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Year : 2016  |  Volume : 82  |  Issue : 1  |  Page : 109-111

Solitary asymptomatic nodule on the leg


1 Department of Dermatology, San Cecilio University Hospital, Granada, Spain
2 Department of Pathology, San Cecilio University Hospital, Granada, Spain

Date of Web Publication31-Dec-2015

Correspondence Address:
Ana Almodovar-Real
Department of Dermatology, San Cecilio University Hospital, Avenida Doctor Olóriz 16, 18012 Granada
Spain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0378-6323.168940

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How to cite this article:
Almodovar-Real A, Aneiros-Fernandez J, Diaz-Martinez MA, Naranjo-Sintes R. Solitary asymptomatic nodule on the leg. Indian J Dermatol Venereol Leprol 2016;82:109-11

How to cite this URL:
Almodovar-Real A, Aneiros-Fernandez J, Diaz-Martinez MA, Naranjo-Sintes R. Solitary asymptomatic nodule on the leg. Indian J Dermatol Venereol Leprol [serial online] 2016 [cited 2019 Dec 7];82:109-11. Available from: http://www.ijdvl.com/text.asp?2016/82/1/109/168940


A 58-year-old man presented with an asymptomatic skin nodule on the left leg for several months. Physical examination showed a well-defined, erythematous nodule (2 cm × 1.5 cm) with a lobulated surface [Figure 1]. Differential diagnoses of squamous cell carcinoma, basal cell carcinoma and cutaneous lymphoma were considered. An excisional biopsy was performed. Histopathology showed pseudoepitheliomatous hyperplasia [Figure 2]. There was a dense, irregular, lymphoid infiltrate with admixture of neutrophils, eosinophils and large, atypical Reed-Sternberg-like cells in the dermis [Figure 3]. Immunohistochemical analysis revealed strong positivity for CD30 [Figure 4]a. Tumor cells were also positive for the cytotoxic marker T-cell intracellular antigen-1 [Figure 4]b, CD3, CD7 and CD4 [Figure 4]c. On the other hand, AE1-AE3, CD8, CD56, CD20, ALK-1, CD5, CD15 and CD25 were all negative. Routine investigations and positron emission tomography-computed tomography study were normal. There was no recurrence after 1 year of follow-up.
Figure 1: Asymptomatic nodule on leg

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Figure 2: Pseudoepitheliomatous epidermal hyperplasia (H and E, ×10)

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Figure 3: Dense infiltrates of atypical lymphocytes in dermis; large and atypical Reed–Sternberg-like cells (H and E, ×200)

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Figures 4: Neoplastic cells positive for (a) CD30 (×100), (b) cytotoxic marker T-cell intracellular antigen-1 (×100) and (c) CD4 (×100)

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  References Top

1.
Szpor J, Dyduch G, Galazka K, Bahyrycz J, Stój A, Tomaszewska R. Primary cutaneous CD30+lymphoproliferative disorder – A 10-year follow-up. A case report and differential diagnosis. Pol J Pathol 2009;60:43-8.  Back to cited text no. 1
    
2.
Ralfkiaer E, Willemze R, Paulli M, Kadin ME. Primary cutaneous CD30-positive T-cell lymphoproliferative disorders. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues, 4th ed. Lyon: IARC; 2008. p. 300-1.  Back to cited text no. 2
    
3.
Quintanilla-Martinez L, Jansen PM, Kinney MC, Swerdlow SH, Willemze R. Non-mycosis fungoides cutaneous T-cell lymphomas: Report of the 2011 Society for Hematopathology/European Association for Haematopathology workshop. Am J Clin Pathol 2013;139:491-514.  Back to cited text no. 3
    
4.
Querfeld C, Kuzel TM, Guitart J, Rosen ST. Primary cutaneous CD30+ lymphoproliferative disorders: New insights into biology and therapy. Oncology (Williston Park) 2007;21:689-96.  Back to cited text no. 4
    
5.
Kadin ME. Primary cutaneous CD30-positive T-cell lymphoproliferative disorders. In: Jaffe ES, editor. Hematopathology: Expert Consult. 1st ed. Philadelphia, PA: Saunders/Elsevier; 2011. p. 604-16.  Back to cited text no. 5
    


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