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Robson A, Costa Rosa J, Semkova K, Bakr F, Cabecadas J. Homozygous Loss of CDKN2 in Primary Cutaneous CD8(+) Lymphoma NOS. Am J Dermatopathol 2024; 46:147-152. [PMID: 38175704 PMCID: PMC10868672 DOI: 10.1097/dad.0000000000002613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
ABSTRACT Primary cutaneous acral CD8(+) lymphoma (AL) has been accepted as primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder in the revised WHO and updated WHO-EORTC lymphoma classifications. Commonly arising on the ears and comprising a clonal cytotoxic CD8 + T-cell infiltrate, almost all cases follow an indolent clinical course. A single aggressive case reported in the literature had a deletion at the CDKN2 locus at 9p21. We report an atypical CD8 + T-cell proliferation arising on the chest of an elderly man who had some similarities to AL but with a very high proliferation rate, absent p16 protein expression, and homozygous loss of the CDKN2 locus using FISH analysis. A diagnosis of peripheral T-cell lymphoma not otherwise specified (PTCL NOS) was preferred. Analyses of 4 cases of AL demonstrated often low p16 protein expression but intact CDKN2 loci. This case raises the problems of the boundaries between AL and PTCL NOS, and a possible role in the loss of p16 function in pathogenesis.
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Affiliation(s)
- Alistair Robson
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal; and
| | - Joaninha Costa Rosa
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal; and
| | - Kristina Semkova
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - Farrah Bakr
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, United Kingdom
| | - Jose Cabecadas
- Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal; and
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2
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Sahraoui G, Sassi F, Charfi L, Doghri R, Mrad K. The enigmatic ear: Unveiling a rare case of a primary cutaneous CD8+ acral T-cell lymphoproliferative disorder with a literature review. Rare Tumors 2023; 15:20363613231204046. [PMID: 37743904 PMCID: PMC10517602 DOI: 10.1177/20363613231204046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction: Primary cutaneous CD8+ acral T-cell lymphoproliferative disorder (CD8+ ATCLPD) is a rare form of cutaneous T-cell lymphoma that commonly presents on the acral regions of the body. We report a case of a 61-year-old man diagnosed with primary cutaneous CD8+ ATCLPD of the ear. Case presentation: A 61-year-old man presented with a non-healing, erythematous painful macule on the ear that had been evolving for the past 3 months. The lesion was resected, and histopathological examination revealed a primary cutaneous CD8+ ATCLPD with acral localization. Further investigations including CT scan of the thorax, abdomen and pelvis were done to stage the disease. The results showed no extracutaneous involvement. Conclusion: Accurate identification of primary cutaneous CD8+ ATCLPD is crucial due to its distinct prognostic and therapeutic implications compared to other CD8+ cytotoxic lymphoid proliferations. Primary cutaneous CD8+ ATCLPD can be treated conservatively and typically follows a slow clinical course, regardless of the treatment method. Understanding the clinical context, as well as the morphological and immunophenotypic characteristics, can assist in making a precise diagnosis.
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Affiliation(s)
- Ghada Sahraoui
- Department of Pathology, Salah Azaiez Institute of Cancer, Tunis, Tunisia
- Research Laboratory LR21SP01, Salah Azaiez Institute, Tunis, Tunisia
| | - Farah Sassi
- Department of Pathology, Salah Azaiez Institute of Cancer, Tunis, Tunisia
| | - Lamia Charfi
- Department of Pathology, Salah Azaiez Institute of Cancer, Tunis, Tunisia
- Research Laboratory LR21SP01, Salah Azaiez Institute, Tunis, Tunisia
| | - Raoudha Doghri
- Department of Pathology, Salah Azaiez Institute of Cancer, Tunis, Tunisia
- Research Laboratory LR21SP01, Salah Azaiez Institute, Tunis, Tunisia
| | - Karima Mrad
- Department of Pathology, Salah Azaiez Institute of Cancer, Tunis, Tunisia
- Research Laboratory LR21SP01, Salah Azaiez Institute, Tunis, Tunisia
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3
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Rolim I, BakShi A, West E, Azurdia R, Kempf W, Robson A. Solitary CD8-Positive Primary Cutaneous Peripheral T-Cell Lymphoma: A Question of Classification. Am J Dermatopathol 2021; 43:e107-e110. [PMID: 33767068 DOI: 10.1097/dad.0000000000001908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Acral CD8(+) lymphoma is a provisional entity in the latest edition of the WHO Lymphoma Classification and is associated with a highly specific dot-like pattern of immunohistochemical expression of CD68. We report a case of an ulcerated solitary cutaneous lesion arising on the forehead of an adult man, which had a CD8(+) cytotoxic phenotype and areas of dot-like CD68 positivity, but with a number of features that significantly detracted from the classically described acral CD8(+) lymphoma. The nosological status of the lesion is discussed with respect to a preferred diagnosis of peripheral T-cell lymphoma, not otherwise specified.
