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Disseminated, Miliarial Type Lymphocytoma Cutis. A Report Of Two Cases

Moreno et al., 1991Lymphoma

Moreno, A., Curcó, N., Serrano, T., Garcia, J., Llistosella, E., & Bordas, X. (1991). Disseminated, miliarial type lymphocytoma cutis. A report of two cases. Acta dermato-venereologica, 71(4), 334–336. https://doi.org/10.2340/0001555571334336

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Abstract

The disseminated, miliarial type of lymphocytoma cutis (DMLC) is a clinicopathologic subtype of lymphocytoma, characterized by multiple, 1-2 mm translucent asymptomatic papules located in the exposed areas of the head and neck. DMLC represents a multifocal hyperplasia of B-lymphocytes with follicular differentiation and formation of follicular germinal centres. The evolution of the disease is characteristic, with some of the lesions resolving and other progressing to nodules or pseudolymphomas. The disease has a chronic course, with complete resolution in one to several years.

Case Details

Disease Location

Forehead and anterior scalp

Personal Characteristics

79 -year-old male, has severe androgenic alopecia

Clinical Characteristics

The patient had an asymptomatic erupatiention of micropapular elements on the forehead and anterior scalp lasting 2 months exam revealed multiple dome-shaped, translucent 1-3mm pseudovesiculous papules, there was smooth surface and depressed center 4 months later, the erupatiention extended to the parietal sides of the head and retro-auricular folds with more than a hundred elements simultaneously being present the patient was treated with chloroquine with no benefit several 4mm punch biopsy specimens were obtained from well-develped and regressing papules epidermis was normal or atrophic, nodules of lymphocytic infiltrate were detected in the superficial and mid-dermis, the nodules formed lymphoid follicles with prominent germinal centers they were composed of centroblasts, centrocytes and dendritic retiuclar cells, surrounded by small lymphocytes ihc markers for b-lymphocytes were positive in follicle-like structures. The biopsies from the large tumors showed a pseydotumoral lymphoid proliferation that occupied all the dermis, there were large follicular centers showing large 'atypical' centroblsts separated by narrow mantles of small lymphocytes. The ihc also showed that these centroblasts were of b-cell phenotype

Remission Characteristics

Two months later after cholorquine treatment, the lesions began to resolve spotaneousaneoulsy the regression was completed within 2 months without any clinical residue the biopsies from resolving lesions exhibited involutive changes, with follicular hyalinization and infiltration by plasma cells, the follicular centers were less prominent or even inconspicuous

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism proposed

Clinical Treatment

Chloroquine

Non-Clinical Treatment

None reported