AI Article Synopsis
- - Clinical features of cutaneous pseudolymphoma (CPL) often mimic those of Paget carcinoma, presenting as nipple induration, but it is generally benign despite atypical histological findings that can suggest malignancy.
- - A significant number of CPL cases associated with the breast nipple result from antigenic stimulation by Borrelia burgdorferi, sometimes linked to documented tick bites.
- - Treatment typically involves surgical excision, but some patients may respond to antibiotic therapy; accurate diagnosis requires serological and molecular testing for Borrelia burgdorferi and consideration of differential diagnoses such as Paget carcinoma and eczema.
Article Abstract
Clinical, pathological, and molecular-genetic features as well as etiology of cutaneous pseudolymphoma (CPL, cutaneous lymphoid hyperplasia, lymphocytoma cutis) of the breast nipple are summarized. CPL presents as a nipple induration and it is often suspected to be Paget carcinoma pre-operatively. Histologically, atypical microscopic features of a dense lymhoid infiltrate with follicles often mislead to the diagnosis of a malignant lymphoma. However, CPL runs a benign course. Rare cases of CPL contain a clonal lymphoid population. A substantial number of CPL in the breast nipple is caused by antigenic stimulation by Borrelia burgdorferi. In some patients a tick bite is documented. CPL of the breast is commonly treated by excision, but some patients may be cured by antibiotic therapy. The presence of Borrelia burgdorferi should be detected using methods of serology, culture, and molecular biology. Beside CPL, the differential diagnosis of the breast nipple lesions further includes Paget carcinoma, eczema, and florid papillomatosis.
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