Disseminated, Miliarial Type Lymphocytoma Cutis. A Report Of Two Cases
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
View Original Source →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
Face, neck, trunk
Personal Characteristics
83 -year-old male past history of hypertrophic cardiopathy and obliterant atherosclerosis with chronic ischemia of the legs
Clinical Characteristics
First seen in september 1989 because of an asymptomatic papulo-nodular erupatiention in the exposed areas of the face which had been noticed for 3 years in the previous 3 years, the patient had developed several nodules and numberous small papules on his face, neck and scalp the larger lesions were nodules wth a smooth surface and light red hue. They were single or intermingled with the small papules. The patient presented about 10 lesions of this type, measuring 1 to 4 cm located to the lateral sides of the neck, the preauricular region and the scalp. The smaller lesions in similar locations consisted of numerous translucent or waxy small papules, 2-5mm in diameter the erupatiention was painless and caused only slight pruritus physical exam did not reveal ln enlargement or visceromegaly chest xray film showed discrete cardiomegaly without other abnormalities several 4mm punch biopsy specimens were obtained from well-develped and regressing papules, also two large excisional biopsies were taken from nodules 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
Some of the lesions became less prominent and began to fade during the immediate follow-up after six months, only a few lesions remained and they were receding 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
Two large excisional biopsies
Non-Clinical Treatment
None reported