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  Vol. 139 No. 6, June 2003 TABLE OF CONTENTS
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A Pig Farmer With Pruritic Pink Papules and Plaques—Diagnosis

Arch Dermatol. 2003;139:803-808.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Lymphomatoid granulomatosis.

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Biopsy specimens of the skin lesions and lungs showed a granulomatous, angiocentric, angiodestructive infiltrate composed of an admixture of epithelioid histiocytes, small lymphocytes, and medium to large pleomorphic lymphocytes. Cultures of the tissue were negative for fungi, bacteria, and mycobacteria. Immunostaining of the skin and lung biopsy tissue was positive for CD45 (large anaplastic cells), CD20 (large anaplastic cells), CD3 (reactive T cells), and CD43. Taken together, the biopsy findings were consistent with a malignant lymphoma of the large-cell type with B-cell phenotype, associated with numerous reactive T cells and extensive necrosis, so-called lymphomatoid granulomatosis.

The patient was treated with 6 cycles of CHOP (cyclophosphamide, doxorubicin hydrochloride [hydroxydaunomycin (Adriamycin)], vincristine sulfate [Oncovin], and prednisone) during a 5-month period. The fever and arthralgias resolved.

At follow-up 6 months later, no active skin lesions were observed. Computed tomography showed a residual mass in the left lung, with no lymphadenopathy. At follow-up 4 . . . [Full Text of this Article]

DISCUSSION


RELATED ARTICLE

A Pig Farmer With Pruritic Pink Papules and Plaques—Quiz Case
David R. Byrd, Daniel P. Vandersteen, Emma J. Beech, and Mark D. P. Davis
Arch Dermatol. 2003;139(6):803-808.
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