Insect bite-like reaction associated with mantle cell lymphoma: a report of two cases and review of the literature.
BACKGROUND
An insect bite-like reaction and exaggerated reactions to insect bites are nonspecific phenomena described primarily in association with chronic lymphocytic leukemia (CLL), but also with other hematological malignancies. Two cases of mantle cell lymphoma (MCL), one associated with an insect bite-like reaction and the other with a true hypersensitivity to mosquito bites, have previously been reported in the English language literature. The pathogenesis of the skin eruption may be related to the release of different cytokines that also trigger an IgE elevation and dermal eosinophils.


METHODS
We describe two additional cases of MCL associated with an insect bite-like reaction. One patient had been diagnosed with MCL 4.5 years prior to the appearance of the skin eruption, and in the other patient the skin symptoms preceded the diagnosis of the MCL by 2 years and led to its diagnosis.


CONCLUSIONS
Insect bite-like reaction may appear in patients with MCL. It is important to recognize this entity because it may be the presenting sign of MCL.
Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Roni P
RP
Dodiuk-Gad
Eldad J
EJ
Dann
Reuven
R
Bergman
D003937:Diagnosis, Differential; D006119:Groin; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D020522:Lymphoma, Mantle-Cell; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000209:etiology; D013933:Thumb