Enigmatic Diagnosis: Idiopathic Cutaneous Pseudolymphoma - A Case Report

TITOU, ANOUAR; Jazzar, Taha; Essioti, Mohammed; Kamal, Dounia

doi:10.21608/omx.2024.297599.1253

Enigmatic Diagnosis: Idiopathic Cutaneous Pseudolymphoma - A Case Report

Document Type : Case Report

Authors

Department of Reconstructive and Maxillofacial Surgery, Hassan II University Hospital of Fez, Sidi Mohamed Ben Abdellah University, Faculty of Medicine, Pharmacy, and Dentistry, Fez, Morocco.

10.21608/omx.2024.297599.1253

Abstract

Introduction

pseudolymphomas are benign reactive lymphoid proliferations that clinically, histologically, or both clinically and histologically resemble cutaneous lymphomas. They arise from known or unknown stimuli. Traditionally, cutaneous pseudolymphomas have been classified based on their histological and immunophenotypic characteristics or in relation to the lymphoma they mimic.

Observation

This is a 60-year-old female patient with no significant medical history or medication use. She was admitted for management of a swelling at the root of her nose that had been gradually increasing in size over 2 years.

Facial CT scan showed a tissue mass causing multi-fragmentary destruction of the nasal bones and reaching the inner corners of the orbits, measuring 25x12x25 mm, with no cervical lymphadenopathy noted.

Based on these findings, the patient underwent complete excision of the nasal root mass; the excised specimen was sent for histopathological examination. Immunohistochemical confirmed a B-type pseudolymphoma.

For this patient, a somewhat aggressive treatment approach was chosen, starting with complete excision of the lesion followed by treatment with potent dermocorticoids, resulting in a somewhat satisfactory outcome after a 6-month follow-up period.

Discussion

Pseudolymphoma present a diagnostic challenge. A judicious panel of immunohistochemistry is sufficient to diagnose pseudolymphomas. In many cases, an appropriate etiology may not be identified, leading to labeling these cases as idiopathic. A follow-up of at least 5 years is necessary to exclude the risk of cutaneous lymphomas. This observation highlights the difficulties in diagnosing benign cutaneous lymphoid hyperplasia as well as the delicacy of management.

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