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Borrelia burgdorferi ‐associated lymphocytoma cutis: clinicopathologic, immunophenotypic, and molecular study of 106 cases
Author(s) -
Colli Claudia,
Leinweber Bernd,
Müllegger Robert,
Chott Andreas,
Kerl Helmut,
Cerroni Lorenzo
Publication year - 2004
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.0303-6987.2003.00167.x
Subject(s) - borrelia burgdorferi , serology , pathology , borrelia burgdorferi infection , pseudolymphoma , medicine , erythema migrans , germinal center , cutaneous lymphoma , dermatology , b cell , antibody , immunology , lymphoma , lyme borreliosis , mycosis fungoides
Lymphocytoma cutis (LC) is considered as the stereotypical example of the cutaneous B‐cell pseudolymphomas. It can be induced by various antigenic stimuli including arthropod bites, vaccination, and drugs among others. In endemic regions, Borrelia burgdorferi is the principal causative agent for LC. We studied retrospectively 108 biopsies from 106 patients (male : female, 48 : 58; mean age, 44.6; median, 51.5; range, 3–81) with B. burgdorferi ‐associated LC retrieved from the files of the Department of Dermatology of the University of Graz (Austria). Only cases with a B. burgdorferi etiology (typical locations, positivity of serologic and/or polymerase chain reaction (PCR) tests, clinical history) were included in the study. Lesions were located on the nipple (63 cases), earlobe (18 cases), genital region (9 cases), and trunk or extremities (16 cases). PCR analysis of B. burgdorferi DNA was positive in 54 of 80 cases tested (67.5%). In 47 cases, we could retrieve data on serologic examination for B. burgdorferi antibodies performed at the time of diagnosis of LC. Positivity was found in 45 patients (IgG + /IgM + , 5 cases; IgG + /IgM – , 37 cases; IgG – /IgM + , 3 cases; IgG – /IgM – , 2 cases). Histology revealed dense lymphoid infiltrates with prominent germinal centers (GCs) in all cases. Atypical morphologic and/or immunophenotypic features of the GCs were commonly observed. In 5 cases, due to confluence of large follicles, the histopathologic pattern simulated that of a large B‐cell lymphoma. PCR analysis of the IgH gene rearrangement performed in 33 cases showed a polyclonal pattern in 31 cases and a monoclonal band in 2. In summary, B. burgdorferi ‐associated LC can present with misleading histopathologic, immunophenotypic, and molecular features, and integration of all data is necessary for a correct diagnosis.