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Granulomatous Slack Skin Following Non-Hodgkin Lymphoma: First Case Reported in Mexico

Issue: Vol.2, No.2 - January 2003

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Article Type: Manuscript

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  1. Dr Adelardo Meneses Garcia
    Subdirection of Pathology, Instituto Nacional de Cancerologia
  2. Jaimes Hernandez
  3. R L M Rulz-Godoy

A twenty-four year old woman from Mexico City with initial asymptomatic erythematous maculae in limbs and trunk was admitted. Biopsy showed non-Hodgkin's lymphoma-associated granulomatous dermatitis. The patient was treated with poly-chemotherapy without clinical response. Twelve years later, she developed slack skin of neck and both armpits, along with several pulmonary nodules. Skin biopsies showed epidermis with atrophic changes and crest network loss. The dermis was infiltrated with lymphoid cells with nuclei of cerebriform appearance, slight hyper-chromasia, some convoluted, as well as sporadic giant cells with no cessation. Some of these showed lymphocyte and elastic fiber phagocytosis. Immuno-histochemical studies of lymph cells with atypia were positive to T cell markers (UCHL-1). Mono-nuclear cells and giant cells were positive to macrophage markers (CD-68).
Ultra-structural studies confirmed the lymphoid origin with nuclear lobulations. The patient received gamma interferon after poly-chemotherapy treatment with no clinical response.

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