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Naor S, Adam E, Schiby G, Gratzinger D. A personalized approach to lymphoproliferations in patients with inborn errors of immunity. Semin Diagn Pathol 2023; 40:408-419. [PMID: 37479638 DOI: 10.1053/j.semdp.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
Biopsies from patients with inborn error of immunity (IEI) may pose a diagnostic challenge due to the abnormal anatomy of their lymphoid organs and the tendency for the development of lymphoproliferations in various organs, some of which may lead to the wrong impression of malignant lymphoma which may prompt aggressive unnecessary treatment. In this article we will review typical histologic findings in various IEI's described in the literature and discuss the appropriate approach to the diagnosis of lymphoproliferations in these patients by presenting illustrative cases.
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Affiliation(s)
- Shachar Naor
- Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel.
| | - Etai Adam
- Division of Pediatric Hematology and Oncology, Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel
| | - Ginette Schiby
- Institute of Pathology, Sheba Medical Center, Ramat Gan, Israel
| | - Dita Gratzinger
- Department of Pathology, Stanford University, Stanford, CA, United States
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Skayem C, Beylot-Barry M, de Masson A, Dereure O, Ram-Wolff C, Bagot M, Vergier B, Battistella M, Ortonne N, Ingen-Housz-Oro S. Lymph node and visceral progression without erythroderma or blood worsening in erythrodermic cutaneous T-cell lymphoma: nine cases. Br J Dermatol 2021; 185:1061-1063. [PMID: 34128541 DOI: 10.1111/bjd.20580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- C Skayem
- Department of Dermatology, AP-HP, Henri Mondor Hospital, Créteil, France
| | - M Beylot-Barry
- Department of Dermatology, Bordeaux University Hospital, Bordeaux, France.,INSERM U1053, Bordeaux Research in Translational Oncology (BaRITOn), Cutaneous Lymphoma Oncogenesis Team, Bordeaux University, Bordeaux, France.,French Cutaneous Lymphomas Study Group (GFELC), Paris, France
| | - A de Masson
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Dermatology, AP-HP, Saint-Louis Hospital, Université de Paris, INSERM U976, Paris, France
| | - O Dereure
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Dermatology, University of Montpellier and INSERM U1058 Pathogenesis and Control of Chronic Infections, Montpellier, France
| | - C Ram-Wolff
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Dermatology, AP-HP, Saint-Louis Hospital, Université de Paris, INSERM U976, Paris, France
| | - M Bagot
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Dermatology, AP-HP, Saint-Louis Hospital, Université de Paris, INSERM U976, Paris, France
| | - B Vergier
- INSERM U1053, Bordeaux Research in Translational Oncology (BaRITOn), Cutaneous Lymphoma Oncogenesis Team, Bordeaux University, Bordeaux, France.,French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - M Battistella
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Pathology, AP-HP, Saint-Louis Hospital, Université de Paris, INSERM U976, Paris, France
| | - N Ortonne
- French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,Department of Pathology, AP-HP, Henri Mondor Hospital, Créteil, France.,Paris Est Créteil University (UPEC) and IMRB, INSERM U955 Team Ortonne (NFL), Créteil, France
| | - S Ingen-Housz-Oro
- Department of Dermatology, AP-HP, Henri Mondor Hospital, Créteil, France.,French Cutaneous Lymphomas Study Group (GFELC), Paris, France.,University Paris Est Créteil EpiDermE, Créteil, France
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Gratzinger D, de Jong D, Jaffe ES, Chadburn A, Chan JKC, Goodlad JR, Said J, Natkunam Y. T- and NK-Cell Lymphomas and Systemic Lymphoproliferative Disorders and the Immunodeficiency Setting: 2015 SH/EAHP Workshop Report-Part 4. Am J Clin Pathol 2017; 147:188-203. [PMID: 28395105 PMCID: PMC6248696 DOI: 10.1093/ajcp/aqw213] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES The 2015 Workshop of the Society for Hematopathology/European Association for Haematopathology aimed to review immunodeficiency-related T- and natural killer (NK)-cell lymphoproliferations. METHODS The Workshop Panel reviewed 88 T- or NK-cell lymphoproliferations and rendered consensus diagnoses. RESULTS Hyperplasias of T-cell subsets may be clonal; retained architecture and the clinical setting support a benign diagnosis. Specific associations include hepatosplenic T-cell lymphoma with iatrogenic immunosuppression and breast implants with an indolent variant of anaplastic large cell lymphoma. Epstein-Barr virus (EBV)-positive T-cell lymphomas rarely occur in the acquired immunodeficiency setting. Systemic T- and NK-cell lymphoma of childhood overlaps with chronic active EBV and reversible hemophagocytic lymphohistiocytosis-related T-cell lymphoproliferations. CONCLUSIONS Immunodeficiencies predispose to T-cell hyperplasias, which must not be overdiagnosed as lymphoma. Many T-cell lymphomas in the immunodeficiency setting are likely coincidental, with specific exceptions. Systemic T- or NK-cell lymphomas are part of a spectrum of EBV+ T or NK lymphoproliferations and can present in the acquired immunodeficiency setting.
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Affiliation(s)
- Dita Gratzinger
- From the Stanford University School of Medicine, Stanford, CA
| | - Daphne de Jong
- VU University Medical Center, Amsterdam, the Netherlands
| | | | - Amy Chadburn
- Weill Medical College of Cornell University, New York, NY
| | | | | | - Jonathan Said
- University of California Los Angeles Medical Center, Los Angeles
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