BỆNH HẠCH PHẢN ỨNG DO VIÊM DA: CẠM BẪY CHẨN ĐOÁN U LYMPHO ÁC TÍNH

Abstract

Dermatopathic lymphadenopathy (DL) – a benign lymph node hyperplasia associated with chronic skin disease that can be easily mistaken for lymphoma. Case report: A 35-year-old male patient with a long history of atopic dermatitis presented with painless enlargement of cervical and axillary lymph nodes. Ultrasound revealed multiple bilateral jugulo-subclavian lymph nodes, the largest measuring 14×6 mm, with preserved fatty hilum. Lymph node histopathology showed paracortical hyperplasia with an increase in Langerhans cells and reticular cells, along with the presence of melanophages infiltrating the paracortex and sinuses. Some follicles exhibited Castleman-like and hyperplastic changes. Immunohistochemistry demonstrated CD1a and S100 positive staining in histiocytic populations; CD30 positive in immunoblasts; and no evidence of monoclonal T- or B-cell proliferation with expression CD3 and CD20. A diagnosis of dermatopathic lymphadenopathy was established. This case highlights that DL commonly occurs in patients with chronic skin diseases and presents as persistent but self-limited peripheral lymphadenopathy. Close correlation among clinical findings, histopathology, and immunohistochemistry is essential to avoid misdiagnosis as lymphoma and to guide appropriate management.