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Colli, C; Leinweber, B; Müllegger, R; Chott, A; Kerl, H; Cerroni, L.
Borrelia burgdorferi-associated lymphocytoma cutis: clinicopathologic, immunophenotypic, and molecular study of 106 cases.
J CUTANEOUS PATHOL. 2004; 31(3): 232-240.
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Autor/innen der Med Uni Graz:
Cerroni Lorenzo
Kerl Helmut
Leinweber Bernd
Müllegger Robert
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Abstract:
Lymphocytoma cutis (LC) is considered as the stereotypical example of the cutaneous B-cell pseudolymphomas. It can be induced by various antigenic stimuli including arthropod bites, vaccination, and drugs among others. In endemic regions, Borrelia burgdorferi is the principal causative agent for LC. We studied retrospectively 108 biopsies from 106 patients (male : female, 48 : 58; mean age, 44.6; median, 51.5; range, 3-81) with B. burgdorferi-associated LC retrieved from the files of the Department of Dermatology of the University of Graz (Austria). Only cases with a B. burgdorferi etiology (typical locations, positivity of serologic and/or polymerase chain reaction (PCR) tests, clinical history) were included in the study. Lesions were located on the nipple (63 cases), earlobe (18 cases), genital region (9 cases), and trunk or extremities (16 cases). PCR analysis of B. burgdorferi DNA was positive in 54 of 80 cases tested (67.5%). In 47 cases, we could retrieve data on serologic examination for B. burgdorferi antibodies performed at the time of diagnosis of LC. Positivity was found in 45 patients (IgG+/IgM+, 5 cases; IgG+/IgM-, 37 cases; IgG-/IgM+, 3 cases; IgG-/IgM-, 2 cases). Histology revealed dense lymphoid infiltrates with prominent germinal centers (GCs) in all cases. Atypical morphologic and/or immunophenotypic features of the GCs were commonly observed. In 5 cases, due to confluence of large follicles, the histopathologic pattern simulated that of a large B-cell lymphoma. PCR analysis of the IgH gene rearrangement performed in 33 cases showed a polyclonal pattern in 31 cases and a monoclonal band in 2. In summary, B. burgdorferi-associated LC can present with misleading histopathologic, immunophenotypic, and molecular features, and integration of all data is necessary for a correct diagnosis.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Adult -
Aged -
Aged, 80 and over -
Blotting, Southern -
Borrelia Infections - pathology
Borrelia burgdorferi - immunology
Child - immunology
Child, Preschool - immunology
DNA Primers - immunology
DNA, Bacterial - analysis
Diagnosis, Differential - analysis
Female - analysis
Gene Rearrangement, B-Lymphocyte, Heavy Chain - analysis
Humans - analysis
Immunoglobulin G - blood
Immunoglobulin M - blood
Immunohistochemistry - blood
Male - blood
Middle Aged - blood
Polymerase Chain Reaction - blood
Pseudolymphoma - microbiology
Retrospective Studies - microbiology
Skin Diseases - microbiology

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