GRANULOMA-ANNULARE IN PATIENTS WITH MALIGNANT-LYMPHOMA - CLINICOPATHOLOGICAL STUDY OF 13 NEW CASES

Background: Reports of necrobiotic granulomas or granuloma annulare in patient Objective: Our intent was to determine any unique clinical or histopathologic features in patients with granuloma annulare and lymphoma. Methods: We reviewed the medical records and biopsy material from 13 patients with granuloma annulare and lymphoma. Results: Three patients had Hodgkin's disease and 10 had non-Hodgkin's lymphoma. The granuloma annulare lesions showed typical histopathologic features. However, the clinical pattern was frequently atypical, with painful lesions in unusual locations including the palms and soles. Three patients displayed granulomatous inflammation in noncutaneous sites, either within the malignant lymphoma or in uninvolved tissues, and all three had atypical clinical presentations of granuloma annulare. Conclusion: Granuloma annulare with atypical clinical presentations may be associated with an underlying hematopoietic malignancy and may be part of a generalized granulomatous reaction to malignant lymphoma.