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Cordoba A, Querol I, Monzon FJ, Ayensa J, Martinez-Peñuela JM, Idoate M. Lymphomatoid Papulosis Associated with Cutaneous T-Cell Signet Ring Lymphoma. Int J Surg Pathol 2016. [DOI: 10.1177/106689699800600306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors describe a new case of cutaneous T-cell lymphoma of signet ring cell type with CD-30 (Ki-t) expression. The patient was a 52-year-old woman with a 20-year history of recurrent papulonodular lesions characteristic of lymphomatoid papulosis (LP). Subsequent to developing the signet ring cell lymphoma (SRL) the patient's cutaneous lesions did not resolve as previously, and a skin biopsy showed a diffuse proliferation of atypical lymphoid cells with cytoplasmic vacuoles. SRL was first reported in 1985 by Weiss, and a literature search found only six further reports since then. Vaillant suggests that the peculiar morphology is retated to the special indolent course of this condition and that the cutaneous form should be considered a distinct entity. This is the first report of a patient with LP who subsequently developed a cutaneouis T-cell signet ring lymphoma with CD-30 antigen expression. The case could be an example of a so-called borderline lymphoma.
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Affiliation(s)
- Alicia Cordoba
- Service of Pathology, Hospital “Reina Sofia,” Tudela; Iturriagagoitia, Plaza Obispo Iruirita n° 5-1 3D, 31011 Pamplona, Spain
| | | | | | - Jesus Ayensa
- Service of Dermatology, Hospital ‘Reina Sofia,’ Tudela
| | | | - Miguel Idoate
- Department of Pathology, Clinica Universitaria de Navarra, Pamplona, Spain
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2
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Anaplastic lymphoma kinase (ALK1) immunohistochemistry in diagnostic dermatopathology; an update. Am J Dermatopathol 2013; 35:403-8; quiz 409-11. [PMID: 23689691 DOI: 10.1097/dad.0b013e31823d2943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of anaplastic lymphoma kinase antibodies (ALK1) as a diagnostic aid has expanded since becoming a routinely available immunohistochemical stain. Because the skin may be the site of a wide variety of hematolymphoid and fibroblastic proliferations, dermatopathologists commonly use ALK1 as part of a broader staining panel in diagnosing soft tissue and cutaneous hematolymphoid neoplasms. Furthermore, new entities and differential diagnostic contexts are emerging, which broaden the utility of ALK1 immunohistochemistry. We review the expanding role of ALK1 immunohistochemistry in contemporary dermatopathology.
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3
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Min JA, Oh ST, Kim JE, Cho BK, Chung NG, Park HJ. Lymphomatoid papulosis followed by anaplastic large cell lymphoma in a pediatric patient. Ann Dermatol 2010; 22:447-51. [PMID: 21165218 DOI: 10.5021/ad.2010.22.4.447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 12/04/2009] [Accepted: 01/25/2010] [Indexed: 11/08/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP. However, this transformation rarely occurs in patients younger than 20 years of age. Here, we present the first known pediatric patient in Korea, a 12-year-old boy who developed a subcutaneous nodule on the scrotum 13 months after papulonecrotic lesions of LyP were identified on both lower extremities and face. Histological and immunohistochemical examination of the subcutaneous nodule revealed anaplastic large cell lymphoma (ALCL). A T-cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in the two specimens, indicating that a common T-cell clone had proliferated over time in both the LyP and ALCL lesions.
