[Granuloma with lymphocytic hyperplasia following vaccination: 10 cases. Presence of aluminium in the biopsies].
BACKGROUND
Few cases of cutaneous lymphocytic hyperplasia secondary to vaccination have been published, although such lesions are not rare.


METHODS
We report a series of 10 cases registered between 1993 and 2003.


RESULTS
Mean age was 25. The clinical aspect was solitary or multiple subcutaneous nodules, located on the arm, developing after a delay of 1 to 18 months after vaccination. Histologic examination showed a lymphocytic infiltration of the subcutaneous fat, with diffuse and/or follicular pattern, without nuclear atypia, the morphological and immunohistochemical analysis of which revealed the benign nature. In all cases, there was fibrosis and granuloma composed of lymphocytes, plasma cells, eosinophils and macrophages with basophilic cytoplasm. Morin stain showed intralesional aluminium in the 6 investigated cases. Evolution was always benign, with no relapse following exeresis.


CONCLUSIONS
Cutaneous lymphocytic hyperplasia secondary to vaccination has to be suspected in a young patient with subcutaneous nodules appearing at a vaccination site. Evidence of aluminium in the lesions supports the diagnosis and the hypothesis that aluminium in the vaccine excipient might have a role in the onset of such lesions.
Lafaye
S
S
Département de Pathologie, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
Authier
F-J
FJ
Fraitag
S
S
Rethers
L
L
Bagot
M
M
Wechsler
J
J
D000293:Adolescent; D000328:Adult; D000535:Aluminum / Q000009:adverse effects* / Q000302:isolation & purification*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005079:Excipients / Q000009:adverse effects*; D005260:Female; D006099:Granuloma / Q000209:etiology*; D006801:Humans; D006965:Hyperplasia; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D014611:Vaccination / Q000009:adverse effects*
D005079:Excipients; D000535:Aluminum