Case Number : Case 2777 - 26 February 2021 Posted By: Richard Logan

Cutaneous lymphadenoma

Cutaneous lymphadenoma (a subtype of trichoblastoma in my opinion)

Nice Lymphadenoma, yes. 

Lymphadenoma, yes

There is an saying amongst Dermatologists: "This is a very good example of something I have never seen before".  By this they mean they are looking at a clinical entity so striking that they realise that they should be able to recognise it.  A good clinical example would be a halo naevus, unique in appearance but puzzling for the uninitiated.

I think the same applies to this case, which is cutaneous lymphadenoma as you have all correctly identified.  This is the only case I have knowingly encountered, further emphasising its rarity, as pointed out previously by Mark Hurt (case 763 21st May 2013) and others.  When I first saw this histology I was surprised that it was called a lymphadenoma, which conjures up an image of an entity predominantly composed of lymphocytes, which is far from the case.  I rather like Mark Hurt's suggestion of lymphocyte-rich trichoblastoma, which more accurately describes the histology.  Richard Carr discussed the nosology in detail (Case 28, July 2010).

The histology of this lesion is strikingly characteristic and rather pretty I think.  Phillip McKee made the tongue-in-cheek comment (Case 763 21st May 2013) "Miss this a second time, and a career change is in order"!

Adamantinoid trichoblastoma, beautiful! Thanks for.