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Affiliation(s)
- Jung Ah Min
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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4
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Secondary ALK Negative Anaplastic Large Cell Lymphoma in a Patient With Lymphomatoid Papulosis of 40 Years Duration. Am J Dermatopathol 2010; 32:708-12. [DOI: 10.1097/dad.0b013e3181d46eba] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Matsumoto N, Ohki H, Mukae S, Amano Y, Harada D, Nishimura S, Komiyama K. Anaplastic large cell lymphoma in gingiva: case report and literature review. ACTA ACUST UNITED AC 2008; 106:e29-34. [DOI: 10.1016/j.tripleo.2008.05.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 05/09/2008] [Accepted: 05/16/2008] [Indexed: 10/21/2022]
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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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7
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WOODROW S, BASARAB T, RUSSELL JONES R. Mycosis fungoides with spontaneously regressing CD30-positive tumorous lesions. Clin Exp Dermatol 2006. [DOI: 10.1111/j.1365-2230.1996.tb00127.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Sachs BA, Shahab N, Kaplan PA, Doll DC, Haider S. Conditions Suggesting Lymphoma. J Clin Oncol 2005; 23:3843-4. [PMID: 15923577 DOI: 10.1200/jco.2005.04.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bradley A Sachs
- University of Missouri, Ellis Fischel Cancer Center, Columbia, MO, USA
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Clarke LE, Bayerl MG, Bruggeman RD, Mauger D, Ioffreda MD, Abou-Elella A, Helm KF. Death Receptor Apoptosis Signaling Mediated by FADD in CD30-Positive Lymphoproliferative Disorders Involving the Skin. Am J Surg Pathol 2005; 29:452-9. [PMID: 15767797 DOI: 10.1097/01.pas.0000155154.46434.93] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The CD30-positive lymphoproliferative disorders lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (C-ALCL), and systemic anaplastic large cell lymphoma (S-ALCL) are lesions that overlap clinically, histopathologically, and immunophenotypically. Their biologic behaviors, however, vary considerably. In particular, lesions of LyP regress spontaneously while those of S-ALCL persist and often progress. Apoptosis has been suggested as the mechanism by which the lesions of LyP regress, but the underlying signaling pathways remain unclear. In this study, we used newly developed activation state-specific antibodies to demonstrate apoptosis signaling through the death receptor-mediated pathway regulated by FADD and caspase 3. METHODS Dual immunohistochemistry for CD30 and activated forms of FADD and caspase 3 was performed on cutaneous biopsy specimens from 27 patients with CD30-positive lymphoproliferative disorders involving the skin. The patients included 18 with primary cutaneous CD30-positive LPDs (15 with LyP and 3 with C-ALCL) and 9 with S-ALCL. RESULTS The proportion of CD30-positive cells expressing activated FADD was significantly different between primary cutaneous CD30-positive lymphoproliferative disorders and S-ALCL (36.4% vs. 14.5%, P = 0.0083). Expression of cleaved caspase 3 was also significantly different between primary cutaneous lesions and S-ALCL (9.2% vs. 1.9%, P = 0.048). CONCLUSIONS Although a larger number of cases should be studied to validate these results, these data provide evidence that differences in signaling through the death-receptor apoptosis pathway mediated by FADD may be responsible for the varying biologic behaviors of CD30-positive lymphoproliferative disorders involving the skin.
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Affiliation(s)
- Loren E Clarke
- Departments of Pathology, Penn State University College of Medicine/Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
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Abstract
BACKGROUND Meningiomas involving the tuberculum sellae and planum sphenoidale typically cause visual loss by affecting the optic nerve and anterior chiasm. We present a case of a tuberculum sellae meningioma concurrent with lymphomatoid papulosis, a T-cell lymphomatoid skin disorder. CASE REPORT A 50-year-old black woman came to the eye clinic with a symptom of decreased vision in the right eye for one week, especially when reading. Best-corrected vision was counting fingers at two feet O.D. and 20/40 O.S. She was seen seven months earlier, with 20/25 O.D. and O.S. Dilated fundus examination revealed bilateral optic atrophy, O.D. greater than O.S. MRI revealed a meningioma arising from the tuberculum sellae and planum sphenoidale region. The meningioma was partially resected nine days later Visual field performed 18 days postoperatively demonstrated an overall depression in the right eye and no defect in the left eye. Best-corrected vision improved to 20/150 O.D. and 20/30 O.S. CONCLUSION Meningiomas are generally benign tumors that can cause symptoms if vital structures are compromised. Altered visual function and optic atrophy may be the only presentation of intracranial and orbital tumors. Intracranial meningiomas may be associated with systemic conditions that can infiltrate the optic nerve, including lymphocytic disorders. Lymphomatoid papulosis (LyP) is a rare cutaneous disorder involving infiltrating clonal T-cells that has been associated with disseminated lymphomatic skin tumors. It is unclear if there is a direct association between LyP and meningiomas.
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Affiliation(s)
- Lee Ong
- VA Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center and Nursing Home, Sepulveda, Calfornia, USA.
