EBER in situ hybridization in subcutaneous aluminum granulomas/lymphoid hyperplasia: A diagnostic clue to differentiate injection-associated lymphoid hyperplasia from other forms of pseudolymphomas and cutaneous lymphomas.
Adult
Aluminum
/ administration & dosage
Biopsy
Case-Control Studies
Diagnosis, Differential
Female
Granuloma
/ chemically induced
Histiocytes
/ pathology
Humans
Immunohistochemistry
/ methods
In Situ Hybridization
/ methods
Lymphoma, T-Cell, Cutaneous
/ diagnosis
Microscopy, Electron
/ methods
Pseudolymphoma
/ diagnosis
RNA-Binding Proteins
/ metabolism
Retrospective Studies
Ribosomal Proteins
/ metabolism
Skin Neoplasms
/ pathology
Subcutaneous Tissue
/ pathology
Vaccination
/ adverse effects
EBER in situ hybridization
RNA probe
aluminum granuloma
lymphoid hyperplasia
pseudolymphoma
Journal
Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
revised:
28
12
2020
received:
18
09
2020
accepted:
08
01
2021
pubmed:
27
1
2021
medline:
16
11
2021
entrez:
26
1
2021
Statut:
ppublish
Résumé
Subcutaneous vaccination or desensitization may induce persistent nodules at the injection sites. Without the knowledge of prior injection, histopathological work-up may be challenging. Aim of this study was to contribute to the histopathological work-up of unclear subcutaneous nodules, especially their differentiation from cutaneous lymphoma. We retrospectively reviewed clinical data and histopathological slides of four patients with subcutaneous nodules, which were suspected to suffer from cutaneous T- or B-cell lymphoma. Sections of these cases and 12 negative controls were stained with hematoxylin and eosin and a standardized immunohistochemical panel of B- and T-cell markers including EBER in situ hybridization as well as electron microscopy. In all cases, large histiocytes with granular cytoplasm compatible with intracellular aluminum hydroxide were present. EBER in situ hybridization revealed positive staining of these granular histiocytes while staining was absent in negative controls. Post hoc completion of medical history revealed that vaccination or specific immunotherapy had been applied before at the biopsy site in only three out of four patients; one patient was lost to follow-up. EBER in situ hybridization is an adjunctive tool to differentiate aluminum-induced granuloma/lymphoid hyperplasia from other forms of pseudolymphoma and cutaneous B- or T-cell lymphomas.
Sections du résumé
BACKGROUND
BACKGROUND
Subcutaneous vaccination or desensitization may induce persistent nodules at the injection sites. Without the knowledge of prior injection, histopathological work-up may be challenging.
OBJECTIVE
OBJECTIVE
Aim of this study was to contribute to the histopathological work-up of unclear subcutaneous nodules, especially their differentiation from cutaneous lymphoma.
METHODS
METHODS
We retrospectively reviewed clinical data and histopathological slides of four patients with subcutaneous nodules, which were suspected to suffer from cutaneous T- or B-cell lymphoma. Sections of these cases and 12 negative controls were stained with hematoxylin and eosin and a standardized immunohistochemical panel of B- and T-cell markers including EBER in situ hybridization as well as electron microscopy.
RESULTS
RESULTS
In all cases, large histiocytes with granular cytoplasm compatible with intracellular aluminum hydroxide were present. EBER in situ hybridization revealed positive staining of these granular histiocytes while staining was absent in negative controls.
LIMITATIONS
CONCLUSIONS
Post hoc completion of medical history revealed that vaccination or specific immunotherapy had been applied before at the biopsy site in only three out of four patients; one patient was lost to follow-up.
CONCLUSION
CONCLUSIONS
EBER in situ hybridization is an adjunctive tool to differentiate aluminum-induced granuloma/lymphoid hyperplasia from other forms of pseudolymphoma and cutaneous B- or T-cell lymphomas.
Substances chimiques
RNA-Binding Proteins
0
Ribosomal Proteins
0
RPL22 protein, human
135844-68-7
Aluminum
CPD4NFA903
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
625-631Informations de copyright
© 2021 The Authors. Journal of Cutaneous Pathology published by John Wiley & Sons Ltd.
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