Follicular Lymphoma Detected in a Patient Undergoing Mohs Surgery: A Case Report

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Dades bibliogràfiques
Publicat a:Cureus vol. 17, no. 1 (2025)
Autor principal: Defty Charlotte
Altres autors: Yamini, Krishna, Khan Muhammad Adil A, Sharma, Naveen, Tehrani Hamid
Publicat:
Springer Nature B.V.
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Accés en línia:Citation/Abstract
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024 7 |a 10.7759/cureus.77583  |2 doi 
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100 1 |a Defty Charlotte  |u Plastic and Reconstructive Surgery, St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, GBR 
245 1 |a Follicular Lymphoma Detected in a Patient Undergoing Mohs Surgery: A Case Report 
260 |b Springer Nature B.V.  |c 2025 
513 |a Journal Article 
520 3 |a Mohs surgery is performed by surgeons trained in detecting specific cutaneous malignancies, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and dermatofibrosarcoma protuberans (DFSP). Mohs-trained surgeons are typically not holistic pathologists and may, when working in isolation, fail to identify lesions that are not of cutaneous origin. The presence of a second lesion adjacent to the primary lesion is always a possibility. Such a lesion may be misinterpreted as an extension of the identified primary lesion, leading to unnecessary surgery, or it may be overlooked, resulting in a diagnostic failure. There is an advantage to conducting Mohs surgery with the surgeon and histopathologist reviewing the frozen section slides together, as this approach can aid in the identification of rarer diagnoses. Here, we describe the case of a female patient who underwent Mohs micrographic surgery (MMS) for a recurrent BCC located in the left preauricular area and medial helical rim of the pinna. The surgery involved two excisional stages. The first stage showed morphoeic BCC at all levels of all blocks. The second stage showed no BCC but revealed a dense inflammatory infiltrate. On further assessment by the consultant histopathologist, this infiltrate raised suspicion of possible lymphoma. Based on this consensus, no further Mohs excisional surgery was performed, and the surgical defect was closed. Formalin-fixed paraffin-embedded (FFPE) histological assessment and immunohistochemistry confirmed the diagnosis of cutaneous B-cell follicular lymphoma (FL). Thus, the incidental finding on the examination of fresh frozen MMS sections was correctly interpreted by the combined approach of the Mohs surgeon and pathologist, guiding appropriate and timely management for the patient. 
653 |a Lymphocytes 
653 |a Patients 
653 |a Surgeons 
653 |a Collaboration 
653 |a Medical prognosis 
653 |a Melanoma 
653 |a Surgery 
653 |a Tumors 
653 |a Lymphoma 
653 |a Mutation 
653 |a Lymphatic system 
653 |a Skin cancer 
653 |a General anesthesia 
700 1 |a Yamini, Krishna  |u Cellular Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, GBR 
700 1 |a Khan Muhammad Adil A  |u Plastic and Reconstructive Surgery, Northumbria Healthcare NHS Foundation Trust, North Shields, GBR 
700 1 |a Sharma, Naveen  |u Histopathology, St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, GBR 
700 1 |a Tehrani Hamid  |u Plastic and Reconstructive Surgery, St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, GBR 
773 0 |t Cureus  |g vol. 17, no. 1 (2025) 
786 0 |d ProQuest  |t Health & Medical Collection 
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856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3203887914/fulltextPDF/embedded/Q8Z64E4HU3OH5N8U?source=fedsrch