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Dermatopathic Lymphadenitis: A Pitfall for Lymphoma Evaluation by F-18 FDG PET/CT

Makis, William MD*; Hickeson, Marc MD*; Blumenkrantz, Miriam MD†

doi: 10.1097/RLU.0b013e3181f4baba
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Dermatopathic lymphadenitis (also known as lipomelanotic reticulosis, or Pautrier–Woringer disease) is a rare type of benign lymphatic hyperplasia associated with a variety of exfoliative or eczematoid type inflammatory erythrodermas. The axillary and inguinal regions are most commonly affected, although occasionally it can present in the head and neck as well. On histologic examination, the affected lymph nodes contain melanin and fat-laden reticular cells. This is a case of a 10-year-old boy with a history of severe eczema, who presented with enlarged lymph nodes. F-18 FDG PET/CT imaging showed intensely FDG-avid lymph nodes in the cervical, axillary, and inguinal regions and a diagnosis of lymphoma was suggested; however, histopathology revealed dermatopathic lymphadenitis. This entity is a potential pitfall in the F-18 FDG PET/CT evaluation of lymphoma and should be considered in the differential diagnosis, especially in individuals with a history of inflammatory erythrodermas. To our knowledge, this is the first report of F-18 FDG PET/CT imaging of dermatopathic lymphadenitis mimicking lymphoma.

From the *Department of Nuclear Medicine, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada; and †Department of Pathology, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.

Received for publication November 29, 2009; revision accepted April 25, 2010.

This manuscript or any containing figures or tables have not been submitted to any publication previously. None of the authors have any financial or other relationships that might lead to a conflict of interest. The manuscript has been read and approved by all the authors, and the requirements for authorship have been met. Each author believes that the manuscript represents honest work.

Reprints: William Makis, Department of Nuclear Medicine, Royal Victoria Hospital, 687 Pine Ave West, Floor M2, Montreal, Quebec H3A 1A1, Canada. E-mail: makisw79@yahoo.com.

© 2010 Lippincott Williams & Wilkins, Inc.