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Cutaneous pseudolymphoma

Author: Dr Ben Tallon, Dermatology Registrar, Greenlane Hospital, Auckland, New Zealand, 2006.

Cutaneous pseudolymphomas are a group of conditions that simulate a lymphoma (blood cell cancer), but behave in a harmless manner. In most situations this appears to be a reactive process, though a number of dermatologic conditions can be difficult to distinguish from a lymphoma.

Clinicopathologic conditionSimulated malignant lymphoma
Atypical lymphoid infiltrates (CD30+) associated with:
Lymphocytoma cutis B cell lymphomas
  • Follicle center lymphoma
  • Marginal zone B-cell lymphoma
  • Large B-cell lymphoma
  • Lymphomatoid drug reaction, B cell type
  • Pseudolymphoma after vaccination
  • Pseudolymphoma in tattoos
  • Pseudolymphoma caused by Hirudo medicinalis therapy
  • Follicle center lymphoma
  • Marginal zone B-cell lymphoma
    • Marginal zone B-cell lymphoma
  • Chronic lymphocytic leukaemia, B cell type
  • Inflammatory pseudotumour
Classification of cutaneous pseudolymphomas*

*Table modified from Dr L.Cerroni presentation at the 2006 Australasian Dermatopathology Society Annual Conference

Clinical Features and Diagnosis

The original description applied only to lymphocytoma cutis. Over time a number of other conditions have been added to this category, as reports of conditions mimicking a lymphoma have been described. This is largely based on the histological (microscopic) appearance.

The presentation and behaviour depends on which the particular subtype. Most cases tend to resolve spontaneously if the precipitating agent is removed. Some may recur over time.

The diagnosis is made by both a combination of the clinical features and careful histological ananlysis. Often only by observing the behaviour of the condition over time can the diagnosis be confirmed.

Treatment

Treatment is dependent on the particular subtype, but in cases resulting from a reactive process observation may be all that is required.

Related information

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