1
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Hu J, Zhang X, Zhao L, Zhao Q, Geng S. Decrease of 5-hydroxymethylcytosine in primary cutaneous CD4 + small/medium sized pleomorphic T-cell lymphoproliferative disorder. An Bras Dermatol 2024; 99:27-33. [PMID: 37657958 DOI: 10.1016/j.abd.2023.01.003] [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] [Received: 11/20/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Primary cutaneous CD4+ small/medium-sized pleomorphic T-Cell lymphoproliferative disorder (PC-SMTLD) has been considered as a controversial dermatological disease that has been included in cutaneous T-cell lymphoma group, presenting most commonly as a solitary nodule and/or plaque with a specific and characteristic head and neck predilection. Due to the considerable overlap between PC-SMTLD and pseudolymphoma (PL), the differential diagnosis is often challenging. Methylation of DNA at position 5 of cytosine, and the subsequent reduction in intracellular 5-hydroxymethylcytosine (5-hmC) levels, is a key epigenetic event in several cancers, including systemic lymphomas. However, it has rarely been studied in cutaneous lymphomas. OBJECTIVES The authors aimed to explore the role of differential 5-hmC immunostaining as a useful marker to distinguish PC-SMTLD from PL. METHODS Retrospective case series study with immunohistochemical and immunofluorescence analysis of 5-hmC was performed in PL and PC-SMTLD. RESULTS Significant decrease of 5-hmC nuclear staining was observed in PC-SMTLD when compared with PL (p < 0.0001). By semi-quantitative grade integration, there were statistical differences in the final 5-hmC scores in the two study groups. The IF co-staining of 5-hmC with CD4 revealed a decrease of 5-hmC in CD4+ lymphocytes of PC-SMTLD. STUDY LIMITATIONS The small clinical sample size of the study. CONCLUSIONS The immunorreactivity of 5-hmC in CD4+ lymphocytes was highly suggestive of a benign process as PL. Furthermore, the decrease of 5-hmC nuclear staining in PC-SMTLD indicated its lymphoproliferative status and helped to make the differential diagnosis with PL.
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Affiliation(s)
- Jiahui Hu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xian Jiaotong University, Xian, China
| | - Xinyue Zhang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xian Jiaotong University, Xian, China
| | - Lihong Zhao
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xian Jiaotong University, Xian, China
| | - Qiang Zhao
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xian Jiaotong University, Xian, China
| | - Songmei Geng
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Xian Jiaotong University, Xian, China.
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2
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Xu KR, Rohr BR. T-Cell-Rich Angiomatoid Polypoid Pseudolymphoma: A Case Report and Comparison With Key Differential Diagnoses. Cureus 2023; 15:e37241. [PMID: 37168171 PMCID: PMC10166403 DOI: 10.7759/cureus.37241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 05/13/2023] Open
Abstract
T-cell-rich angiomatoid polypoid pseudolymphoma (TRAPP) is a rare and recently defined entity, conceptualized just over a decade ago. Recognition of TRAPP is important because it can be clinically and microscopically confused with low-grade cutaneous lymphomas and other vascular proliferations. We report a case of a 28-year-old male with a solitary 1.2 cm red polypoid papule on the middle posterior base of the neck. The histopathological examination revealed a well-circumscribed dermal nodular proliferation of banal-appearing lymphovascular spaces with plump endothelial cells. Immunohistochemical analysis showed a T-cell-rich infiltrate. The clinical-pathological differential diagnosis for TRAPP includes pyogenic granuloma, angiolymphoid hyperplasia (epithelioid hemangioma), acral pseudolymphomatous angiokeratoma of children, cutaneous lymphoid hyperplasia, and low-grade cutaneous lymphomas and lymphoproliferative disorders. We review the literature and discuss the key differentiating features between TRAPP and its common differential diagnoses.
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Affiliation(s)
- Katie R Xu
- Dermatology, Case Western Reserve University School of Medicine, Cleveland, USA
| | - Bethany R Rohr
- Dermatology, University Hospitals Cleveland Medical Center, Cleveland, USA
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3
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Plumptre IR, Said JT, Sun T, Larocca C, Virgen CA, Kupper TS, Fisher DC, Devlin PM, Elco CP, Song JS, LeBoeuf NR. Clinical features and treatment outcomes for primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder: a retrospective cohort study from the Dana-Farber Cancer Institute and updated literature review. Leuk Lymphoma 2022; 63:2832-2846. [PMID: 35862569 DOI: 10.1080/10428194.2022.2098287] [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: 12/14/2022]
Abstract
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-TCLPD) was reclassified in 2016 as a rare benign entity with an excellent prognosis, yet its clinical features and best treatments remain poorly defined. We collected clinical data, treatments, and treatment-responses from our institution's patients with PCSM-TCLPD through September 2018 and an identical PubMed review through June 2021. Among 36 cases (median-age 54 years; 58.3% head/neck), diagnostic biopsy resulted in sustained complete remission (CR) in 13/33 punch/shave biopsies and 3/3 excisional biopsies. The remaining 20 patients further required topical corticosteroids (n = 5); intralesional corticosteroids (n = 1); surgical-excision (n = 5); electron-beam-radiation (n = 6); or brachytherapy (n = 3). All patients ultimately achieved CR, excluding one patient continuing treatment at end-of-study. 57/59 (96.6%) of institutional and literature-reported radiation-treated patients experienced CR. No institutional cases progressed beyond skin; 5/209 (2.4%) literature-reported cases progressed to systemic/extracutaneous involvement, all pre-reclassification. PCSM-TCLPD responds well to local-directed therapy including radiation, and only rarely if ever progresses.
