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Szablewski V, Dereure O, René C, Tempier A, Durand L, Alame M, Cacheux V, Costes-Martineau V. Cutaneous localization of angioimmunoblastic T-cell lymphoma may masquerade as B-cell lymphoma or classical Hodgkin lymphoma: A histologic diagnostic pitfall. J Cutan Pathol 2018; 46:102-110. [PMID: 30370547 DOI: 10.1111/cup.13382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/12/2018] [Accepted: 10/22/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND We report the cases of three patients presenting skin lesions whose biopsies showed nodular polymorphic infiltrates consisting of lymphocytes, plasma cells, histiocytes, eosinophils, B blasts, and Hodgkin Reed-Sternberg (HRS)-like cells. Two of them were initially diagnosed as classical Hodgkin lymphoma (cHL), on the other hand, the last one as a B-cell lymphoma. All patients have been treated for angioimmunoblastic T-cell lymphoma (AITL). METHODS We performed a second review of the skin biopsies with further immunophenotypic molecular analyses. Scrupulous observation revealed, in the background of the three cases, atypical small to medium-sized lymphocytes carrying a CD3+, CD4+ T-cell phenotype and expressing PD1 and CXCL13 follicular helper T-cell markers. The two lesions initially diagnosed as cHL showed scattered HRS-like cells with CD30+, CD15+, PAX5+, CD20-, Epstein Barr Virus (EBV) + classical phenotype. The case initially diagnosed as B-cell lymphoma showed a diffuse B-cell proliferation associated with small B-cell and medium to large-sized B blasts that were positive for EBV. CONCLUSION Those cases highlighted that atypical T-cells may be obscured by B-cell proliferation mimicking cHL or B-cell lymphoma in cutaneous localization of AITL and confirmed the requirement of collecting clinical information before performing a diagnosis.
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Affiliation(s)
- Vanessa Szablewski
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Olivier Dereure
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département de Dermatologie, CHU Montpellier, Hôpital Saint-Eloi, Montpellier
| | - Céline René
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Immunologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Ariane Tempier
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Luc Durand
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,MEDIPATH, Grabels, France
| | - Melissa Alame
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valère Cacheux
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valérie Costes-Martineau
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
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