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Affiliation(s)
- Inês Rolim
- Anatomic Pathology Service, Champalimaud Clinical Centre (CCC), Lisbon, Portugal
| | - Arti BakShi
- Department of Pathology, Royal Liverpool and Broadgreen University Hospitals NHS trust, Liverpool, United Kingdom
| | - Elizabeth West
- Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals NHS trust, Liverpool, United Kingdom
| | - Richard Azurdia
- Department of Dermatology, Royal Liverpool and Broadgreen University Hospitals NHS trust, Liverpool, United Kingdom
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik and Department of Dermatology, University Hospital Zurich, Zurich, Switzerland; and
| | - Alistair Robson
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Lisboa, Portugal
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4
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Multiple Erythematous Papules on the Toes: Answer. Am J Dermatopathol 2021; 43:599-600. [PMID: 34276030 DOI: 10.1097/dad.0000000000001806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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5
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Lopez A, Trager MH, Magro C, Geskin LJ. Collisional variant of CD8 + mycosis fungoides and indolent CD8 + lymphoid proliferation. JAAD Case Rep 2020; 6:921-924. [PMID: 32939387 PMCID: PMC7479255 DOI: 10.1016/j.jdcr.2020.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Adriana Lopez
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Megan H Trager
- Department of Dermatology, Columbia University Medical Center, New York, New York
| | - Cynthia Magro
- Department of Pathology, Weill Cornell Medicine, New York, New York
| | - Larisa J Geskin
- Department of Dermatology, Columbia University Medical Center, New York, New York
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6
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Ellerin BE, Demandante CGN, Martins JT. Pure abscopal effect of radiotherapy in a salivary gland carcinoma: Case report, literature review, and a search for new approaches. Cancer Radiother 2020; 24:226-246. [PMID: 32192840 DOI: 10.1016/j.canrad.2020.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022]
Abstract
We report the case of an 84-year-old woman with poorly differentiated non-small cell carcinoma of the right parotid who presented with headache, was found to have a primary right parotid gland cancer as well as metastatic disease, and underwent palliative radiotherapy to the primary site. The patient received no chemotherapy or immunotherapy, but both the primary site and several non-irradiated foci in the lungs regressed or completely resolved. The patient remained free of disease for about one year before progression. The case is a rare instance of abscopal regression of metastatic disease in the absence of pharmacologic immunomodulation. A literature review surveys the history of the abscopal effect of radiation therapy, attempts to understand the mechanisms of its successes and failures, and points to new approaches that can inform and improve the outcomes of radioimmunotherapy.
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Affiliation(s)
| | | | - J T Martins
- UT Health HOPE Cancer Center, Tyler, TX 75701, USA
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7
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Wobser M, Goebeler M. [Cutaneous lymphomas : Clinical presentation - diagnosis - treatment]. DER PATHOLOGE 2020; 41:79-94. [PMID: 31932947 DOI: 10.1007/s00292-019-00743-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cutaneous lymphomas comprise different subgroups with distinct biological behavior. Mycosis fungoides, the most common cutaneous lymphoma, presents with patches, plaques, tumors and erythroderma. Therapeutic options depend on stage and comprise local skin-directed treatment in early stages, while later stages and Sézary syndrome require systemic therapies including bexarotene, interferon or brentuximab vedotin. While the rare CD4-positive lymphoproliferation and acral CD8-positive lymphoma present with an invariably indolent course, cutaneous peripheral T‑cell lymphomas exhibit an aggressive clinical behavior. Among the subgroup of cutaneous B‑cell lymphomas, primary cutaneous marginal zone lymphoma and follicle center cell lymphoma belong to indolent entities with almost unrestricted overall survival, whereas cutaneous large B‑cell lymphoma presents with a significant risk of systemic dissemination and is associated with high lethality.
