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Ann Dermatol Venereol. 2011 Aug-Sep;138(8-9):591-6. doi: 10.1016/j.annder.2011.02.017. Epub 2011 Apr 13.

[Lymphomatoid granulomatosis revealed by cutaneous lesions].

[Article in French]

Author information

1
Clinique dermatologique, CHU de Nantes, 1, place A.-Ricordeau, 44093 Nantes cedex 01, France.

Abstract

BACKGROUND:

Lymphomatoid granulomatosis is a rare Epstein Barr virus (EBV)-related lymphoproliferative disorder. It most frequently involves the lungs, skin and central nervous system and arises preferentially in patients with immune disorders. Here we report a case revealed by cutaneous lesions in an immunocompetent patient.

CASE REPORT:

A 56-year-old man consulted for erythematous nodules of the trunk associated with malaise and marked weight loss (14kg). In a few days the nodules became necrotic. Two weeks later a cough appeared and the chest computerized tomography showed multiple poorly defined nodular opacities with a peribronchovascular distribution. Cutaneous and pulmonary biopsies showed an infiltrate composed of medium-sized atypical lymphocytes T and B. EBV was present in the infiltrate (in situ hybridization) with a high EBV load in plasma. All of these data helped confirm the diagnosis of lymphoid granulomatosis. Despite aggressive treatment with polychemotherapy, the patient died after 2 months.

DISCUSSION:

Lymphomatoid granulomatosis represents a diagnostic challenge. In most cases, the presenting symptoms are not specific: malaise, weight loss, fever and cough. Moreover histology is difficult because of the T-cell-rich background. It is essential to consider this diagnosis in cases of cutaneous and pulmonary symptoms.

PMID:
21893233
DOI:
10.1016/j.annder.2011.02.017
[Indexed for MEDLINE]

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