SourceNederlands Tijdschrift voor Geneeskunde, 157, 52, (2013), pp. A6605
Article / Letter to editor
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Paediatrics - OUD tm 2017
Nederlands Tijdschrift voor Geneeskunde
SubjectIGMD 5: Health aging / healthy living; N4i 1: Pathogenesis and modulation of inflammation NCMLS 1: Infection and autoimmunity; N4i 2: Invasive mycoses and compromised host; NCEBP 2: Evaluation of complex medical interventions; ONCOL 3: Translational research NCMLS 3: Tissue engineering and pathology
BACKGROUND: Borrelial lymphocytoma is a relatively rare but typical presentation of Lyme disease. Predilection sites are the ears in children and chest/nipples in adults. It is treated like an erythema migrans and has a good prognosis. CASE DESCRIPTION: A 16-year-old boy presented with a swollen, red and painful right nipple since several months. An ultrasound showed normal breast tissue. The patient was referred to the pediatric surgeon who performed an incision biopsy. Histopathological examination revealed follicular hyperplasia without signs of malignancy. An infectious cause, most likely Lyme disease, was suspected. Serological analysis and PCR of the tissue confirmed the diagnosis of a borrelial lymphocytoma, and the patient was treated with doxycycline with good result. CONCLUSION: Early recognition of the characteristic clinical presentation of borrelial lymphocytoma, supported by positive results from serologic testing for Lyme disease, avoids the need for additional and invasive diagnostic tests.
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