B-cell cutaneous lymphoid hyperplasia representing progressive transformation of germinal center: a report of 2 cases

Int J Surg Pathol. 2010 Oct;18(5):429-32. doi: 10.1177/1066896908323097. Epub 2008 Sep 24.

Abstract

Cutaneous lymphoid hyperplasia (CLH) is a reactive polyclonal benign lymphoproliferative process predominantly composed of B cells or T cells, either localized or disseminated. The authors report histomorphologic, immunophenotypic, and genotypic findings of 2 cases of B-cell CLH demonstrating progressive transformation of germinal center (PTGC). Histologically, most of the lymphoid follicles were PTGCs with a few hyperplastic germinal centers. PTGC was characterized by enlarged but well-circumscribed follicles without clear demarcation of the germinal center and mantle zone, which contained a predominance of small lymphocytes and variable numbers of centrocytes, centroblasts, and immunoblasts. However, there were no centroblasts and immunoblasts resembling lymphocytic and/or histiocytic Reed-Sternberg cell variants in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in either lesion. These unusual CLHs should be differentiated from the primary cutaneous marginal zone B-cell lymphoma, primary cutaneous follicular lymphoma, particularly "floral variant," or NLPHL. To avoid overdiagnosis and overtreatment, immunophenotypic and genotypic studies are required along with careful morphologic examination.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • B-Lymphocytes / immunology
  • B-Lymphocytes / pathology*
  • Biomarkers / metabolism
  • Cell Transformation, Neoplastic / pathology*
  • Diagnosis, Differential
  • Female
  • Fluorescent Antibody Technique, Direct
  • Germinal Center / pathology*
  • Humans
  • Immunophenotyping
  • Lymphoma, B-Cell, Marginal Zone / diagnosis
  • Lymphoma, Follicular / diagnosis
  • Male
  • Middle Aged
  • Pseudolymphoma / immunology
  • Pseudolymphoma / pathology*
  • Skin Diseases / immunology
  • Skin Diseases / pathology*
  • Skin Neoplasms / diagnosis

Substances

  • Biomarkers