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Objective: To determine the relationship between lymphoid distribution and taper of the vermiform appendix in the adult Zimbabwean male population. Study design: A cross-sectional descriptive study Place and duration of study: A six-month study carried out in the Anatomy Department (Gross Anatomy Laboratory), University of Zimbabwe, College of Health Sciences, Harare (from October 2021 to March 2022). Methods: A total of 15 male cadavers from the Department of Anatomy at the University of Zimbabwe were used. The length of the appendix, luminal diameter, external diameter and wall thickness were measured using a vernier calliper at three segmental levels, i.e. the base, mid part and the tip of the appendix. IBM SPSS version 23 was used to calculate the means and standard deviations. To determine the lymphoid distribution, histological sections of the appendix were prepared and viewed using a light microscope. Results: Appendix length ranged from 4.52cm to 15cm with an average length and standard deviation of 8.43± 2.45cm. The average luminal diameter with standard deviation at the base, mid-part, and tip was found to be 0.53± 0.22cm, 0.39± 0.21cm and 0.36±0.17cm, respectively. The average external diameter with standard deviation at the base, mid-part and tip was measured as 0.74± 0.18cm, 0.61± 0.16cm and 0.55± 0.15cm, respectively. The average wall thickness with standard deviation at the base, mid-point and tip was noted to be 0.21± 0.14cm, 0.25± 0.14cm and 0.20± 0.17cm, respectively. In this study, the lymphoid follicles were found to be more extensive at the base and mid-part, and less extensive at the tip. The lymphoid follicles extended from the mucosa to the submucosa at the base and mid-part while at the tip they only traversed the mucosa. External diameter decreased from base to tip, showing the taper of the appendix in the adult male Zimbabwean population. Conclusion: It was found that a strong relationship exists among the lymphoid tissue aggregations, luminal diameter and wall thickness of the adult male Zimbabwean inhabitants. The luminal diameter was observed to decrease in cadavers having an increase in wall thickness or hypertrophy of the lymphoid tissue. Moreover, there was a reduction in the number and size of lymphoid follicles along the length of the appendix. [ABSTRACT FROM AUTHOR]

Tumour necrosis factor-α (TNF) antagonists have improved the management of inflammatory bowel disease (IBD), however, their usage and administration persist to be suboptimal. Here, we examined the relationship between tissue-specific TNF mRNA expression in mucosal biopsies from IBD patients and anti-TNF treatment response. Archived tissue samples from patients with luminal IBD that had all been or were in treatment with anti-TNF were included (18 adults and 24 paediatric patients). Patients were stratified into three groups according to anti-TNF response: responders, primary non-responders (PNR) and secondary loss of response (SLOR). TNF mRNA was detected using RNAscope in situ hybridisation (ISH) and the expression was quantified using image analysis. The ISH analysis showed varying occurrence of TNF mRNA positive cells located in lamina propria and often with increased density in lymphoid follicles (LF). Consequently, expression estimates were obtained in whole tissue areas with and without LF. Significantly higher TNF mRNA expression levels were measured in adults compared to paediatric patients in both the analyses with and without LF (p =.015 and p =.016, respectively). Considering the relation to response, the adult and paediatric patients were evaluated separately. In adults, the TNF expression estimates were higher in PNRs compared to responders with and without LF (p =.017 and p =.024, respectively). Our data indicate that adult PNR have significantly higher TNF mRNA levels than responders. This suggests that higher anti-TNF dose may be considered for IBD patients with high TNF mRNA expression estimates from the start of treatment. [ABSTRACT FROM AUTHOR]

The lymph node is a highly structured organ that mediates the body’s adaptive immune response to antigens and other foreign particles. Central to its function is the distinct spatial assortment of lymphocytes and stromal cells, as well as chemokines that drive the signaling cascades which underpin immune responses. Investigations of lymph node biology were historically explored in vivo in animal models, using technologies that were breakthroughs in their time such as immunofluorescence with monoclonal antibodies, genetic reporters, in vivo two-photon imaging, and, more recently spatial biology techniques. However, new approaches are needed to enable tests of cell behavior and spatiotemporal dynamics under well controlled experimental perturbation, particularly for human immunity. This review presents a suite of technologies, comprising in vitro, ex vivo and in silico models, developed to study the lymph node or its components. We discuss the use of these tools to model cell behaviors in increasing order of complexity, from cell motility, to cell-cell interactions, to organ-level functions such as vaccination. Next, we identify current challenges regarding cell sourcing and culture, real time measurements of lymph node behavior in vivo and tool development for analysis and control of engineered cultures. Finally, we propose new research directions and offer our perspective on the future of this rapidly growing field. We anticipate that this review will be especially beneficial to immunologists looking to expand their toolkit for probing lymph node structure and function. [ABSTRACT FROM AUTHOR]

