Volume 1, Issue 4, Pages (July 2015)

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Volume 1, Issue 4, Pages 234-237 (July 2015) A case of lymphomatoid granulomatosis presenting with cutaneous lesions Sheila Shaigany, BS, Nicole A. Weitz, MD, Sameera Husain, MD, Larisa Geskin, MD, Marc E. Grossman, MD, FACP JAAD Case Reports Volume 1, Issue 4, Pages 234-237 (July 2015) DOI: 10.1016/j.jdcr.2015.05.008 Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Lymphomatoid granulomatosis as seen on a previously healthy 28-year-old man. Multiple yellowish-red, 3-mm to 4-cm papules and circular plaques over the left back. JAAD Case Reports 2015 1, 234-237DOI: (10.1016/j.jdcr.2015.05.008) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Lymphomatoid granulomatosis as seen on a skin biopsy specimen from the right upper arm. A, A dense dermal nodular lymphoid infiltrate surrounding the vessel walls (black arrows). Inset shows an inflammatory infiltrate with pleomorphic morphology and consisting of atypical-appearing lymphocytes associated with a few large/transformed cells and a prominent histiocytic component in the background. B, Immunohistochemical analysis of skin biopsy shows an infiltrate that is diffusely and strongly positive for CD3, diffusely positive for CD68, very focally and weakly positive for CD20 and negative for EBER-ISH. (A and inset, Hematoxylin-eosin stain; original magnifications: A, ×4; inset, ×40; B, Immunohistochemical staining for CD3, CD68, CD20 antibodies and in-situ hybridization for Epstein-Barr virus-encoded small RNA; original magnification: ×4.) JAAD Case Reports 2015 1, 234-237DOI: (10.1016/j.jdcr.2015.05.008) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Lymphomatoid granulomatosis as seen on H&E staining and immunohistochemical analysis of lung biopsy. The infiltrate is strongly positive for CD3 and CD20. EBER-ISH is positive in atypical lymphocytes present in lung tissue (EBER positivity is indicated by dark blue staining of the nuclei). (Hematoxylin-eosin stain; original magnification: ×4.) JAAD Case Reports 2015 1, 234-237DOI: (10.1016/j.jdcr.2015.05.008) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Lymphomatoid granulomatosis as seen on full-body positron emission tomographic/CT imaging shows multiple new fluorodeoxyglucose-avid lesions in the subcutaneous tissue, lungs, and brain. JAAD Case Reports 2015 1, 234-237DOI: (10.1016/j.jdcr.2015.05.008) Copyright © 2015 American Academy of Dermatology, Inc. Terms and Conditions