Most examples simulate B-cell lymphoma. The infiltrate in lymphocytoma cutis tends to be more superficially located while most lymphomas are centered in the deep dermis or subcutis. Lymphocytoma cutis typically shows germinal centers and tingible body macrophages. Immunohistochemical staining may also be useful and will generally show a mixed B cell and T cell population. Staining for kappa and lambda light chains will show a polyclonal pattern of staining.
Some cases show a T-cell histologic pattern.
Changes include a band-like infiltrate in the papillary dermis, predominantly of small lymphocytes, with variable epidermotropism. When the offending agent is known, removal of it will result in resolution. Cases documented to occur as a result of infection should be treated appropriately. In idiopathic cases, treatment is not mandatory. Cures may be effected via surgical removal, cryosurgery or local irradiation.