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Machan S, Juárez Martín Á, Cullen Aravena D, Haro R, Pielasinski Ú, Fuertes L, Córdoba R, Santonja C, Rodríguez-Pinilla SM, Requena L. Acral lymphomatoid papulosis: Report of five cases, differential diagnosis, and review. J Cutan Pathol 2021; 48:650-658. [PMID: 33269496 DOI: 10.1111/cup.13929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/26/2022]
Abstract
Acral lymphomatoid papulosis (a-LyP) is a rare clinical variant of LyP whose diagnosis may be challenging. A case series of a-LyP was studied clinically, histopathologically, immunohistochemically, and from molecular point of view. Including ours, 25 cases of a-LyP have so far been reported. Clinically, a-LyP may present as acral involvement exclusively, in combination with mucosal lesions, (in itself a rare presentation), or in association with conventional LyP. The age of presentation was slightly higher than that of conventional LyP (55 vs 45 years) and a male predominance has been observed, as usually reported. Histopathologically, no morphological differences exclusively from conventional LyP were observed. LyP types A and E were the main variants. We describe for the first time one case of type D a-LyP. Acral LyP is a rare entity and correct diagnosis can only be reached with clinical and histopathological correlation, to avoid aggressive treatment of this indolent lymphoproliferative disorder.
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Affiliation(s)
- Salma Machan
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - África Juárez Martín
- Department of Dermatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | | | - Rosario Haro
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Úrsula Pielasinski
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Laura Fuertes
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Raúl Córdoba
- Department of Hematology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Carlos Santonja
- Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | | | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Di Raimondo C, Parekh V, Song JY, Rosen ST, Querfeld C, Zain J, Martinez XU, Abdulla FR. Primary Cutaneous CD30+ Lymphoproliferative Disorders: a Comprehensive Review. Curr Hematol Malig Rep 2020; 15:333-342. [DOI: 10.1007/s11899-020-00583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Wehkamp U, Weichenthal M, Klapper W, Schwarz T, Oschlies I. Unilesional locally recurrent lymphomatoid papulosis with variable histological presentation. Leuk Lymphoma 2017; 59:262-264. [PMID: 28562138 DOI: 10.1080/10428194.2017.1323274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ulrike Wehkamp
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Michael Weichenthal
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Wolfram Klapper
- b Department of Pathology , Hematopathology Section, University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Thomas Schwarz
- a Department of Dermatology , University Hospital Schleswig-Holstein , Campus Kiel , Germany
| | - Ilske Oschlies
- b Department of Pathology , Hematopathology Section, University Hospital Schleswig-Holstein , Campus Kiel , Germany
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Eminger LA, Shinohara MM, Kim EJ, Heymann WR. Clinicopathologic challenge: acral lymphomatoid papulosis. Int J Dermatol 2012; 51:531-4. [DOI: 10.1111/j.1365-4632.2011.05303.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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EORTC, ISCL, and USCLC consensus recommendations for the treatment of primary cutaneous CD30-positive lymphoproliferative disorders: lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Blood 2011; 118:4024-35. [PMID: 21841159 DOI: 10.1182/blood-2011-05-351346] [Citation(s) in RCA: 259] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Primary cutaneous CD30(+) lymphoproliferative disorders (CD30(+) LPDs) are the second most common form of cutaneous T-cell lymphomas and include lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Despite the anaplastic cytomorphology of tumor cells that suggest an aggressive course, CD30(+) LPDs are characterized by an excellent prognosis. Although a broad spectrum of therapeutic strategies has been reported, these have been limited mostly to small retrospective cohort series or case reports, and only very few prospective controlled or multicenter studies have been performed, which results in a low level of evidence for most therapies. The response rates to treatment, recurrence rates, and outcome have not been analyzed in a systematic review. Moreover, international guidelines for staging and treatment of CD30(+) LPDs have not yet been presented. Based on a literature analysis and discussions, recommendations were elaborated by a multidisciplinary expert panel of the Cutaneous Lymphoma Task Force of the European Organization for Research and Treatment of Cancer, the International Society for Cutaneous Lymphomas, and the United States Cutaneous Lymphoma Consortium. The recommendations represent the state-of-the-art management of CD30(+) LPDs and include definitions for clinical endpoints as well as response criteria for future clinical trials in CD30(+) LPDs.