The lymph node is a highly structured organ that mediates the body’s adaptive immune response to antigens and other foreign particles. Central to its function is the distinct spatial assortment of lymphocytes and stromal cells, as well as chemokines that drive the signaling cascades which underpin immune responses. Investigations of lymph node biology were historically explored in vivo in animal models, using technologies that were breakthroughs in their time such as immunofluorescence with monoclonal antibodies, genetic reporters, in vivo two-photon imaging, and, more recently spatial biology techniques. However, new approaches are needed to enable tests of cell behavior and spatiotemporal dynamics under well controlled experimental perturbation, particularly for human immunity. This review presents a suite of technologies, comprising in vitro, ex vivo and in silico models, developed to study the lymph node or its components. We discuss the use of these tools to model cell behaviors in increasing order of complexity, from cell motility, to cell-cell interactions, to organ-level functions such as vaccination. Next, we identify current challenges regarding cell sourcing and culture, real time measurements of lymph node behavior in vivo and tool development for analysis and control of engineered cultures. Finally, we propose new research directions and offer our perspective on the future of this rapidly growing field. We anticipate that this review will be especially beneficial to immunologists looking to expand their toolkit for probing lymph node structure and function.

OBJECTIVE: To evaluate the frequency of H-pylori infection and lymphoid follicle formation in gastric biopsies. METHODOLOGY: The presented study was a cross-sectional and performed in PNS Shifa hospital, Karachi from November 2013 to May 2014. Gastric biopsies of 122 patients of age between (15 to 65), male and female with complain of mild to severe gastritis were included, while patients on treatment or known case of carcinoma, inadequate, unfixed and crushed biopsies were excluded. Detail histopathological examination was carried out. The frequencies of H. pylori infection and lymphoid follicles formation were noticed along with the history of the patients. RESULTS: In the present study, out of 122 cases, 46(37.70%)were between 15-40 years of age while 76(62.30%) were in between 41-65 years of age, mean age was calculated as 44.39+12.29 years, 63(51.64%) were male and 59(48.36%) were females. Frequency of H-pylori infection and lymphoid follicles in gastric biopsies were calculated as 81(66.39%) and 49(40.16%) respectively. Significant association of H. pylori infection and lymphoid follicle formation was seen. (P-value= 0.03, by Chi-square test) CONCLUSION: This study concludes that the frequency of H-pylori infection and lymphoid follicle formation (precursor of MALT lymphoma) in gastric biopsy is significantly associated and this study will help in early detection of positive cases for appropriate antibiotic therapy and H-pylori eradication therapy, thus saving the patient from developing MALT Lymphoma and other malignancies.

• Dermatomyositis is an autoimmune disease characterized by lesions in skin and inflammatory infiltrates of the muscle. • Its association with ectopic lymphoid structures (ELS) is very rare typical variant. • The role of B-cells in lymphoid follicle is not linked to an unfavorable prognosis. Dermatomyositis (DM) is an immune-mediated inflammatory disease characterized by pathognomic lesions in skin and skeletal muscle including lymphocytic infiltrates. It rarely presents with ectopic lymphoid structures, as other autoimmune and chronic inflammatory diseases. We describe a case of a 47-year-old male, who presented clinically with proximal muscle weakness, skin rash and elevated creatin kinase (CK) levels. The muscle biopsy revealed inflammatory myopathy, with perifascicular pathology, and scattered ectopic lymphoid follicles-like structures harboring reactive B-cells. Clonality analysis of B-cells using polymerase chain reaction ruled out malignant lymphoma. The patient responded favorably to steroid therapy, and his muscle weakness improved. In conclusion, the clinical and histopathologic features of DM can be atypical, and the presence of lymphoid follicles, although rare, is not inevitably linked to an unfavorable prognosis. [ABSTRACT FROM AUTHOR]

