpigmentados), caracterizada histologicamente por infiltrados linfocitários B e T dérmicos com um padrão "top-heavy" e, formação de folículos com centros germinativos sem critérios de "malignidade" (ver acima) (Fig. 7).…”