Case Number : Case 2331 - 23 May 2019 Posted By: Iskander H. Chaudhry

Triphasic pattern, with pale areas corresponding to germinal centers, surrounded by dark areas of mantle zone and by pale neoplastic areas of mz-cells admixed with many plasma cells. Some plasma cells contains intra nuclear Deutcher-bodies.

My spot is cutaneous marginal zone lymphoma..light chain restriction to confirm the diagnosis.

ALHE. :)

reactive follicles in deep dermis with eosinophils

? psudolymphoma-tick bite/drug induced

As a diffetential diagnosis, despite really rare in the skin, I would like to add cutaneous Castleman´s disease. Usually there is systemic disease associated, so I would ask for more clinical information.

Deep inflamation with follicles that show expansion of the marginal zone (to my eyes).

So i think in Marginal zone lymphoma too (so agree with Vincenzo)

Lot of plasma cells. Would do IgG and IgG4 immunos. IgG4-related skin disease commonly occurs on the head and neck

sir, whats the diagnosis

MZL vs Lymphocytoma

Needs CD3, CD20, CD21, Bcl-2, Bcl-6, CD10 and Ki67 in addition to kappa and lambda

So, what's the diagnosis, Dr Iskander?

Dear All

Well done! The clinical fitted with a drug induced pseudo-lymphoma! All your differentials were great :) 

Iskander H. Chaudhry