Homayoon Bashiri,1,2 Abbas Esmaeilzadeh,3 Hassan Vossoughinia,3 Kamran Ghaffarzadegan,4 Hamid Reza Raziei,5 Arezoo Bozorgomid1 1Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Internal Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran; 4Pathology Department, Education and Research Department, Razavi Hospital, Mashhad, Iran; 5Department of Oncology and Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Arezoo BozorgomidInfectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranTel +98 918 872 8269Email arezoobozorgomid@yahoo.comPurpose: Mucosa-associated lymphoid tissue (MALT) is the most common endoscopic finding in Helicobacter pylori positive patients that can progress to MALT lymphoma after a prolonged antigenic contact. This study was aimed to evaluate the prevalence of lymphoid follicles and aggregates (precursors of MALT lymphomas) in gastric mucosal biopsies and their correlation with H. pylori infection.Patients and methods: In this study, 100 patients who had undergone an upper gastrointestinal endoscopy were enrolled. Five biopsy specimens were taken each patient through screening endoscopy and histopathological changes were evaluated and graded using the Wotherspoon System. The clinical background and H. pylori infection status were also investigated.Results: Among the 100 cases in our series, 79 patients (79%) showed evidence of MALT in at least one biopsy specimen taken from the stomach and 21 cases (21%) had no evidence of MALT. H. pylori infection was detected in 74 (74%) patients. Lymphoid follicles were detected more frequently in H. pylori-positive patients (59%) compared to H. pylori-negative cases (3%) (P

Background Tumor infiltrating lymphocytes (TILs) are known to correlate with the prognosis of patients affected by a variety of cancer types. We evaluated TILs in patients who underwent surgery for lung squamous cell carcinoma (SCC). Methods Specimens obtained from patients during resection of lung SCC were examined for TIL density, lymphoid follicle formation, PD‐L1 expression, and the appearance of regulatory T cells (Tregs). Results We enrolled 72 patients who underwent surgery for SCC (TIL grades 0, 1, and 2: 29, 18, and 25, respectively). Lymphoid follicles were observed in 13 (18.1%) patients and 8 were positive for Tregs, which were always observed in association with lymphoid follicles (P < 0.001). Multivariate analysis revealed that lymphoid follicle formation, the appearance of Tregs, pathological stage, and pleural invasion were independent prognostic factors related to overall survival, whereas TIL density and PD‐L1 expression were not. Conclusion SCC patients with lymphoid follicle formation accompanied by Tregs show poor survival following lung resection surgery.

• Pretreatment with PEG-Lip triggered accumulation of second dose in splenic follicle. • PEG-Lip-mediated antigen delivery to splenic follicle elicited high IgG production. • Our intravenous immunization was superior to conventional subcutaneous immunization. Antigen (Ag) delivery to lymphoid follicles is important in achieving adaptive immunity. We recently developed a novel two-step Ag delivery system that efficiently induces cellular immune responses to Ags in mice by using priming intravenous (i.v.) injections of empty PEGylated liposomes (PEG-Lip) followed 3 days later by Ag-entrapped PEG-Lip (Ag-PEG-lip). In this study, we looked for humoral immune responses in rats and mice with IgG production specific to the encapsulated Ags. We observed that initial i.v. injections of empty PEG-Lip triggered accumulation of subsequent doses ovalbumin-PEG-Lip (OVA-PEG-lip) in splenic follicles and enhanced IgG production against OVA in both rats and mice. Anti-OVA IgG production was diminished by inhibition of splenic follicular accumulation of OVA-PEG-Lip by fingolimod (FTY720), which inhibits lymphocyte egress from lymphoid tissues. This indicates that the follicular accumulation of Ags that we observed is an indispensable and unique step in the production of anti-OVA IgG. Interestingly, in BALB/c nude mice, which are T cell deficient, a high follicular accumulation of OVA-PEG-Lip was observed, but anti-OVA IgG production was not observed. This suggests that T cells are also indispensable for the induction of cellular immune responses by our two-step immunization procedure. Our unique Ag delivery platform, which efficiently delivers Ags to splenic follicles, may be a useful technique for the enhancement of cellular immunity, as well as humoral immunity. Further experimental evaluation should be undertaken in relevant animal models in order for efficacy, safety and immunological correlates to be determined. [ABSTRACT FROM AUTHOR]

