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Skleroderm versus lymphoma?

Could this answer from a skinbiopsy on the backside of the knee indicate lymphoma?

surface epithelium essentially normal thickness easily hyperkeratosis, corium slightly increased width partially confluent collagen bands with poorcell areas. Between theese, patchy areas of increased number of fibroblast / histiocytic cells and perivascular infiltrates of round cells which include some lymphocytes. Isolated arterioles in the deep part of the corium appears wallthickened with lumen narrowing. There are attached, subcutis no convincing picture of lipodystrophy, no pannikulitpicture, no fatty acids or elements of foamcells. The dermal dyeings can be consistent with localized scleroderma, on the other hand patches of "busy dermis" similar image with increased number of fibroblast-like cells and possibly histocyter interstiellt between the collagenous fibers, changes also seen in the deep part of the dermis. This image recalls that seen in interstiell granumatös drug reaction. The lack of eosinofilism and the absence of elements of lichenoid reaction pines, however, against this diagnosis
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907672 tn?1381025723
Hello and welcome,
Because I'm not a doctor, interpreting biopsy results is not my strong suit so I will not attempt.  May I ask what lead you to believe this might be Lymphoma?  Did your doctor mention it?  Have you had any other tests (blood tests, scans, etc)?
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Avatar universal
Thank you,

I wonder because she also has been diagnosed with gastric cancer in her stomach (scirrhous carcinoma). I´m concerned if she has been misdiagnosed, because, she has a redbrownish patches on her leg that looks like lymphoma (mycosis fungoides-like patches) wich has been there for many years and is slowly growing.
Could it perhaps be Malt-lymphoma?
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1081992 tn?1389903637
COMMUNITY LEADER
Hi, mycosis fungoides is a T-cell lymhphoma, but MALT is B-cell. I'm not aware of any association between the two.

Have you looked at photos of lichen planus (which lasts for years) or other autoimmune skin disorders to see how they compare? I assume you have already looked at scleroderma pictures.

But your idea of misdiagnosed stomach MALT can have a possible association with the skin condition this way: a B-cell lymphoma (rarely) can create a secondary autoimmune condition, since B-cells go on to become the plasma cells that make antibodies.

Or, since there is such as thing as mucosal lichen planus, I'd ask about how certain the diagnosis of stomach cancer was. You possibly have reason to be suspicious of that diagnosis?
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1081992 tn?1389903637
COMMUNITY LEADER
From the biopsy, the presence of fibroblasts (which create scar tissue in healing after inflammation) and histiocytes (like macrophages, which are immune cells) doesn't really fit with lymphoma but does fit with scleroderma. They also talk about blockage in arteries, and how that's not from what occurs in atherosclerosis (with lipids/cholesterol and foam cells).

So, is there cancer in the skin of the leg? Apparently not. Is there cancer in the stomach? Do you have the pathology report from that?
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Avatar universal
Thank you Ken för your extensive analys.

The patches on her leg don´t look like lichen planus, more morphea/mycosis fungoides  like. It is a big erythtroumus patch built up with 4 smaller patches and they are brighter in the center, like in lyme disease.

No i don´t have the pathology report from the stomach, only the diagnos, aggressive scirrhous adenocarcinom. They say there is no special notes from the PAD.

She also have a swollen lymphnode on her throat since one week with horseness and  they now treat her with tyreostatica for struma.  Maybe they also will take a fineneedle punction from the swollen node. She also got urininfammation so she also gets antibiotics.

She has a history  of immunsuppressive medicals because of her ulcerous colit.

I have asked for a second opinion from a special hospital, but the doctor sent the request to another hospital instead of that we agreed on. The results are not ready.

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1081992 tn?1389903637
COMMUNITY LEADER
Well, it still seems like an immune reaction and not cancer. Having an enlarged node pop up in the remote site (throat) is troubling, but then if it grew very quickly, that seems less like cancer and more like immune reaction.

This might be one of those mystery conditions, so don't get too discouraged if a diagnosis doesn't come quickly.

In the U.S. patients have a right to copies of their records, If that is the same there, you should get the pathology report. I bet it would set your mind at ease somewhat. You'd have less worry over cancer, though you still need to keep searching and testing until a diagnosis is made. I'd want an immunologist to see her or at least look at her records. Her family history of similar medical conditions is important, too. Maybe even think about genetic testing at some time. Good luck.
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