Foreign-body granuloma and IgE-pseudolymphoma after multiple bee stings.
We report a patient with an unusual combination of an eosinophilic foreign-body granuloma and a pseudolymphoma, with recurrent severe oedema on the forehead, after multiple bee stings. On immunohistology the foreign-body granuloma and lymphoid follicles reacted with monoclonal antibodies against the high- and low-affinity IgE receptors, and against IgE. Prick and intradermal tests with whole-body bee extracts showed positive immediate-type reactions. The eosinophilic granuloma formation and lymphoid follicles may have been induced by a combination of immune complex and cell-mediated hypersensitivity following antigen persistence. Although bee stings are common, as far as we are aware, this complex reaction pattern has not been reported previously.
Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany.
B
B
Hermes
N
N
Haas
J
J
Grabbe
B M
BM
Czarnetzki
D000818:Animals; D001516:Bees; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007150:Immunohistochemistry; D007299:Insect Bites and Stings / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017455:Receptors, IgE / Q000276:immunology; D012867:Skin / Q000473:pathology
D017455:Receptors, IgE; D007073:Immunoglobulin E