Send to

Choose Destination
See comment in PubMed Commons below
J Cutan Pathol. 2012 Nov;39(11):996-1003. doi: 10.1111/j.1600-0560.2012.01967.x. Epub 2012 Jul 25.

Granuloma annulare-like eruption associated with B-cell chronic lymphocytic leukemia.

Author information

  • 1Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.



Cutaneous granulomatous inflammation can occur in patients with T-cell lymphoma and Hodgkin disease. We describe the unusual microscopic pattern of a granuloma annulare (GA)-like eruption co-existing with B-cell chronic lymphocytic leukemia (B-CLL).


We reviewed the histopathology and immunophenotype of skin biopsies from two patients with B-CLL and cutaneous lesions resembling GA.


Both patients had symptomatic cutaneous lesions clinically resembling GA; one had lesions refractory to standard dermatologic therapy. Histopathology showed GA-like palisaded histiocytic infiltration, with subtle collections of lymphocytes interspersed among the granulomatous inflammation. Immunohistochemistry showed strong expression of CD20 and CD79a, with aberrant CD5 co-expression, confirming cutaneous involvement by B-CLL.


Co-existence of a GA-like infiltrate and cutaneous B-CLL raises the possibility that granulomatous inflammation occurs as a secondary response to dermal infiltration by leukemic cells. Because histopathologic findings can be subtle, knowledge of this association is essential to avoid overlooking the diagnosis. Regardless of whether histopathology reflects a reactive or primary phenomenon, documentation of cutaneous involvement by B-CLL may serve as a rationale for specific treatment of the underlying B-CLL in patients with skin lesions unresponsive to dermatologic therapy and for whom there is no other justification for leukemia-targeted therapy.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center