Rarely, cutaneous lesions in secondary syphilis may show dense lymphoplasmacellular infiltrates simulating histopath-ologically the picture of a marginal zone B-cell lymphoma (Figs 20.41 & 20.42) [90,91]. These plasma cells always reveal a polyclonal pattern of immunoglobulin light-chain
Fig. 20.40 Acral pseudolymphomatous angiokeratoma (small papular pseudolymphoma). Nodular lymphoid infiltrate in the superficial and mid-dermis of acral skin.
Fig. 20.42 Pseudolymphome in secondary syphilis. Lymphocytes and histiocytes admixed with several plasma cells (detail of Fig. 20.41).
expression. Correlation with the clinical picture and posi-tivity of serological tests for syphilis confirm the diagnosis. Antibiotic treatment leads to a rapid resolution of the lesions.
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