Solitary asymptomatic nodule on the leg
2 Department of Pathology, San Cecilio University Hospital, Granada, Spain
Department of Dermatology, San Cecilio University Hospital, Avenida Doctor Olóriz 16, 18012 Granada
|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;82:109-111
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|
|Figure 2: Pseudoepitheliomatous epidermal hyperplasia (H and E, ×10)|
|Figure 3: Dense infiltrates of atypical lymphocytes in dermis; large and atypical Reed–Sternberg-like cells (H and E, ×200)|
|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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