Ali S Sawan | PubMed Health

PubMed2006

Hodgkin's lymphoma with exuberant granulomatous reaction.

We report a 36-year-old woman, presented with cervical lymphadenopathy and low-grade fever. Two fine needle aspiration cytology and one excisional biopsy were performed in the referral hospital, all showed granulomatous lesions without necrosis. A tentative diagnosis of tuberculosis was made, and she started on antituberculous treatment. However, there was no clinical improvement. She presented to our institution one year after the initial diagnosis, and a new biopsy from the cervical lymph node revealed effacement of the whole node by marked non-necrotizing granulomatous reaction. However, there were scattered large cells with few classic Reed-Sternberg cells between the granulomas. Immunohistochemistry reveals strong reaction of CD15 and CD30, and negative staining for CD45RB, CD45RO, and CD20. These findings confirmed the diagnosis of Hodgkin's lymphoma with remarkable granulomatous reaction that almost masked the malignant component. She was treated with chemotherapy, and she showed an excellent response.

Adult↗

PubMed2005

Malignant eccrine poroma.

Benign eccrine poroma arises from the intraepidermal portion of the eccrine gland duct. Malignant transformation is rare and should be suspected when these lesions present with pain, bleeding or itching. We report a 44-year-old male patient who presented primarily with a lesion diagnostic of benign eccrine poroma of the right foot sole with no clear evidence of malignancy, which was incompletely excised, followed 5 months later by local recurrence, ulceration, occasional bleeding and right inguinal lymphadenopathy. Incomplete excision of the primary tumor as well as excision of a skin lesion on the right knee joint revealed malignant eccrine poroma with aggressive histology, lymphovascular and perineural invasion. Investigations revealed no evidence of distant metastasis. This tumor might be malignant at the first presentation, which was not confirmed histopathologically considering the short duration of only 5 months for malignant transformation. The patient received 3 cycles of Docetaxel Taxotere, Cisplatin combination chemotherapy with partial response. The management of metastatic malignant eccrine poroma is difficult. It has proven resistant to many chemotherapeutic agents and radiotherapy.

Adult↗