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Acral lymphomatoid papulosis. J Am Acad Dermatol 2010; 62:530-1. [DOI: 10.1016/j.jaad.2009.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Revised: 02/15/2009] [Accepted: 02/17/2009] [Indexed: 11/19/2022]
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Localized lymphomatoid papulosis. J Am Acad Dermatol 2010; 62:353-6. [DOI: 10.1016/j.jaad.2009.01.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 01/28/2009] [Accepted: 01/28/2009] [Indexed: 11/22/2022]
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Kim YJ, Rho YK, Yoo KH, Kim JY, Seo SJ, Hong CK, Moon NJ, Song KY. Case of regional lymphomatoid papulosis confined to the periorbital areas. J Dermatol 2009; 36:163-5. [PMID: 19335692 DOI: 10.1111/j.1346-8138.2009.00611.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A localized form of lymphomatoid papulosis (LyP) has been described very rarely. A 38-year-old Korean man presented with a single bean-sized, non-tender, erythematous nodule confined to periorbital areas with three recurrences over a 2-year duration. With findings of biopsy, immunohistochemical staining and T-cell receptor gene rearrangement, LyP was diagnosed. We report a case of CD30 (Ki-1)-positive LyP which developed recurrently and was confined to the periorbital areas.
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Affiliation(s)
- Yeon Jin Kim
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
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Allabert C, Estève E, Joly P, Troussard X, Comoz F, Courville P, Morice A, Verneuil L, Leroy D, Dompmartin A. Atteinte muqueuse dans la papulose lymphomatoïde : quatre cas. Ann Dermatol Venereol 2008; 135:273-8. [DOI: 10.1016/j.annder.2007.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 11/23/2007] [Indexed: 11/26/2022]
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Persistent agmination of lymphomatoid papulosis: An equivalent of limited plaque mycosis fungoides type of cutaneous T-cell lymphoma. J Am Acad Dermatol 2007; 57:1005-11. [DOI: 10.1016/j.jaad.2007.05.046] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 04/24/2007] [Accepted: 05/11/2007] [Indexed: 11/20/2022]
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Affiliation(s)
- Vishakha Sharma
- Section of Dermatology, Department of Medicine, University of Chicago, Chicago, IL, USA.
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Ribeiro-Silva A, Chang D, Arruda D, Félix PR. Lymphomatoid papulosis in a patient with Waldenström's macroglobulinemia. J Dermatol 2005; 32:132-6. [PMID: 15906545 DOI: 10.1111/j.1346-8138.2005.tb00731.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lymphomatoid papulosis (LyP) is a rare skin disease with a benign course but a malignant histologic appearance based on atypical lymphocytes. Waldenström's macroglobulinemia (WM) is a diffuse infiltration of the bone marrow by cells that synthesize IgM immunoglobulins. A 46-year-old female presented with a two year history of weakness, fatigue, anemia, and recurring multiple erythematous papules and nodules in the skin. The skin biopsy showed pleomorphic lymphoid cells with atypical mitoses permeated by a diffuse dermal infiltrate of normal appearing lymphocytes. The neoplastic cells were positive for CD30, CD3, and CD5 but negative for CD20 and EMA. The bone marrow was hypercellular due to a diffuse infiltration by lymphocytes, plasma cells, and plasmacytoid lymphocytes. LyP is a lymphoproliferative disorder of CD30-positive T cells that may be associated with other lymphoid malignancies, particularly Hodgkin's disease, mycosis fungoides, and anaplastic T cell lymphomas. To our knowledge, this is the first report of a LyP appearing in a patient with WM.
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Affiliation(s)
- Alfredo Ribeiro-Silva
- Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Pujol RM, Muret MPG, Bergua P, Bordes R, Alomar A. Oral Involvement in Lymphomatoid Papulosis. Dermatology 2005; 210:53-7. [PMID: 15604547 DOI: 10.1159/000081485] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 05/28/2004] [Indexed: 11/19/2022] Open
Abstract
Oral involvement in cutaneous CD30+ T-cell lymphoid proliferations is rare and has received little attention in the dermatologic literature. The authors report 2 patients with self-healing, recurrent papulonodular eruptions with the classic clinical, histopathological and immunophenotypic features of lymphomatoid papulosis, which developed two ulcerated papules and an ulcerative nodule on the dorsum of the tongue, respectively. The lesions appeared coincident with a new cutaneous relapse of the disease. Histopathological and immunophenotypic features were similar to those of the cutaneous lesions. All lesions regressed spontaneously after several weeks. Since then, and after follow-up periods of 3 and 7 years, respectively, no evidence of extracutaneous involvement has been detected. Oral involvement in lymphomatoid papulosis is an uncommon event, probably without prognostic significance. Previously reported cases are reviewed. The differential diagnosis of atypical T-cell lymphoid infiltrates observed in the oral mucosa is discussed.
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Affiliation(s)
- Ramon M Pujol
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain.
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