Persistent atypical lymphocytic hyperplasia following tick bite in a child: report of a case and review of the literature.
We report a 6-year-old girl who developed a red papule on the posterior neck at the site of a previous tick bite. Initial biopsy was performed a year after the bite and the specimen showed a dense lymphoid infiltrate with admixed CD30+ cells. The patient was referred to our center because of concern about the development of a CD30+ lymphoproliferative disorder. The lesion was completely excised. Histology showed no evidence of a clonal lymphoproliferative disorder or Borrelia infection, but persistence of CD30+ cells. This case demonstrates that a tick bite reaction can persist for more than 1 year and show immunophenotypic and morphologic overlap with a CD30+ lymphoproliferative disorder. Complete history with thorough clinical and histopathologic evaluation is necessary to arrive at the correct diagnosis.
Hwong
H
H
Department of Internal Medicine Specialties, Section of Dermatology, University of Texas-M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Jones
D
D
Prieto
V G
VG
Schulz
C
C
Duvic
M
M
D000818:Animals; D001733:Bites and Stings / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D019310:Pseudolymphoma / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D013987:Ticks