Granuloma With an Underlying Lymphoma: A Diagnostic Challenge and a Wider Histologic Spectrum Including Adult T-Cell Leukemia/Lymphoma.
Appl Immunohistochem Mol Morphol
; 28(4): 316-324, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-30653030
ABSTRACT
Granulomatous reaction is not uncommon in histopathology, with various etiologies in different organs and geographic regions. Lymphoma is one of the underlying causes of granuloma; and sometimes the neoplastic cells may be masked by the granulomatous reaction. In this report, we present our experience with 7 lymphoma cases of various histologic types with coexisting granuloma to show the diagnostic challenges. In all cases, a granulomatous reaction was simultaneously present with the neoplastic cells. The 7 cases included 3 cases of adult T-cell leukemia/lymphoma in the lymph node or skin including one coexisting with mycobacterial infection, 2 cases of classical Hodgkin lymphoma involving the liver, and 1 case each of systemic Epstein-Barr virus-positive peripheral T-cell lymphoma and a hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma. Three cases were initially misdiagnosed as reactive change or mycobacterial infection instead of lymphoma, and a wrong histologic lymphoma type was diagnosed in 1 case. In this report, we showed that granulomatous reaction might mask lymphomas of various histologic types; and a diagnosis of mycobacterial infection or sarcoidosis could not exclude the possibility of an underlying lymphoma. We emphasized the importance of detailed histologic examination with the aid of ancillary studies to reach a correct diagnosis and to avoid inappropriate management of the patients. Our study also broadened the spectrum of lymphoma types coexisting with granuloma.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de Hodgkin
/
Leucemia-Linfoma de Células T del Adulto
/
Linfoma de Células T Periférico
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Herpesvirus Humano 4
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Infecciones por Virus de Epstein-Barr
/
Granuloma
Tipo de estudio:
Diagnostic_studies
Idioma:
En
Revista:
Appl Immunohistochem Mol Morphol
Asunto de la revista:
BIOLOGIA MOLECULAR
/
HISTOCITOQUIMICA
Año:
2020
Tipo del documento:
Article