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Nowicka D, Mertowska P, Mertowski S, Hymos A, Forma A, Michalski A, Morawska I, Hrynkiewicz R, Niedźwiedzka-Rystwej P, Grywalska E. Etiopathogenesis, Diagnosis, and Treatment Strategies for Lymphomatoid Papulosis with Particular Emphasis on the Role of the Immune System. Cells 2022; 11:cells11223697. [PMID: 36429125 PMCID: PMC9688547 DOI: 10.3390/cells11223697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/04/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is a very rare disease that belongs to the group of CD30+ lymphoproliferative skin diseases. LyP is localized or generalized and usually presents as isolated or clustered red/brown-red lesions in the form of nodules and/or papules. The course of the disease is in most cases mild; however, depending on concomitant risk factors and history, it may progress to lymphoma, significantly reducing the survival rate and prognosis. Importantly, the clinical picture of the disease remains somewhat ambiguous, leading to a large number of misdiagnoses that result in inappropriate treatment, which is usually insufficient to alleviate symptoms. In addition to clinical manifestations, the histological characteristics vary widely and usually overlap with other conditions, especially those belonging to the group of lymphoproliferative disorders. Although diagnosis remains a challenge, several recommendations and guidelines have been introduced to standardize and facilitate the diagnostic process. This article reviews the available literature on the most important aspects of etiopathogenesis, clinical and histopathological features, diagnostic criteria, and possible treatment strategies for LyP, with particular emphasis on the role of the immune system.
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Affiliation(s)
- Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Anna Hymos
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland
| | - Adam Michalski
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Izabela Morawska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Rafał Hrynkiewicz
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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Torres-Cabala CA, Huen A, Iyer SP, Miranda RN. Gamma/Delta Phenotype in Primary Cutaneous T-cell Lymphomas and Lymphoid Proliferations: Challenges for Diagnosis and Classification. Surg Pathol Clin 2021; 14:177-194. [PMID: 34023099 DOI: 10.1016/j.path.2021.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Primary cutaneous T-cell lymphomas pose a diagnostic challenge for dermatopathologists, hematopathologists, and general surgical pathologists. Recognition of gamma/delta phenotype in cutaneous T proliferations has been enhanced by the availability of antibodies against TCRgamma and delta for immunohistochemistry. Thus, reporting gamma/delta phenotype in a cutaneous T-cell lymphoid proliferation may indicate a significant change in therapy and a challenge for dermatologists and oncologists who treat these patients. Herein, we discuss primary cutaneous gamma/delta T-cell lymphoma, its differential diagnosis, and other skin lymphoid proliferations that may show gamma/delta phenotype. Awareness of the occurrence of gamma/delta phenotype in both T-cell lymphomas and benign lymphoid proliferations involving skin is crucial for a better interpretation of histopathologic findings. Integration of clinical presentation, morphology, immunoprofile, and molecular findings is key for a correct diagnosis and appropriate therapy of lesions displaying gamma/delta T-cell phenotype.
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Affiliation(s)
- Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 85, Houston, TX 77030, USA; Department of Dermatology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1452, Houston, TX 77030, USA.
| | - Auris Huen
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1452, Houston, TX 77030, USA
| | - Swaminathan P Iyer
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 429, Houston, TX 77030, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 72, Houston, TX 77030, USA
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Rajashekara Swamy M, Pollock S, J Goldberg L, Shen L. A case of lymphomatoid papulosis type E in a young adult: An uncommon entity. J Cutan Pathol 2021; 48:694-700. [PMID: 33533041 DOI: 10.1111/cup.13974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/16/2021] [Accepted: 01/26/2021] [Indexed: 01/16/2023]
Abstract
Lymphomatoid papulosis (LyP) type E is a rare variant of the primary cutaneous CD30+ lymphoproliferative disorders, characterized clinically by large necrotic eschar-like lesions and histopathologically by angiodestructive and angioinvasive infiltrates of CD30+ lymphocytes. As in other forms of lymphomatoid papulosis, type E lesions may undergo spontaneous regression after weeks, with frequent recurrences. We report a 21-year old male with an angiodestructive infiltrate of CD30+ lymphocytes manifesting as a papular eruption rather than ulceration, and suggest that this clinical phenotype might be related to the presence of CD4+ lymphocytes in the inflammatory cell infiltrate.