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Kumar S, Pittaluga S, Raffeld M, Guerrera M, Seibel NL, Jaffe ES. Primary cutaneous CD30-positive anaplastic large cell lymphoma in childhood: report of 4 cases and review of the literature. Pediatr Dev Pathol 2005; 8:52-60. [PMID: 15719203 DOI: 10.1007/s10024-004-8087-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2004] [Accepted: 10/19/2004] [Indexed: 11/30/2022]
Abstract
We present the clinicopathologic findings in 4 children with primary cutaneous anaplastic large cell lymphoma (C-ALCL). The patients ranged in age from 13 months to 8 years, with 3 females and 1 male. All presented with a rapidly enlarging mass involving the skin and subcutaneous tissue. Histologic evaluation showed sheets of large pleomorphic lymphoid cells that were diffusely and strongly CD30(+). Tumor cells were CD45(+) in 1 of 4 cases. Cells were of T-cell phenotype, with variable positivity for CD3 (3 of 4 cases) and CD5 (2 of 4 cases). All 4 cases were positive for CD4 and clusterin. Staining for anaplastic lymphoma kinase was negative in all cases. No evidence of systemic involvement was noted at initial presentation or over a follow-up of 5 to 78 months, although 3 patients had cutaneous recurrences. Primary C-ALCL has only rarely been described in the pediatric population. The high-grade histologic appearance of this lymphoma belies its generally favorable clinical course and prognosis. Recognition of this entity and its differentiation from other T-cell lymphomas that secondarily involve the skin is important to avoid unnecessarily aggressive therapy in these children.
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Affiliation(s)
- Shimareet Kumar
- Department of Anatomic Pathology, Children's National Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA.
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12
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Sander CA, Flaig MJ, Jaffe ES. Cutaneous manifestations of lymphoma: a clinical guide based on the WHO classification. World Health Organization. CLINICAL LYMPHOMA 2001; 2:86-100; discussion 101-2. [PMID: 11707848 DOI: 10.3816/clm.2001.n.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cutaneous lymphomas are a heterogeneous group of lymphomas that show variations in histology, immunophenotype, and prognosis. At the time of presentation, cutaneous lymphomas may be primary or may involve the skin as a secondary site of involvement. Primary cutaneous lymphomas, in many instances, are distinct from morphologically similar lymphomas arising in lymph nodes. Their natural history is often more indolent than nodal lymphomas, and for that reason, they often require different therapeutic approaches. A classification scheme should recognize those lymphomas that are unique to the skin, as well as those arising in other sites. The mode of presentation of a lymphoma is often an indication of underlying biological distinctions. However, organ-specific classification systems undermine communication among medical specialists. The World Health Organization classification of hematopoietic and lymphoid malignancies offers a comprehensive approach and proposes that lymphomas should be viewed as a list of individual diseases and that each disease can be defined by a constellation of morphological, biological, and clinical features. The current review will focus on the spectrum of primary and secondary cutaneous lymphomas, emphasizing those features of importance to the clinical oncologist.
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Affiliation(s)
- C A Sander
- Department of Dermatology, Ludwig-Maximilians-Universitaet, Munich, Germany
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13
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Rifkin S, Valderrama E, Lipton JM, Karayalcin G. Lymphomatoid papulosis and Ki-1+ anaplastic large cell lymphoma occurring concurrently in a pediatric patient. J Pediatr Hematol Oncol 2001; 23:321-3. [PMID: 11464993 DOI: 10.1097/00043426-200106000-00019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over the course of time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP, but there are have been no cases reported in patients younger than age 26 years. We describe the first pediatric patient, a 16-year-old girl, who had clinical features of LyP and concurrently was found to have a lesion diagnosed as Ki-1+ anaplastic large cell lymphoma. After treatment with chemotherapy, she has been in continuous remission for 16 months.
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Affiliation(s)
- S Rifkin
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Schneider Children's Hospital, Albert Einstein College of Medicine at the Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
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14
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Abstract
Anaplastic large cell lymphoma (ALCL) is a paradigm for the process used to define new disease entities, and provides a model that is applicable to all areas of pathology. ALCL was first recognized based on characteristic histologic features (sinusoidal invasion) and a distinctive immunophenotype (CD30+). However, neither sinusoidal invasion nor CD30-positivity proved to be entirely specific. Subsequently, a characteristic cytogenetic abnormality was identified, the t(2;5), that led to identification of the genes involved in the translocation (NPM/ALK) and insights into the pathogenesis. Generation of monoclonal antibodies to the aberrantly expressed anaplastic large cell lymphoma kinase (ALK) such as ALK-1 can be used diagnostically, and have led to improved definition of the diagnostic entity with important clinical and prognostic implications. These studies also have clarified the relationship of ALCL to Hodgkin's disease, another lymphoid malignancy associated with CD30 expression. We have learned that the ultimate histologic spectrum of ALCL is both narrower and broader than originally believed. The small cell and lymphohistiocytic variants of ALCL are ALK-positive, and are an accepted part of the disease entity, although the neoplastic cells may appear neither large nor anaplastic. Conversely, most cases of Hodgkin's-like ALCL have proved to be more closely related to true Hodgkin's disease, and are unrelated to ALCL.
