RESUMO
Cutaneous lymphoid hyperplasia (pseudolymphoma) on tattoo is rare. The diagnosis is histological. We report a case of cutaneous lymphoid hyperplasia within the red ink of a tattoo found on a 35-year-old man presenting multiple infiltrated nodules confined to the red areas of his tattoo, which he had done 2 months ago. The pathological examination showed a diffuse lympho-histiocytic dermo-hypodermal infiltrate, associated with a lichenoid reaction. Immunohistochemistry displayed T-cell infiltration (CD3+, CD5+, CD8+). The treatment is difficult, knowing that the spontaneous regression seems possible, and the progression into a lymphoma is exceptional in the case of a chronic evolution over a number of years.
Assuntos
Corantes/efeitos adversos , Erupções Liquenoides/induzido quimicamente , Pseudolinfoma/induzido quimicamente , Tatuagem , Corticosteroides/uso terapêutico , Adulto , Biópsia , Diagnóstico Diferencial , Toxidermias/diagnóstico , Toxidermias/etiologia , Toxidermias/patologia , Rearranjo Gênico do Linfócito T , Humanos , Hidroxicloroquina/uso terapêutico , Erupções Liquenoides/diagnóstico , Erupções Liquenoides/tratamento farmacológico , Erupções Liquenoides/patologia , Linfoma não Hodgkin/diagnóstico , Masculino , Pseudolinfoma/diagnóstico , Pseudolinfoma/tratamento farmacológico , Pseudolinfoma/patologia , Neoplasias Cutâneas/diagnóstico , Linfócitos T/patologia , Falha de TratamentoRESUMO
A standardized second histological review for lymphomas was established by the French National Cancer Institute in 2010. The objective of our study was to assess the clinical impact of this process between a general hospital (reader 1) and an expert (reader 2). This prospective study was conducted between April 1st 2010 and April 1st 2011. Fifty-four cases of lymphoma were subjected to an expert review following the "LYMPHOPATH" recommendations and diagnoses of readers 1 and 2 were compared according to the WHO 2008 classification of lymphomas. We distinguished serious discrepancies (lymphoma versus other malignancy) from subtyping disagreement with or without impact on therapeutic strategy. We also determined the delays between the initial reception of the sample and reader 1's (period A) and reader 2's (period B) reports, respectively. Any additional analysis performed by second reader was also reported. Our study revealed one case of subtyping discordance (1.85%). The mean delays were 7 days for period A and 20 days for period B, respectively. Additional immunohistochemical techniques were requested by reader 2 in 11 cases (20.4%). These data provide evidence to suggest that in our department, a second review targeted on difficult diagnoses, rare lymphomas or when further analyses are required would be more relevant than a standardized second review.