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Affiliation(s)
| | - Samara Pollock
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lynne J Goldberg
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA.,Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Lisa Shen
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts, USA
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Park M, Kim MH, Kwon JE, Lee YM. Self-healing eschar-like erythematous nodules. JAAD Case Rep 2019; 5:468-470. [PMID: 31192997 PMCID: PMC6510976 DOI: 10.1016/j.jdcr.2019.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Minkee Park
- Department of Dermatology, Dankook University School of Medicine, Cheonan, South Korea
| | - Myung Hwa Kim
- Department of Dermatology, Dankook University School of Medicine, Cheonan, South Korea
| | - Ji-Eun Kwon
- Department of Pathology, Dankook University School of Medicine, Cheonan, South Korea
| | - Yong-Moon Lee
- Department of Pathology, Dankook University School of Medicine, Cheonan, South Korea
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5
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Ba W, Yin G, Yang J, Zhang Z, Wang W, Zhao Z, Chen H, Li C. Lymphomatoid papulosis type E with a CD56+ immunophenotype presenting with purpura‐like lesions. J Cutan Pathol 2019; 46:542-545. [PMID: 30957244 DOI: 10.1111/cup.13472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 03/04/2019] [Accepted: 03/26/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Wei Ba
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
| | - Guang Yin
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
| | - Jingrun Yang
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
| | - Ziyan Zhang
- Department of DermatologyNorth China University of Science and Technology Affiliated Hospital Tangshan China
| | - Wenjuan Wang
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
| | - Zigang Zhao
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
| | - Hongxiao Chen
- Department of DermatologyThe People's Hospital of Linyi Linyi China
| | - Chengxin Li
- Department of DermatologyChinese PLA General Hospital and Medical School Beijing China
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6
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Pindado-Ortega C, Fonda-Pascual P, Buendía-Castaño D, Fernández-González P, Peña-Jaimes L, Carrillo-Gijón R. An unusual case of lymphomatoid papulosis type E with extensive necrosis. Indian J Dermatol Venereol Leprol 2017; 84:515-517. [PMID: 29067932 DOI: 10.4103/ijdvl.ijdvl_871_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Lymphomatoid papulosis type E (LyP) is a recently described subtype of LyP characterized by an angioinvasive infiltrate of atypical lymphocytes expressing CD30. We present a case of type E LyP with extensive cutaneous necrosis in the histopathological evaluation which was misdiagnosed as an ulcerative form of bacterial skin infection. The remarkable cutaneous necrosis showed in our case might be related to the angiodestructive infiltrate that was present in this circumstance.
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Marschalkó M, Gyöngyösi N, Noll J, Károlyi Z, Wikonkál N, Hársing J, Kuroli E, Csomor J, Matolcsy A, Sarolta K, Szepesi Á. Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis. J Cutan Pathol 2016; 43:963-973. [DOI: 10.1111/cup.12779] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/07/2016] [Accepted: 07/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Márta Marschalkó
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Noll
- Department of Dermatology; Heim Pál Childrens Hospital; Budapest Hungary
| | | | - Norbert Wikonkál
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Hársing
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Enikő Kuroli
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Csomor
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - András Matolcsy
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - Kárpáti Sarolta
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Ágota Szepesi
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
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8
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Barrett MM, Strikwerda AM, Somers K, Beck LA, Scott GA. Lymphomatoid Papulosis Type D: Report of a Case in a Child and Review of the Literature. Pediatr Dermatol 2016; 33:e52-6. [PMID: 26763888 DOI: 10.1111/pde.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Lymphomatoid papulosis (LyP) is a cutaneous CD30-positive T-cell lymphoproliferative disorder that occurs primarily in adults and presents with crops of papules that become necrotic and spontaneously regress. It is classified according to the histopathologic findings; currently recognized subtypes include A, B, C, D, and E. LyP is uncommon in children. Herein we describe a child with an unusual clinical presentation of LyP type D and review the literature of reported cases in children.