Chimeric antigen receptor (CAR) T cell therapies have demonstrated immense clinical success for B cell and plasma cell malignancies. We tested their impact on the viral reservoir in a macaque model of HIV persistence, comparing the functions of CD20 CAR T cells between animals infected with simian/human immunodeficiency virus (SHIV) and uninfected controls. We focused on the potential of this approach to disrupt B cell follicles (BCFs), exposing infected cells for immune clearance. In SHIV-infected animals, CAR T cells were highly functional, with rapid expansion and trafficking to tissue-associated viral sanctuaries, including BCFs and gut-associated lymphoid tissue (GALT). CD20 CAR T cells potently ablated BCFs and depleted lymph-node-associated follicular helper T (T FH ) cells, with complete restoration of BCF architecture and T FH cells following CAR T cell contraction. BCF ablation decreased the splenic SHIV reservoir but was insufficient for effective reductions in systemic viral reservoirs. Although associated with moderate hematologic toxicity, CD20 CAR T cells were well tolerated in SHIV-infected and control animals, supporting the feasibility of this therapy in people living with HIV with underlying B cell malignancies. Our findings highlight the unique ability of CD20 CAR T cells to safely and reversibly unmask T FH cells within BCF sanctuaries, informing future combinatorial HIV cure strategies designed to augment antiviral efficacy., Competing Interests: Declaration of interests The authors declare the following competing interests: H.-P.K. is or was a consultant to and has or had ownership interests in Rocket Pharmaceuticals, Homology Medicines, Vor Biopharma, and Ensoma, Inc., (Copyright © 2024 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.)

OBJECTIVE: To evaluate the frequency of H-pylori infection and lymphoid follicle formation in gastric biopsies. METHODOLOGY: The presented study was a cross-sectional and performed in PNS Shifa hospital, Karachi from November 2013 to May 2014. Gastric biopsies of 122 patients of age between (15 to 65), male and female with complain of mild to severe gastritis were included, while patients on treatment or known case of carcinoma, inadequate, unfixed and crushed biopsies were excluded. Detail histopathological examination was carried out. The frequencies of H. pylori infection and lymphoid follicles formation were noticed along with the history of the patients. RESULTS: In the present study, out of 122 cases, 46(37.70%)were between 15-40 years of age while 76 (62.30%) were in between 41-65 years of age, mean age was calculated as 44.39+12.29 years, 63(51.64%) were male and 59(48.36%) were females. Frequency of H-pylori infection and lymphoid follicles in gastric biopsies were calculated as 81(66.39%) and 49(40.16%) respectively. Significant association of H. pylori infection and lymphoid follicle formation was seen. (P-value= 0.03, by Chi-square test). CONCLUSION: This study concludes that the frequency of H-pylori infection and lymphoid follicle formation (precursor of MALT lymphoma) in gastric biopsy is significantly associated and this study will help in early detection of positive cases for appropriate antibiotic therapy and H-pylori eradication therapy, thus saving the patient from developing MALT Lymphoma and other malignancies. [ABSTRACT FROM AUTHOR]

Supernumerary nipples or teats (polythelia) are congenital accessory structures that may develop at any location along the milk line and have been implicated in the pathogenesis of mastitis. We describe the anatomy and histology of 27 spontaneously occurring supernumerary teats from 16 sheep, delineating two groups of teats – simple and anatomically complex – according to the complexity of the anatomy and microenvironment. Anatomically complex supernumerary teats exhibited significantly increased length and barrel diameter compared with simple supernumerary teats. A teat canal and/or teat cistern was present in anatomically complex teats, with smooth muscle fibres forming a variably well‐organised encircling teat sphincter. Complex supernumerary teats also exhibited immune cell infiltrates similar to those of normal teats, including lymphoid follicle‐like structures at the folds of the teat cistern–teat canal junction, and macrophages that infiltrated the peri‐cisternal glandular tissue. One complex supernumerary teat exhibited teat end hyperkeratosis. These anatomical and histological features allow inference that supernumerary teats may be susceptible to bacterial ingress through the teat canal and we hypothesise that this may be more likely in those teats with less well‐organised encircling smooth muscle. The teat cistern of anatomically complex teats may also constitute a focus of milk accumulation and thus a possible nidus for bacterial infection, potentially predisposing to mastitis. We suggest that size of the supernumerary teat, and relationship to the main teats, particularly in the case of 'cluster teats', should be considerations if surgical removal is contemplated. [ABSTRACT FROM AUTHOR]