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Affiliation(s)
- Marion Wobser
- Universitätshautklinik Würzburg, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - Matthias Goebeler
- Universitätshautklinik Würzburg, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
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8
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Wobser M, Goebeler M. [Cutaneous lymphomas : Clinical presentation - diagnosis - treatment]. DER HAUTARZT 2019; 70:815-830. [PMID: 31511903 DOI: 10.1007/s00105-019-04469-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cutaneous lymphomas comprise different subgroups with distinct biological behavior. Mycosis fungoides, the most common cutaneous lymphoma, presents with patches, plaques, tumors and erythroderma. Therapeutic options depend on stage and comprise local skin-directed treatment in early stages, while later stages and Sézary syndrome require systemic therapies including bexarotene, interferon or brentuximab vedotin. While the rare CD4-positive lymphoproliferation and acral CD8-positive lymphoma present with an invariably indolent course, cutaneous peripheral T‑cell lymphomas exhibit an aggressive clinical behavior. Among the subgroup of cutaneous B‑cell lymphomas, primary cutaneous marginal zone lymphoma and follicle center cell lymphoma belong to indolent entities with almost unrestricted overall survival, whereas cutaneous large B‑cell lymphoma presents with a significant risk of systemic dissemination and is associated with high lethality.
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Affiliation(s)
- Marion Wobser
- Universitätshautklinik Würzburg, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - Matthias Goebeler
- Universitätshautklinik Würzburg, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
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9
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Ormerod E, Murigu T, Pawade J, Beasley M, Dunnill G. Primary cutaneous acral CD8+ T‐cell lymphoma of the ear: A case report. J Cutan Pathol 2019; 46:790-793. [DOI: 10.1111/cup.13517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 05/08/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Emma Ormerod
- Dermatology DepartmentBristol Royal Infirmary Bristol UK
| | - Timothy Murigu
- Department of Cellular PathologySouthmead Hospital Bristol UK
| | - Joya Pawade
- Department of Cellular PathologySouthmead Hospital Bristol UK
| | | | - Giles Dunnill
- Dermatology DepartmentBristol Royal Infirmary Bristol UK
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10
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Cutaneous Lymphoproliferative Disorders: What's New in the Revised 4th Edition of the World Health Organization (WHO) Classification of Lymphoid Neoplasms. Adv Anat Pathol 2019; 26:93-113. [PMID: 30199396 DOI: 10.1097/pap.0000000000000208] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cutaneous lymphoproliferative disorders remain a challenging aspect of dermatopathology, in part due to the rarity of the entities and extreme variability in clinical outcomes. Although many of the entities remain unchanged, the approach to some of them has changed in the new 2016 classification scheme of the World Health Organization. Chief among these are Epstein-Barr virus-associated lymphoproliferative disorders such as Epstein-Barr virus-associated mucocutaneous ulcer and hydroa vacciniforme-like lymphoproliferative disorder, primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, primary cutaneous acral CD8+ T-cell lymphoma, primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, and breast implant-associated anaplastic large cell lymphoma. In addition, translocations and gene rearrangements such as those involving the 6p25.3 locus have started to inform diagnosis and classification of anaplastic large cell lymphoma and lymphomatoid papulosis. In this review, we will examine what is new in the diagnostic toolbox of cutaneous lymphoproliferative disorders.
