title: Malignant lymphoma presenting with cutaneous granulomas.
abstract: A 49-year-old man with fever, malaise, weight loss, and pneumonia developed cutaneous nodules and neurologic symptoms. Skin biopsy studies revealed granulomatous inflammation consistent with a sarcoid reaction, and mild granulomatous changes were noted on biopsy specimens of liver and bone marrow. A lymph node biopsy was unremarkable. Neurologic deterioration prompted an extensive workup that revealed an intracranial mass. A brain biopsy study revealed malignant lymphoma, large cell type. Autopsy study confirmed the diagnosis and showed no evidence of granulomatous infiltrates. The cutaneous granulomas represent a nonspecific immune response possibly related to the underlying lymphoma. The relationship between sarcoidosis and sarcoid reactions and lymphoma is discussed.
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000473:pathology; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*