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The term cutaneous pseudolymphoma refers to a heterogeneous group of benign skin disorders that simulate cutaneous lymphomas histologically and sometimes clinically. The diagnosis of B cell pseudolymphoma requires a representative biopsy (excisional biopy) which should be evaluated for morphology, growth patt ern, and immunophenotype. We treated a female patient, aged 33, presented with the painful, erythematosus, radiant tumor formation at skin in the temporal region. The patient had enlarged lymph nodes on the right side of the neck before the appearance of that tumor formation. The dermatoscopic fi nding was nonspecifi c. After the tumor biopsy was done, histologically the diagnosis of reactive lymphatic proliferation – pseudolymphoma or cutaneous lymphoma of B-cell immunophenotyp was set. After we had completely excised the change and had sent it to the immunohistochemical analysis, the fi nding hinted at fl uorid skin lymphocyte hyperplasia of B- and T- lymphocytes. The results of other fi ndings were normal (serologic test on Borelia Burgdorferi, ultrasound scan of the neck’s lymph nodes, supraclavicular, and of the axillary nodes, nodes in inguinal canal and abdomen. Finally, the etiology remains unknown. In conclusion, the diagnosis of B cell pseudolymphoma requires a skin biopsy for histopathologic evaluation and immunophenotyping. In areas endemic for Lyme disease, patients with cutaneous B cell pseudolymphomas should undergo laboratory investigations for Borelia burgdorferi infection. B cell pseudolymphomas may resolve spontaneously over time. In clinical practice, lesions are often initially treated with topical or intralesional corticosteroids, but refractory lesions may be treated with surgical excision or radiotherapy. |