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11
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12
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Toberer F, Christopoulos P, Lasitschka F, Enk A, Haenssle HA, Cerroni L. Double‐positive CD8/CD4 primary cutaneous acral T‐cell lymphoma. J Cutan Pathol 2019; 46:231-233. [DOI: 10.1111/cup.13403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/07/2018] [Accepted: 12/12/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ferdinand Toberer
- Department of Dermatology, Venerology and AllergologyUniversity Medical Center Ruprecht‐Karls‐University Heidelberg Heidelberg Germany
| | - Petros Christopoulos
- Department of Thoracic OncologyThoraxklinik at Heidelberg University Hospital Heidelberg Germany
| | - Felix Lasitschka
- Department of PathologyUniversity Medical Center Ruprecht‐Karls‐University Heidelberg Heidelberg Germany
| | - Alexander Enk
- Department of Dermatology, Venerology and AllergologyUniversity Medical Center Ruprecht‐Karls‐University Heidelberg Heidelberg Germany
| | - Holger A. Haenssle
- Department of Dermatology, Venerology and AllergologyUniversity Medical Center Ruprecht‐Karls‐University Heidelberg Heidelberg Germany
| | - Lorenzo Cerroni
- Department of Dermatology, Venerology and AllergologyUniversity Medical Center Graz Graz Austria
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13
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Abstract
There are a number of rare T-cell lymphoma subtypes that may be encountered in clinical practice. In recent years, improved immunohistochemical techniques and molecular tumor profiling have permitted refinement of some of the diagnostic categories in this group, as well as the recognition of distinct conditions not previously well elucidated. In this chapter, we cover the diagnostic and clinical features of some of the more common of these conditions, including subcutaneous panniculitis-like T-cell lymphoma, cutaneous gamma-delta T-cell lymphoma, enteropathy-associated T-cell lymphoma, monomorphic epitheliotropic intestinal T-cell lymphoma, primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma, CD4-positive small/medium T-cell lymphoproliferative disorder, and acral CD8-positive T-cell lymphoma. Given the rarity of these conditions, optimal treatments approaches are not always well established, not least as data from large-scale clinical trials are lacking. In this chapter, we aim to provide a summation of current thinking around best treatment, as well as highlighting some controversies in the management of these diagnoses.
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Affiliation(s)
- C van der Weyden
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - C McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Australia
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
| | - S Lade
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Department of Anatomical Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - R W Johnstone
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - H M Prince
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Epworth Healthcare, Melbourne, Australia
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14
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Hathuc VM, Hristov AC, Smith LB. Primary Cutaneous Acral CD8+ T-Cell Lymphoma. Arch Pathol Lab Med 2017; 141:1469-1475. [DOI: 10.5858/arpa.2017-0230-ra] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary cutaneous acral CD8+ T-cell lymphoma is a new provisional entity in the 2016 revision of the World Health Organization classification of lymphoid neoplasms. This is a challenging diagnosis because of its rarity, as well as its morphologic and immunophenotypic overlap with other CD8+ cytotoxic lymphoid proliferations. Appropriate classification of this entity is crucial because of its indolent clinical behavior compared with other CD8+ T-cell lymphomas. Knowledge of the clinical setting, sites of involvement, and morphologic features can aid in correct diagnosis. Here, we review the clinical and pathologic features of primary cutaneous acral CD8+ T-cell lymphoma with an emphasis on the differential diagnosis among other C8+ T-cell lymphomas.
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Affiliation(s)
- Vivian M. Hathuc
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
| | - Alexandra C. Hristov
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
| | - Lauren B. Smith
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
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15
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Abstract
Primary cutaneous cytotoxic lymphomas are T-cell or natural killer-cell lymphomas that express 1 or more cytotoxic markers. These neoplasms constitute a spectrum of diseases. In this review, an overview of clinical, morphologic, and phenotypical features of each subtype is provided. Differential diagnosis is discussed with attention to scenarios in which diagnostic difficulties are most frequently encountered.
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Affiliation(s)
- Adriana García-Herrera
- Department of Pathology, Hospital Clínic de Barcelona, Villarroel, 170, Escalera 3, Planta 5, Barcelona 08036, Spain
| | - Eduardo Calonje
- Dermatopathology Laboratory, St John's Institute of Dermatology, St Thomas' Hospital, South Wing, Staircase C, Westminster Bridge Road, London SE1 7EH, UK.
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16
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Abstract
Primary cutaneous marginal zone lymphoma (CMZL) is one of the major primary B-cell lymphomas of skin. Two types are recognized: a more common class-chain switched CMZL, and a much less common IgM+ CMZL. The extremely indolent course, together with other features distinct from most other MALT lymphomas, has led some to question whether at least the class-switched cases should be considered an overt lymphoma.
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Affiliation(s)
- Steven H Swerdlow
- Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, UPMC-Presbyterian, G-335, 200 Lothrop Street, Pittsburgh, PA 15213.
