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[Pseudolymphoma caused by cholesterol embolism]

P Castell¹, J Friedel, J Siré

¹Service de Dermatologie, Centre Hospitalier, Chalonsur-Saône.

Annales De Dermatologie Et De Venereologie

|January 1, 1993

Summary

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This case study details a man with chronic inflammatory lesions, later identified as cholesterol crystal emboli, which resolved with aspirin treatment. The findings highlight unusual pseudo-lymphomatous features and a prolonged embolization process.

Area of Science:

Vascular pathology
Dermatology
Rheumatology

Background:

A 60-year-old male presented with a four-year history of atypical inflammatory skin lesions following inguinal hernia repair and transient antithrombotic therapy.
Lesions included a nodule on the left foot, erythematous plaque on the first intermetatarsal space, plaque on the right fifth finger, and hairless plaques on both wrists.

Observation:

Histopathological examination of a foot nodule revealed cholesterol crystal emboli within a vascular lumen and giant multinucleate cells.
These findings suggest a chronic, low-grade embolization process with pseudo-lymphomatous characteristics.

Findings:

The patient's inflammatory lesions resolved completely after treatment with 250 mg/day aspirin.
This suggests aspirin's anti-inflammatory and anti-platelet effects were beneficial in managing cholesterol crystal emboli.

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Implications:

This case highlights the uncommon presentation of cholesterol crystal emboli mimicking other inflammatory or neoplastic conditions.
The description is original due to the chronicity of the embolizing process and the unique histopathological findings.
Effective management with low-dose aspirin suggests a potential therapeutic strategy for similar chronic embolization syndromes.