Author/Editor		Boudova, Ludmila; Kazakov, Dmitry V; Sima, Radek; Vanecek, Tomas; Torlaković, Emina; Lamovec, Janez; Kutzner, Heinz; Szepe, Peter; Plank, Lukas; Bouda, Jiri; Hes, Ondrej; Mukensnabl, Petr; Michal, Michal
Title		Cutaneous lymphoid hyperplasia and other lymphoid infiltrates of the breast nipple: a retrospective clinicopathologic study of fifty-six patients
Type		članek
Source		Am J Dermatopathol
Vol. and No.		Letnik 27, št. 5
Publication year		2005
Volume		str. 375-86
Language		eng
Abstract		Abstract: This study characterizes the clinicopathological spectrum of lymphoproliferations involving the breast nipple and/or areola. Morphologic, immunohistochemical, molecular-genetic, and clinical features of 58 specimens from 56 patients were analyzed. They were re-diagnosed as cutaneous lymphoid hyperplasia (CLH, n = 44); other benign lymphoid infiltrates (OBLI, n = 8); peripheral T cell Iymphoma, not otherwise specified (n = 1 ); cases with overlapping features of CLH and B-cell lymphoma (n = 3), one of them composed of spindle cells. Cutaneous lymphoid hyperplasia infiltrates were dense, composed mainly of B cells forming follicles with germinal centers (GC). Cutaneous lymphoid hyperplasia frequently showed features suggesting a malignancy as coalescing follicles with nonpolarized germinal centers lacking mantle zones, and smudged infiltrates of lymphoid cells spreading into collagen (often as "Indian files"), smooth muscle, vessel walls, and newe sheaths. Only two cutaneous lymphoid hyperplasias recurred; otherwise all patients are without disease (mean follow-up 62 months). Monoclonal rearrangement of immunoglobulin heavy chain gene was detected in five, and of T-cell receptor y gene in two cutaneous lymphoid hyperplasias using polymerase chain reaction (PCR), but the patients fared well too. In 47% of cases Borreelia burgdorferi was detected by polymerase chain reaction and/or serology, of which one was monoclonal. We conclude that cutaneous lymphoid hyperplasia is the most common lymphoproliferation of the breast nipple, rarely recognized clinically, and often overdiagnosed histologically as lymphoma.
Descriptors		LYME DISEASE LYMPHOPROLIFERATIVE DISORDERS NIPPLES PSEUDOLYMPHOMA SKIN DISEASES AGE FACTORS SEX FACTORS BORRELIA BURGDORFERI GENE REARRANGEMENT, B-LYMPHOCYTE, HEAVY CHAIN HYPERPLASIA POLYMERASE CHAIN REACTION RETROSPECTIVE STUDIES