Evolution of B-cell lymphoma from pseudolymphoma: A multidisciplinary approach using histology, immunohistochemistry, and Southern blot analysis

O. P. Sangueza, S. Yadav, C. R. White, R. M. Braziel

Research output: Contribution to journalArticle

96 Scopus citations

Abstract

Cutaneous B-cell lymphomas are rare neoplasms that can present as lesions involving solely the skin or develop in association with a systemic lymphoma. Histologically they are often difficult to differentiate from pseudolymphomas, and the use of immunohistochemistry may be necessary to correctly classify them. We report a study of multiple skin lesions in a patient who initially presented with multiple pseudolymphomas, apparently associated with an immune response to the dye of his tattoos. Over a period of 4 years his skin lesions evolved from histologically benign and immunologically polyclonal pseudolymphomas to a histologically malignant and immunologically monoclonal B-cell large cell lymphoma. Genotypic analysis with a probe for the heavy-chain immunoglobulin gene demonstrated the presence of clonal B-cell populations in all of the pseudolymphoma biopsy samples as well as in the subsequent lymphoma tissue samples, with a pattern of clonal bands suggestive of evolution of the B-cell clones. These findings suggest that the development of B-cell lymphoma in this patient was related to a persistent abnormal immune response to the chronic antigenic stimulus of the dye of the tattoo. The presence of clonal B-cell populations in pseudolymphoma by Southern blot analysis may be useful in predicting those patients who will subsequently develop overt lymphoma.

Original languageEnglish (US)
Pages (from-to)408-413
Number of pages6
JournalAmerican Journal of Dermatopathology
Volume14
Issue number5
DOIs
StatePublished - Jan 1 1992

Keywords

  • Cutaneous B-cell lymphoma
  • Immunoglobulin gene rearrangement
  • Pseudolymphoma
  • Tattoo

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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