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Affiliation(s)
- Mary M Barrett
- Department of Pathology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Amy M Strikwerda
- Department of Dermatology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Kathryn Somers
- Department of Dermatology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Lisa A Beck
- Department of Dermatology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Glynis A Scott
- Department of Pathology, School of Medicine and Dentistry, University of Rochester, Rochester, New York.,Department of Dermatology, School of Medicine and Dentistry, University of Rochester, Rochester, New York
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9
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Characterization of Primary Cutaneous CD8+/CD30+ Lymphoproliferative Disorders. Am J Dermatopathol 2015; 37:822-33. [DOI: 10.1097/dad.0000000000000375] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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10
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Martinez-Escala ME, Sidiropoulos M, Deonizio J, Gerami P, Kadin M, Guitart J. γδ T-cell-rich variants of pityriasis lichenoides and lymphomatoid papulosis: benign cutaneous disorders to be distinguished from aggressive cutaneous γδ T-cell lymphomas. Br J Dermatol 2014; 172:372-9. [DOI: 10.1111/bjd.13364] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. E. Martinez-Escala
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - M. Sidiropoulos
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - J. Deonizio
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - P. Gerami
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - M.E. Kadin
- Department of Dermatology Boston University; Roger Williams Medical Center; Providence RI U.S.A
| | - J. Guitart
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
- Department of Dermatology; Robert H. Lurie Cancer Center; Chicago IL U.S.A
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11
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Blessing or curse? Proteomics in granzyme research. Proteomics Clin Appl 2014; 8:351-81. [DOI: 10.1002/prca.201300096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/29/2013] [Accepted: 12/21/2013] [Indexed: 01/08/2023]
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12
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McQuitty E, Curry JL, Tetzlaff MT, Prieto VG, Duvic M, Torres-Cabala C. The differential diagnosis of CD8-positive (“type D”) lymphomatoid papulosis. J Cutan Pathol 2013; 41:88-100. [DOI: 10.1111/cup.12243] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 05/12/2013] [Accepted: 06/09/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth McQuitty
- Department of Pathology and Immunology; Baylor College of Medicine; Houston TX USA
| | - Jonathan L. Curry
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | | | - Victor G. Prieto
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | - Madeleine Duvic
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | - Carlos Torres-Cabala
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
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13
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14
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Kempf W, Kazakov DV, Paredes BE, Laeng HR, Palmedo G, Kutzner H. Primary Cutaneous Anaplastic Large Cell Lymphoma with Angioinvasive Features and Cytotoxic Phenotype: A Rare Lymphoma Variant within the Spectrum of CD30+ Lymphoproliferative Disorders. Dermatology 2013; 227:346-52. [DOI: 10.1159/000355479] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 08/23/2013] [Indexed: 11/19/2022] Open
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15
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Fuertes I, Mascaró JM, Martínez A, García-Herrera A, Estrach TE. Primary cutaneous anaplastic large cell lymphoma simulating an aggressive angiocentric T-cell lymphoma. Int J Dermatol 2012; 52:1241-4. [PMID: 22458926 DOI: 10.1111/j.1365-4632.2011.05161.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Irene Fuertes
- Departments of DermatologyPathology, Hospital Clínic, University of Barcelona, Barcelona, Spain
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16
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Kim DS, Choi YJ, Oh SH, Lee MG. A case of indolent CD56-positive lymphomatoid papulosis. J Am Acad Dermatol 2010; 63:e114-6. [DOI: 10.1016/j.jaad.2010.02.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 02/11/2010] [Accepted: 02/17/2010] [Indexed: 11/30/2022]
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17
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A Variant of Lymphomatoid Papulosis Simulating Primary Cutaneous Aggressive Epidermotropic CD8+ Cytotoxic T-cell Lymphoma. Description of 9 Cases. Am J Surg Pathol 2010; 34:1168-75. [DOI: 10.1097/pas.0b013e3181e75356] [Citation(s) in RCA: 172] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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CD8-Positive Primary Cutaneous Anaplastic Large T-Cell Lymphoma (PCALCL): Case Report and Review of This Unusual Variant of PCALCL. Am J Dermatopathol 2010; 32:489-91. [DOI: 10.1097/dad.0b013e3181c57ec2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Cutaneous lymphoid infiltrates may pose some of the most difficult diagnostic problems in dermatopathology. Immunocytochemistry is often employed in an effort to determine whether an infiltrate is neoplastic or, in the case of clearly malignant infiltrates, to provide a specific diagnosis. The rarity of these disorders and the variant immunocytochemical profiles they may present further thwart understanding and sometimes prevent an accurate diagnosis. In this review the common immunocytochemical profiles of various cutaneous lymphomas are presented and potential pitfalls and problems considered. Immunocytochemistry is not a diagnostic test but, as in other areas of histopathology, is a highly valuable tool that requires critical interpretation within a context: so applied, it is an indispensable part of the pathologist's arsenal in evaluating lymphoid infiltrates and defining different lymphomas.
