Cutaneous granulomas as the first manifestation of Hodgkin's disease.
We report the case of a 64-year-old male in whom fever, cutaneous rash and hepatomegaly were the first manifestations of Hodgkin disease (HD). Histologically a dense lymphohistiocytic infiltrate with a granulomatous pattern was found in the skin infiltrate. A computed tomography scan revealed hepatosplenomegaly and a small retroperitoneal lymphadenopathy. An hepatic percutaneous biopsy showed a granulomatous infiltration with typical Reed-Sternberg cells. Cutaneous manifestations of HD are briefly reviewed. The authors underline that granulomatous infiltration of the skin as the first manifestation of lymphoma is a very rare feature. We also discuss the possible pathogenic mechanisms of skin granulomas.
Macaya
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Dermatology Service, Ciutat Sanitària i Universitària de Bellvitge, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. antmacaya@yahoo.es
Servitje
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Moreno
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Peyrí
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J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005334:Fever / Q000209:etiology; D006099:Granuloma / Q000209:etiology* / Q000473:pathology; D006529:Hepatomegaly / Q000209:etiology; D006689:Hodgkin Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D016539:Reed-Sternberg Cells / Q000473:pathology; D012878:Skin Neoplasms / Q000209:etiology* / Q000473:pathology; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D005047:Etoposide; D004317:Doxorubicin; D011241:Prednisone