Sarcoidal Reaction to Lymphoma Presenting as Granulomatous Rosacea

Abstract

A patient with poorly differentiated lymphocytic lymphoma had rosacealike facial lesions noted at the time of diagnosis of the lymphoma. The skin lesions followed the course of exacerbations and remissions of the systemic lymphoma. A biopsy specimen showed a sarcoidal granulomatous inflammation in the skin, and later in subcutaneous nodules that developed on the face. This case is consistent with a sarcoidal tissue reaction to lymphoma, and is unique in its clinical presentation as granulomatous rosacea.

Lymphoepithelioid cell lymphoma (Lennert’s lymphoma) presenting as atypical granuloma annulare

“…2 , 3 However, such a feature has also been reported rarely in association with cutaneous lymphomas, including mycosis fungoides and other non‐Hodgkin’s lymphomas. 4–8 As in this case, these reports emphasize that such granuloma formation should be considered by the pathologist as a potential reaction to an underlying lymphoma, which might obscure the neoplastic infiltrate.…”

Cutaneous lymphomas showing prominent granulomatous component: clinicopathological features in a series of 16 cases

“…Different histopathological patterns associated with malignant lymphomas have been identified. Mostly, cutaneous granulomas have an epithelioid or sarcoid‐like appearance, 21,22 but tuberculoid granulomas, 23 GA‐like, 24,25 granulomatous rosacea 26 or granulomatous panniculitis 4 have also been reported in specific lesions from both primary and secondary cutaneous lymphomas. Different granulomatous patterns may also coexist in different biopsies from the same patient.…”

Rosácea granulomatosa: relato de caso - enfoque terapêutico

“…Granulomatous rosacea classically responds well to systemic administration of tetracycline. 10 Nevertheless, tendency to relapse or recur may persist for several years. Even though some individuals may need prolonged systemic antibiotic therapy to treat relapses, others evolve satisfactorily by avoiding triggering factors and using topical medications, such as metronidazole gel.…”