Borrelia burgdorferi-associated lymphocytoma cutis simulating a primary cutaneous large B-cell lymphoma
Borrelia burgdorferi-associated lymphocytoma cutis simulating a primary cutaneous large B-cell lymphoma
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DOI：
10.1067/mjd.2002.120475
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发表时间：
2002-10-01
影响因子：
13.8
通讯作者：
Cerroni, L
中科院分区：
文献类型：
--
作者：
Grange, F;Wechsler, J;Cerroni, L
原发皮肤B细胞淋巴瘤和B细胞假淋巴瘤在组织学基础上可能很难区分，特别是在一些伯氏疏螺旋体相关淋巴组织增殖的病例中。我们报告两例与伯氏杆菌相关的假淋巴瘤，表现为以大的非典型B细胞为主的致密浸润性。由于这一误导性的组织学特征，在这两个病例中，最初都怀疑是原发性皮肤大B细胞淋巴瘤。在一个病例中，在伯氏杆菌感染被发现之前，连续的复发导致了积极的治疗。然而，组织学和免疫组织化学特征的详细回顾最终提示这两个病例都是B型伯氏相关假性淋巴瘤。伯氏杆菌的血清学、聚合酶链式反应分析证实了伯氏杆菌的病原学作用！皮损皮肤中的DNA，以及对抗生素治疗的反应。由于伯氏杆菌相关性假性淋巴瘤和原发皮肤B细胞淋巴瘤之间的区别可能很困难，而且真实的伯氏相关B细胞淋巴瘤已被描述，我们建议在伯氏杆菌地方性感染地区的疑似或确诊的原发皮肤B细胞淋巴瘤患者中，抗生素治疗应被视为一线治疗。
The distinction between primary cutaneous B-cell lymphoma and B-cell pseudolymphoma on a histologic basis may be difficult, particularly in some cases of Borrelia burgdorferi-associated lymphoid proliferations. We report two cases of B burgdorferi-associated pseudolymphoma that showed a dense infiltrate with a predominance of large atypical B cells. Because of this misleading histologic feature, a diagnosis of primary cutaneous large B-cell lymphoma was first suspected in both cases. In one case, successive recurrences led to aggressive therapies before the B burgdorferi infection was recognized. However, a detailed review of histologic and immunohistochemical features was finally suggestive of a B burgdorferi-associated pseudolymphoma in both cases. The etiologic role of B burgdorferi was confirmed by serology, polymerase chain reaction analysis of B burgdorferi! DNA within the lesional skin, and response to antibiotic therapy. Because the distinction between B burgdorferi-associated pseudolymphoma and primary cutaneous B-cell lymphomas may be difficult and true B burgdorferi-associated B-cell lymphomas have been described, we suggest that antibiotic therapy should be considered as a first-line treatment in suspected or confirmed cases of primary cutaneous B-cell lymphoma in regions with endemic B burgdorferi infection.