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MESH Headings
- Activin Receptors
- Adolescent
- Adult
- Child
- Child, Preschool
- Humans
- Immunohistochemistry
- Immunophenotyping
- Infant
- Ki-1 Antigen/analysis
- Lymphoma, Large-Cell, Anaplastic/chemistry
- Lymphoma, Large-Cell, Anaplastic/classification
- Lymphoma, Large-Cell, Anaplastic/genetics
- Lymphoma, Large-Cell, Anaplastic/immunology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Protein Serine-Threonine Kinases
- Translocation, Genetic
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Affiliation(s)
- E S Jaffe
- Hematopathology Section, Laboratory of Pathology, Division of Clinical Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-1500, USA.
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15
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Abstract
BACKGROUND The epidemiology of cutaneous lymphomas revealed that the incidence of lymphomas differed depending on various factors including area, race, and sex, among others. OBJECTIVE This study was undertaken to analyse the incidence of cutaneous lymphomas in Tokyo. METHODS The clinical records and histologic material from 50 patients with lymphomas of the skin and 12 patients with lymphomatoid papulosis seen during the last 10 years at the Department of Dermatology, The Jikei University School of Medicine, Tokyo, have been reviewed. RESULTS T-cell lymphomas including mycosis fungoides (MF)-Sézary's syndrome (SS) complex and adult T-cell leukemia/lymphoma (ATL) were more frequent than B-cell lymphomas. The incidence of ATL is associated with the number of human T-cell lymphotropic virus type 1 (HTLV-1) carriers in the general population. Cutaneous B-cell lymphoma (CBCL) is not as rare as previously thought in Japan. CONCLUSIONS Although the frequency of these cases depends on many unrelated factors, these values can provide a rough indication of the incidence of cutaneous lymphomas in Tokyo. The incidence of cutaneous lymphomas may be influenced by changes in environmental factors including viral infections.
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Affiliation(s)
- T Ishiji
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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16
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Abstract
Both the REAL and EORTC classification schemes classify lymphomas according to their cell of origin. These schemata also incorporate clinical features that allow for the distinction of some of these disorders. The EORTC classification scheme for primary cutaneous tumors uses terminology similar to that of the REAL classification and should allow for the recognition of teleologically similar tumors in cutaneous and extracutaneous sites. Future investigations will no doubt yield information regarding the true nature of the low-grade B-cell lymphomas of the skin and sort out the ever-increasing number of tumors found to express CD30. Most important, the continued expansion of knowledge regarding cutaneous lymphomas should enhance the ability of physicians to predict prognosis and to arrive at the most effective therapy for patients with these diseases.
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Affiliation(s)
- L M Duncan
- Dermatopathology Unit, Harvard Medical School, Massachusetts General Hospital, Boston, USA.
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17
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Sander CA, Kind P, Kaudewitz P, Raffeld M, Jaffe ES. The Revised European-American Classification of Lymphoid Neoplasms (REAL): a new perspective for the classification of cutaneous lymphomas. J Cutan Pathol 1997; 24:329-41. [PMID: 9243360 DOI: 10.1111/j.1600-0560.1997.tb00801.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Differing classification schemes for malignant lymphomas have been used in Europe and the United States. Attempts to translate between the principle classifications have been unsuccessful and historically it has been difficult to arrive at an unified approach. In addition, many new lymphoma entities have been recognized in recent years that are not delineated in any of the existing classification schemes. To provide a unified international basis for clinical and investigative work in this field, in 1994 the International Lymphoma Study Group (ILSG) proposed a new classification termed Revised European-American Classification of Lymphoid Neoplasms (REAL). This review discusses the REAL classification, especially as it pertains to cutaneous lymphomas, and provides insight into the clinicopathologic features of lymphoproliferative disease involving the skin. The premise of the REAL classification is that a classification scheme should be based on the delineation of disease entities, utilizing pathologic, immunophenotypic, genetic, and clinical features. Therefore, if cutaneous involvement is an integral aspect of any lymphoma subtype, this clinical information is included in the definition of that neoplasm. We conclude that the principles of the REAL classification are applicable to cutaneous lymphomas, as well as lymphomas involving other anatomic sites.