Lupus erythematosus panniculitis is a rare type of chronic cutaneous lupus erythematosus which is histopathologically characterized by a lobular panniculitis. We present a 43-year-old woman with an indurated painful plaque on her right flank from 3 years ago. She mentioned a previous blunt trauma to this site. Microscopic examination revealed a predominant lobular panniculitis with lymphoid follicle formation, hyaline fat necrosis, membranocystic changes and mucin deposition. She was treated with oral hydroxychloroquine with moderate improvement. An indurated subcutaneous painful plaque could be the presenting feature of lupus panniculitis and we should evaluate systemic involvement in these patients.

Cutaneous plasmacytosis is a rare disorder of uncertain etiology, described mainly in patients of Japanese descent. Clinically, it is characterized by multiple pigmented papules and plaques distributed primarily on the trunk. Histopathologically, it is marked by a dense dermal plasma cell infiltrate. Here, we describe a case of cutaneous plasmacytosis in a 55-year-old Indian male who presented with hyperpigmented plaques on the body. Histopathological examination revealed dense superficial and deep perivascular and periappendageal infiltrate composed mainly of plasma cells, lymphoid follicles with reactive germinal centres, perineural distribution of plasma cells, mast cell infiltration and increased dermal small blood vessels. Immunohistochemical analysis confirmed the polyclonal nature of the plasma cells. Laboratory investigations were within normal limits, except for the presence of polyclonal hypergammaglobulinemia without any M band. There was no evidence of autoimmune disease or any infection. There was no systemic involvement in this patient. The patient was diagnosed as cutaneous plasmacytosis and advised long-term follow-up. Peculiar histopathological finding in this case of cutaneous plasmacytosis was the presence of abundant mast cells in the dermis. [ABSTRACT FROM AUTHOR]

Background: Tumor infiltrating lymphocytes (TILs) are known to correlate with the prognosis of patients affected by a variety of cancer types. We evaluated TILs in patients who underwent surgery for lung squamous cell carcinoma (SCC). Methods: Specimens obtained from patients during resection of lung SCC were examined for TIL density, lymphoid follicle formation, PD‐L1 expression, and the appearance of regulatory T cells (Tregs). Results: We enrolled 72 patients who underwent surgery for SCC (TIL grades 0, 1, and 2: 29, 18, and 25, respectively). Lymphoid follicles were observed in 13 (18.1%) patients and 8 were positive for Tregs, which were always observed in association with lymphoid follicles (P < 0.001). Multivariate analysis revealed that lymphoid follicle formation, the appearance of Tregs, pathological stage, and pleural invasion were independent prognostic factors related to overall survival, whereas TIL density and PD‐L1 expression were not. Conclusion: SCC patients with lymphoid follicle formation accompanied by Tregs show poor survival following lung resection surgery. [ABSTRACT FROM AUTHOR]

Background and Aims: Spleen is the largest secondary lymphatic organ. It acts as a graveyard for RBCs, is essential for immune responses, performs lymphopoiesis in adults and haemopoiesis in fetuses. The present study was conducted to assess the histogenesis of spleen in human fetuses in view of existing literature. Material and Methods: The study was carried out on 34 formalin preserved human fetuses procured from Dr Sushila Tiwari Government Hospital, Haldwani with due clearance from ethical committee. The 6 |jm sections of the spleen were stained with Haematoxylin and Eosin and observed under light microscope. Results: At 14 tol5 weeks, spleen had extensive sinusoids filled with RBCs and few lymphocytes. At 16-18 weeks, trabecular arteries were noticed more towards centre along with extensive haemopoietic cells in the venous sinusoids. By 20th week lymphocytic aggregation had started around arterioles. By 24 weeks periarteriolar lymphatic sheath was clearly observed. At term (37-40 weeks), classical primary lymphoid follicle was present but germinal centers were not observed. Conclusion: During earlier differentiation, spleen symbolizes the function of haemopoietic activities and gradually during subsequent gestation; it establishes its identity as a principle lymphoid tissue.

