Follicular lymphoma in situ presenting as dermatopathic lymphadenopathy (a case report)

Abstract

<h3>Introduction</h3> Follicular lymphoma in situ (FLIS) is a recently described entity with few cases recognized worldwide. To our knowledge, this is the first FLIS reported from West Africa. <h3>Case presentation</h3> We present the case of a 48-year-old civil servant with axillary lymphadenopathy discovered on routine mammography. On histology, a predominant reactive change with aggregates of melanophages was seen, prompting a diagnosis of reactive dermatopathic lymphadenopathy. Immunohistochemistry revealed secondary follicles with germinal centres that were variably colonised by small CD 10 and Bcl-6 positive cells that also overexpressed Bcl-2. The involved follicles had a low proliferation fraction as determined by Ki67. S100 stained the increased numbers of inter-follicular dendritic cells. These features indicated an intra-follicular neoplasia/in situ follicular lymphoma. <h3>Conclusion</h3> This highlights the use of immunohistochemistry in lymph node pathology, a resource which is very limited in Sub-Saharan Africa.