Cutaneous Lymphoid Hyperplasia: A Case Report and Brief Review of the Literature
Cutaneous lymphoid hyperplasia (CLH) is considered a benign lymphoid reactive process that results from various antigenic stimuli and may have potential for progression to overt lymphoma. CLH lesions may closely resemble lymphoma both clinically and histologically. We present a case of a 54-year-old woman who spontaneously developed lesions of unknown cause consistent with CLH. We also review the literature and discuss the etiology, clinical features, diagnosis, and management of CLH.
Lesions of CLH often regress spontaneously, though some cases become chronic and others recur locally.19 Rarely, some lesions progress to cutaneous lymphoma. However, it is uncertain if this represents true progression of a benign lesion along a continuum leading to lymphoma or a failure to diagnose a lesion that was malignant from the start.2,9,21
For CLH that results from known stimuli, the first step in treatment is removal of the causative agent. Antibiotic therapy has been effective in cases related to infective causes.10,18 Reported therapies for persistent or idiopathic cases include topical or intralesional corticosteroids, cryosurgery, local radiation, excision, interferon alfa, and laser ablation.19,22,23 Good response to thalidomide has been documented in one small study.24
Conclusion
CLH is a benign lymphoid proliferation resulting from various antigenic stimuli and may have the potential for progression to overt lymphoma. Lesions may closely resemble lymphoma both clinically and histologically, highlighting the importance of immunophenotyping in establishing a diagnosis. Treatment of this benign disease entity needs to be individualized for each patient. Although there are numerous treatment options for CLH, none are consistently effective.