Aim: The present study was aimed to elucidate the histomorphology of ileal and jejunal Peyer’s patches in the small intestine of buffalo calves and their structural comparison. Materials and Methods: The study was conducted on neonatal (n=10) and pre-pubertal (n=10) buffalo calves. The age of the postnatal buffalo calves was estimated by their temporary and permanent dentition. Results: The study revealed that several layers of oval to elongate elliptical lymphoid follicles were observed in submucosa on the anti-mesenteric side in the ileum of early neonatal calves. However, the follicles at this age, in jejunum were of all shapes present within one layer. The interfollicular space was occupied by the interfollicular tissue, which was diffuse and wider around jejunal lymphoid follicles as compared to ileal lymphoid follicles. However, toward the pubertal stage, the number of layers of lymphoid follicles was reduced in ileum due to involution while it remained similar in number in jejunum at this stage. Conclusion: The ileal Peyer’s patches were found to have started involution more or less around reaching puberty, whereas the jejunal Peyer’s patches appear to be functional throughout the lifespan of the animal.

Transient receptor potential melastatin 8 (TRPM8) is a member of the transient receptor potential superfamily of Ca2+ channels. The aim of the present study was to clarify TRPM8 expression in reactive lymphoid tissues and mature B-cell neoplasms. Reactive and neoplastic lymphoid tissues were used to evaluate TRPM8 expression by immunohistochemistry and reverse transcription-polymerase chain reaction (RT-PCR). TRPM8+ cells were frequently detected in the follicular light zone and marginal zone of reactive lymphoid tissues. Double immunostaining revealed that TRPM8+ cells co-expressed cluster of differentiation (CD) 38, CD79a, CD138, interferon regulatory factor 4/melanoma associated antigen (mutated) 1, B cell CLL/lymphoma 6 and transmembrane activator and CAML interactor. TRPM8+ neoplastic cells were frequently detected in plasma cell myeloma. The positive band of TRPM8 mRNA was confirmed by RT-PCR in cases of myeloma. The present study is, to the best of our knowledge, the first to demonstrate the expression of TRPM8 in reactive lymphoid tissues and mature B-cell neoplasms, revealing that TRPM8 is frequently expressed in pre-plasmablasts, plasmablasts, plasma cells and mature B-cell lymphomas that are likely to differentiate into plasma cells. [ABSTRACT FROM AUTHOR]

Abstract: Background: Chronic Helicobacter pylori infection in children induces lymphoid hyperplasia called nodular gastritis (NG) at the antral gastric mucosa. The aim of this study was to evaluate genes in gastric biopsy on microarray analysis, to identify molecules associated with NG on comparison with NG‐negative pediatric corpus tissue and with H. pylori‐infected adult tissue with atrophic gastritis (AG). Methods: Eight pediatric and six adult H. pylori‐infected patients, as well as six pediatric and six adult uninfected patients were evaluated. All infected adults had AG. NG was observed in the antrum of all eight pediatric patients and in the corpus of three patients. Adult and uninfected patients were free of NG; that is, only pediatric H. pylori‐infected patients had NG. Total RNA was purified from gastric biopsy, and microarray analysis was performed to compare gene expression between groups. The three infected children with NG in both the antrum and corpus were excluded from analysis of corpus samples. Results: The number of genes significantly up‐ or downregulated (fold change >3, P < 0.01) compared with uninfected controls varied widely: 72 in pediatric antrum, 45 in pediatric corpus, 103 in adult antrum and 71 in adult corpus. Nineteen genes had significantly altered expression in the antrum of NG tissue compared with NG‐negative pediatric corpus tissue and adult AG tissue. The CD20 B‐cell specific differentiation antigen had the most pronounced increase. Previously described regulators of NG development were not predominantly upregulated in the NG mucosa. Conclusions: CD20 overexpression may play an important role in lymphoid follicle enlargement and NG. [ABSTRACT FROM AUTHOR]

Lupus erythematosus panniculitis is a rare type of chronic cutaneous lupus erythematosus which is histopathologically characterized by a lobular panniculitis. We present a 43-year-old woman with an indurated painful plaque on her right flank from 3 years ago. She mentioned a previous blunt trauma to this site. Microscopic examination revealed a predominant lobular panniculitis with lymphoid follicle formation, hyaline fat necrosis, membranocystic changes and mucin deposition. She was treated with oral hydroxychloroquine with moderate improvement. An indurated subcutaneous painful plaque could be the presenting feature of lupus panniculitis and we should evaluate systemic involvement in these patients. [ABSTRACT FROM AUTHOR]