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Affiliation(s)
- Alistair Robson
- Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
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20
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Slone SP, Martin AW, Wellhausen SR, Woods DR, Malone JC, Lear SC, Laber DA. IL-4 production by CD8+ lymphomatoid papulosis, type C, attracts background eosinophils. J Cutan Pathol 2008; 35 Suppl 1:38-45. [DOI: 10.1111/j.1600-0560.2007.00973.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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The Applicability of the New WHO-EORTC Classification of Primary Cutaneous Lymphomas to a Single Referral Center. Am J Dermatopathol 2008; 30:37-44. [DOI: 10.1097/dad.0b013e31815f9841] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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22
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Korpusik D, Ruzicka T. [Clinical course and therapy of lymphomatoid papulosis. Experience with 17 cases and literature review]. Hautarzt 2008; 58:870-81. [PMID: 17486304 DOI: 10.1007/s00105-007-1295-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphomatoid papulosis is a rare disease with a worldwide incidence of 1.2 to 1.9 per 1 million. It affects all age groups with a peak incidence between 30 and 40 years and an apparent male predominance. Occurrence in childhood has also been described. Both the etiology and pathogenesis of the disease are unknown. The clinical presentation is extremely variable and frequently uncharacteristic. A papulonodular eruption, characterized by self-healing skin lesions appearing in crops can often be seen, particularly on extremities. We report on 17 patients, including 2 children. By detailing 6 cases we point out the variable morphologic manifestations, the different courses of disease and therapeutic options.
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MESH Headings
- Aged
- Biopsy
- Cell Transformation, Neoplastic/pathology
- Child
- Child, Preschool
- Diagnosis, Differential
- Eosinophils/pathology
- Female
- Follow-Up Studies
- Histiocytes/pathology
- Humans
- Ki-1 Antigen/analysis
- Lymphocytes/pathology
- Lymphoma, Large-Cell, Anaplastic/classification
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/therapy
- Lymphomatoid Papulosis/classification
- Lymphomatoid Papulosis/diagnosis
- Lymphomatoid Papulosis/pathology
- Lymphomatoid Papulosis/therapy
- Male
- Middle Aged
- Mitosis/physiology
- Neutrophils/pathology
- Skin/pathology
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Affiliation(s)
- D Korpusik
- Hautklinik des Universitätsklinikums Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
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Flann S, Orchard GE, Wain EM, Russell-Jones R. Three cases of lymphomatoid papulosis with a CD56+ immunophenotype. J Am Acad Dermatol 2006; 55:903-6. [PMID: 17052504 DOI: 10.1016/j.jaad.2006.05.063] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 01/31/2006] [Accepted: 05/24/2006] [Indexed: 10/24/2022]
Abstract
We report 3 cases of lymphomatoid papulosis (LyP) with a CD56+, cytotoxic immunophenotype. All 3 patients presented with clinical histories typical of LyP, with one patient having associated mycosis fungoides. Histologically, two cases were type A LyP and one was type B. All 3 cases demonstrated a T-cell receptor clone in lesional skin without evidence of blood involvement. The atypical lymphocytes in each of the 3 cases expressed cytotoxic granules (T-cell intracellular antigen-1+ and granzyme B+) and were CD8+ and CD56+. Expression of CD56 is associated with a poor prognosis in subcutaneous panniculitis-like T-cell lymphoma and blastic natural killer cell lymphoma. However, the two cases of CD56+ LyP previously reported and the 3 cases in this series all appear to be pursuing an indolent course with no evidence of systemic disease.
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Affiliation(s)
- Sandy Flann
- Skin Tumor Unit, St John's Institute of Dermatology, St Thomas' Hospital, USA.
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24
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Kempf W. CD30+ lymphoproliferative disorders: histopathology, differential diagnosis, new variants, and simulators. J Cutan Pathol 2006; 33 Suppl 1:58-70. [PMID: 16412214 DOI: 10.1111/j.0303-6987.2006.00548.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CD30+ lymphoproliferative disorders of the skin (CD30+ LPD) represent a well-defined spectrum of primary cutaneous T-cell lymphomas which have been recognized as distinct entities in recent lymphoma classifications. Lymphomatoid papulosis and anaplastic large-cell lymphoma share the expression of CD30 antigen as a common phenotypic hallmark but differ in regard to their clinical and histologic features as well as their biologic behavior. This article summarizes the histologic features of CD30+ LPD and presents recently identified new clinicopathologic variants of CD30+ LPD. There is an increasing number of reactive inflammatory disorders and neoplastic diseases which are composed of or contain a significant number of CD30+ cells and mimic LyP or anaplastic large cell lymphoma clinically or histologically. Differential diagnostic considerations focus on other lymphoproliferative processes with CD30+ tumor cells as well as non-lymphoid neoplasms and inflammatory simulators. The term CD30+ pseudolymphoma is proposed to designate inflammatory processes with CD30+ T cells. The final diagnosis of CD30+ LPD is based on a synthesis of clinical, histologic, phenotypic, and molecular genetic findings.
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Affiliation(s)
- Werner Kempf
- Department of Dermatology, University Hospital Zürich, Switzerland.
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