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Affiliation(s)
- C A Sander
- Department of Dermatology, Ludwig-Maximilians-Universitaet, Munich, Germany
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18
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Abstract
Distinguishing malignancy from premalignant conditions can be difficult. Controversy surrounds both the clinical and histologic criteria used to distinguish lymphomatoid papulosis, a benign disorder, from CD30+ anaplastic large-cell lymphoma. Three case histories illustrate important points in categorizing different lymphoproliferative disorders as benign or malignant. We emphasize a multidisciplinary approach to improve diagnosis and patient management.
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Affiliation(s)
- M F Demierre
- Department of Dermatology, Boston University School of Medicine, MA, USA
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19
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Detection of Anaplastic Lymphoma Kinase (ALK) and Nucleolar Protein Nucleophosmin (NPM)-ALK Proteins in Normal and Neoplastic Cells With the Monoclonal Antibody ALK1. Blood 1997. [DOI: 10.1182/blood.v89.4.1394] [Citation(s) in RCA: 423] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The t(2; 5)(p23;q35) translocation, associated with anaplastic large-cell lymphoma (ALCL), results in the production of the nucleolar protein nucleophosmin-anaplastic lymphoma kinase (NPM-ALK) protein. This report describes an immunocytochemical study of the distribution of ALK and NPM-ALK proteins using a new monoclonal antibody, ALK1, that recognizes a formalin resistant epitope in both the 80-kD NPM-ALK chimeric and the 200-kD normal human ALK proteins. Cytoplasmic and nuclear labeling was seen in the t(2; 5)+ SU-DHL-1 and Karpas 299 cell lines. Normal ALK protein expression was restricted to the central nervous system (in scattered neurons, glial cells, and endothelial cells). Two hundred and thirty-nine cases of lymphoma and 80 nonhematopoietic tumors were immunostained. Antibody ALK1 labeled 53.4% (39 of 73 cases) of CD30+ ALCL. A case of ALCL with a t(1; 2) translocation was ALK1+. Three cases of CD30− ALCL with prominent nucleoli showed a unique pattern of coarse granular cytoplasmic labeling. All other tumors, including Hodgkin's disease and lymphomatoid papulosis, were ALK1−. These results indicate that reliable immunostaining of routine biopsy material for NPM-ALK and ALK proteins is feasible. Such analysis is of diagnostic importance, especially because t(2; 5)+ ALCL cases have a good prognosis with appropriate treatment.
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Jaffe E, Krenacs L, Raffeld M. Classification of T-cell and NK-cell neoplasms based on the REAL classification. Ann Oncol 1997. [DOI: 10.1093/annonc/8.suppl_2.s17] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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21
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Abstract
Lymphomatoid papulosis and cutaneous CD30+ lymphoma are closely related conditions in which large atypical lymphocytes that have similar immunophenotypic features occur. In lymphomatoid papulosis, the lesions are papules and nodules that spontaneously involute. There are two polar histologic patterns, type A and B, in which the large atypical cells resemble those of Hodgkin's disease and mycosis fungoides, respectively, but in many cases, features of both types are present, either separately or in the same lesions. Variants of lymphomatoid papulosis include cases with a perifollicular distribution and those with lymphocytic vasculitis or dermal mucin deposits. Clinical lesions that tend to be stable, a monomorphous cellular composition, and in the case of immunocompromised patients, the presence of Epstein-Barr viral genome characterize cutaneous CD30+ lymphoma. A loss of response to transforming growth factor-beta, which normally dampens cellular proliferation, may differentiate CD30+ lymphoma from lymphomatoid papulosis.
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MESH Headings
- Cell Division
- Genome, Viral
- Hair Follicle/pathology
- Herpesvirus 4, Human/genetics
- Hodgkin Disease/pathology
- Humans
- Immunocompromised Host
- Immunophenotyping
- Lymphocytes/pathology
- Lymphoma, Large-Cell, Anaplastic/immunology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, Large-Cell, Anaplastic/virology
- Lymphomatoid Papulosis/classification
- Lymphomatoid Papulosis/immunology
- Lymphomatoid Papulosis/pathology
- Mucins
- Mycosis Fungoides/pathology
- Skin Neoplasms/classification
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- Skin Neoplasms/virology
- Transforming Growth Factor beta/immunology
- Vasculitis, Leukocytoclastic, Cutaneous/pathology
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Affiliation(s)
- P E LeBoit
- Department of Pathology, University of California, San Francisco 94143-0506, USA
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