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17
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Charli-Joseph YV, Gatica-Torres M, Pincus LB. Approach to Cutaneous Lymphoid Infiltrates: When to Consider Lymphoma? Indian J Dermatol 2016; 61:351-74. [PMID: 27512181 PMCID: PMC4966394 DOI: 10.4103/0019-5154.185698] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cutaneous lymphoid infiltrates (CLIs) are common in routine dermatopathology. However, differentiating a reactive CLI from a malignant lymphocytic infiltrate is often a significant challenge since many inflammatory dermatoses can clinically and/or histopathologically mimic cutaneous lymphomas, coined pseudolymphomas. We conducted a literature review from 1966 to July 1, 2015, at PubMed.gov using the search terms: Cutaneous lymphoma, cutaneous pseudolymphoma, cutaneous lymphoid hyperplasia, simulants/mimics/imitators of cutaneous lymphomas, and cutaneous lymphoid infiltrates. The diagnostic approach to CLIs and the most common differential imitators of lymphoma is discussed herein based on six predominant morphologic and immunophenotypic, histopathologic patterns: (1) Superficial dermal T-cell infiltrates (2) superficial and deep dermal perivascular and/or nodular natural killer/T-cell infiltrates (3) pan-dermal diffuse T-cell infiltrates (4) panniculitic T-cell infiltrates (5) small cell predominant B-cell infiltrates, and (6) large-cell predominant B-cell infiltrates. Since no single histopathological feature is sufficient to discern between a benign and a malignant CLI, the overall balance of clinical, histopathological, immunophenotypic, and molecular features should be considered carefully to establish a diagnosis. Despite advances in ancillary studies such as immunohistochemistry and molecular clonality, these studies often display specificity and sensitivity limitations. Therefore, proper clinicopathological correlation still remains the gold standard for the precise diagnosis of CLIs.
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Affiliation(s)
- Yann Vincent Charli-Joseph
- Cutaneous Hematopathology Clinic, Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Michelle Gatica-Torres
- Cutaneous Hematopathology Clinic, Department of Dermatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Laura Beth Pincus
- Department of Dermatology and Pathology, University of California, San Francisco, United States of America
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Kluk J, Kai A, Koch D, Taibjee SM, O'Connor S, Persic M, Morris S, Whittaker S, Cerroni L, Kempf W, Petrella T, Robson A. Indolent CD8-positive lymphoid proliferation of acral sites: three further cases of a rare entity and an update on a unique patient. J Cutan Pathol 2015; 43:125-36. [DOI: 10.1111/cup.12633] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 08/13/2015] [Accepted: 09/06/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Justine Kluk
- Skin Tumour Unit; St John's Institute of Dermatology; London UK
| | - Anneke Kai
- Skin Tumour Unit; St John's Institute of Dermatology; London UK
| | - Dimitra Koch
- Department of Dermatology; Dorset County Hospital NHS Foundation Trust; Dorchester UK
| | - Saleem M. Taibjee
- Department of Dermatology; Dorset County Hospital NHS Foundation Trust; Dorchester UK
| | - Simon O'Connor
- Pathology Department; Nottingham University Hospitals NHS Trust; Nottingham UK
| | - Mojca Persic
- Department of Oncology; Derby Hospitals NHS Foundation Trust; Derby UK
| | - Stephen Morris
- Skin Tumour Unit; St John's Institute of Dermatology; London UK
| | - Sean Whittaker
- Skin Tumour Unit; St John's Institute of Dermatology; London UK
| | - Lorenzo Cerroni
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - Werner Kempf
- Department of Dermatology; University Hospital; Zurich Switzerland
| | - Tony Petrella
- Department of Pathology; University of Dijon; Dijon France
| | - Alistair Robson
- Dermatopathology Department, St John's Institute of Dermatology; Guy's & St Thomas' NHS Foundation Trust; London UK
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19
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Wobser M, Geissinger E, Rosenwald A, Goebeler M. Mycosis fungoides: A mimicker of benign dermatoses. World J Dermatol 2015; 4:135-144. [DOI: 10.5314/wjd.v4.i4.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 08/21/2014] [Accepted: 07/17/2015] [Indexed: 02/06/2023] Open
Abstract
Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitate other dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published “mimickers” of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.
