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Lymphosarcomatosis of the skin

Lymphosarcomatosis of the skin (lymphosarcomatosis cutis) is a group of diseases that differ in origin, as well as in the clinical and histomorphological picture. In addition to true primary and secondary lymphosarcomatosis of the skin, this group includes the Spiegler-Fendt sarcoid, the follicular Brill-Simmers lymphoblastoma, the Fribes lymphocytoma, etc. There are primary isolated and multiple skin tumors and secondary skin lymphosarcomatosis. The latter develop as a result of metastasis of the internal organs and lymph nodes. Primary lymphosarcomatosis of the skin is very rare. It is usually found isolated or merging nodules and nodes the size of a pea to hazelnut, a dense consistency, yellowish, reddish-brownish color; nodules sometimes ulcerate. These forms of lymphosarcomatosis of the skin are difficult to distinguish from disseminated Spiegler-Fendt sarcoids, in which there is a large number of tumors on the skin; other organs may be involved in the process. In follicular lymphoblastoma, the skin lesion proceeds either by the type of erythrodermia, or by exfoliative dermatitis, which are difficult to distinguish from the erythrodermic stage of the fungal mycosis. In follicular lymphosarcoma, enlarged lymph nodes appear early, in contrast to fungal mycosis, in which they appear much later. It is much more difficult to differentiate lymphosarcomatosis of the skin with erythroderma with lymphocytic myeloid leukemia. Ormsby (O. S. Ormsby) and Montgomery (N. Montgomery) are distinguished from true lymphosarcomatosis of the skin by lymphocytoma of the skin - a benign disease, in which mainly miliary brownish-reddish papules appear on the face, less often on the extremities and scrotum. Histomorphological study is mandatory for the diagnosis of the above skin diseases. In primary forms of skin lymphosarcomatosis, round-cell sarcoma is histologically detected, which is difficult to distinguish from other forms of lymphosarcoma. When Shpigler - Fendt sarcoid, there are formations consisting mainly of Mature lymphocytes and often from reticular cells with a small number of mitoses. In lymphocytomas, structures similar to the follicles of the lymph nodes, consisting of lymphocytes and reticular cells, are found. The prognosis for primary and secondary forms of lymphosarcomatosis of the skin is unfavorable, with the exception of limited forms of the Spiegler-Fendt sarcoid. Treatment of primary and secondary lymphosarcomatosis of the skin - arsenic preparations and radiotherapy. Sarkolysin and radioactive phosphorus are used.