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20
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Wobser M, Roth S, Reinartz T, Rosenwald A, Goebeler M, Geissinger E. CD68 expression is a discriminative feature of indolent cutaneous CD8-positive lymphoid proliferation and distinguishes this lymphoma subtype from other CD8-positive cutaneous lymphomas. Br J Dermatol 2015; 172:1573-1580. [PMID: 25524664 DOI: 10.1111/bjd.13628] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Indolent cutaneous CD8+ lymphoid proliferation is a recently described rare entity among cutaneous T-cell lymphomas that typically presents with solitary skin lesions at acral sites. Separation from otherwise aggressive T-cell lymphomas bearing a cytotoxic CD8+ phenotype is fundamental to avoid unnecessary harmful treatment. However, up to now, no reliable discriminative marker has been identified. OBJECTIVES Motivated by these diagnostic quandaries, we have analyzed a large series of archived formalin-fixed paraffin-embedded (FFPE) specimens of atypical CD8+ cutaneous infiltrates with clear-cut diagnosis and clinical follow-up (n = 44) including five cases of indolent CD8+ lymphoid proliferation by using immunohistochemistry with the aim of obtaining markers predictive of subtype assignment. RESULTS We identified exclusive expression of CD68 by lymphoma cells within the subgroup of indolent CD8+ lymphoid proliferation (5/5 cases). Specific CD68 expression in this entity was confirmed by the application of several monoclonal antibodies (KP1, PG-M1, KiM1P) against the CD68 molecule available for FFPE tissue. In contrast, none of the infiltrates of the other CD8+ cutaneous lymphoma entities stained positive for CD68 (0/39). CONCLUSIONS Based on these observations, we suggest CD68 as a new discriminative marker which is helpful in distinguishing indolent CD8+ lymphoid proliferation from other CD8+ cutaneous lymphomas in ambiguous cases.
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Affiliation(s)
- M Wobser
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - S Roth
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - T Reinartz
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - A Rosenwald
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
| | - M Goebeler
- Department of Dermatology, Comprehensive Cancer Center Mainfranken, University Hospital Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, 97080, Germany
| | - E Geissinger
- Institute of Pathology, Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
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Ganapathi KA, Pittaluga S, Odejide OO, Freedman AS, Jaffe ES. Early lymphoid lesions: conceptual, diagnostic and clinical challenges. Haematologica 2015; 99:1421-32. [PMID: 25176983 DOI: 10.3324/haematol.2014.107938] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There are no "benign lymphomas", a fact due to the nature of lymphoid cells to circulate and home as part of their normal function. Thus, benign clonal expansions of lymphocytes are only rarely recognized when localized. Recent studies have identified a number of lymphoid proliferations that lie at the interface between benign and malignant. Some of these are clonal proliferations that carry many of the molecular hallmarks of their malignant counterparts, such as BCL2/IGH and CCND1/IGH translocations associated with the in situ forms of follicular lymphoma and mantle cell lymphoma, respectively. There are other clonal B-cell proliferations with low risk of progression; these include the pediatric variants of follicular lymphoma and marginal zone lymphoma. Historically, early or incipient forms of T/NK-cell neoplasia also have been identified, such as lymphomatoid papulosis and refractory celiac disease. More recently an indolent form of T-cell lymphoproliferative disease affecting the gastrointestinal tract has been described. Usually, CD8(+), the clonal cells are confined to the mucosa. The clinical course is chronic, but non-progressive. NK-cell enteropathy is a clinically similar condition, composed of cytologically atypical NK-cells that may involve the stomach, small bowel or colon. Breast implant-associated anaplastic large cell lymphoma is a cytologically alarming lesion that is self-limited if confined to the seroma cavity. Atypical lymphoid proliferations that lie at the border of benign and malignant can serve as instructive models of lymphomagenesis. It is also critical that they be correctly diagnosed to avoid unnecessary and potentially harmful therapy.
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Affiliation(s)
- Karthik A Ganapathi
- Hematopathology Section, Center for Cancer Research, Laboratory of Pathology, National Cancer Institute, Harvard Medical School, Boston, USA
| | - Stefania Pittaluga
- Hematopathology Section, Center for Cancer Research, Laboratory of Pathology, National Cancer Institute, Harvard Medical School, Boston, USA
| | - Oreofe O Odejide
- Center for Hematologic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - Arnold S Freedman
- Center for Hematologic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - Elaine S Jaffe
- Hematopathology Section, Center for Cancer Research, Laboratory of Pathology, National Cancer Institute, Harvard Medical School, Boston, USA
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