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Affiliation(s)
| | - Jordan T Said
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Tiffany Sun
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cecilia Larocca
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cesar A Virgen
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Thomas S Kupper
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David C Fisher
- Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Philip M Devlin
- Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher P Elco
- Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Johanna Sheu Song
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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4
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Bakr F, Wain EM, Wong S, Palmer R, Robson A. Prominent Blasts in Primary Cutaneous CD4+ Small/Medium T-Cell Lymphoproliferative Disorder. A Reconsideration of Diagnostic Criteria. Am J Dermatopathol 2021; 43:e190-e196. [PMID: 33989212 DOI: 10.1097/dad.0000000000001979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-LPD), recently downgraded from a T-cell lymphoma, is a poorly characterized histopathological entity. Presenting as a solitary lesion that often grows rapidly, it may raise suspicion for a cutaneous B-cell lymphoma. However, classically, the dermal lymphoid proliferation is predominantly CD4+ with a follicular T-helper profile and a smaller B-cell fraction. Diagnostic uncertainty may arise when B cells are present in large numbers, a B-cell clone is present, or large cell populations are seen. To meet the diagnostic criterion of PCSM-LPD, large cells should not constitute more than 30% of the infiltrate. The 2 cases presented in this article caused diagnostic uncertainty owing to the observation of high numbers of large cells and in one case the presence of a B-cell clone, on the background of otherwise typical clinicopathological features of PCSM-LPD. We review the literature specifically regarding the prevalence of large cell populations and their immunophenotypic characteristics and in light of this discuss whether a current diagnostic criterion should be reconsidered.
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Affiliation(s)
- Farrah Bakr
- Department of Dermatology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - E Mary Wain
- Department of Dermatology, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sharon Wong
- Consultant Dermatologist, HCA UK, London, United Kingdom
| | - Roy Palmer
- Department of Dermatology, The Princess Margaret Hospital, Windsor, Berkshire, United Kingdom
| | - Alistair Robson
- Consultant Dermatopathologist, LD Path, London, United Kingdom; and
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
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5
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Bakr F, Wain EM, Barlow R, Robson A. Primary Cutaneous CD4+ Small/Medium T-Cell Lymphoproliferative Disorder or Primary Cutaneous Marginal Zone B-Cell Lymphoma? Two Distinct Entities With Overlapping Histopathological Features. Am J Dermatopathol 2021; 43:e204-e212. [PMID: 34231494 DOI: 10.1097/dad.0000000000002003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder and primary cutaneous marginal zone B-cell lymphoma are 2 distinct entities with several overlapping features which can result in diagnostic uncertainty. Clinically, they both follow an indolent course and present with solitary or multiple papules or nodules. Histologically, they are characterized by polymorphous dermal infiltrates rich in mixed populations of B cells and T cells, often in similar proportions. The histological hallmark of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is the presence of follicular T-helper cells within the infiltrate and has historically been used as a marker for differentiating between the 2 conditions. However, there is now mounting evidence that follicular T-helper cells are also seen in primary cutaneous marginal zone B-cell lymphoma and nodal marginal zone lymphoma. The 2 cases presented herein caused diagnostic uncertainty because they displayed appreciable features of both conditions. We discuss the potential mechanisms behind these overlapping histopathological features and hypothesize a model that explores the idea of a collective organoid response to an antigenic stimulus.
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Affiliation(s)
- Farrah Bakr
- Department of Dermatology, St John's Institute of Dermatology, London, United Kingdom
| | - E Mary Wain
- Department of Dermatology, St John's Institute of Dermatology, London, United Kingdom
| | - Richard Barlow
- Department of Dermatology, St John's Institute of Dermatology, London, United Kingdom
| | - Alistair Robson
- London Digital Pathology, London, United Kingdom; and
- Instituto Português de Oncologia Francisco Gentil (IPOLFG), Serviço de Anatomia Patológica, Lisboa, Portugal
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6
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Kim J, Jeong M, Jun D, Lee M, Shin D, Kim W, Choi H. Primary cutaneous CD4+ small/medium T-cell lymphoma: a case report. Arch Craniofac Surg 2021; 22:199-203. [PMID: 34474543 PMCID: PMC8413923 DOI: 10.7181/acfs.2021.00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022] Open
Abstract
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.
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Affiliation(s)
- Jeenam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Minkyoung Jeong
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Dongkeun Jun
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Myungchul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Donghyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
| | - Wookyoun Kim
- Department of Pathology, Konkuk University Medical Center, Seoul, Korea
| | - Hyungon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Seoul, Korea
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7
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Lymphomatoid Papulosis With a Unique T Follicular Helper-Like Phenotype. Am J Dermatopathol 2021; 42:776-779. [PMID: 32568843 DOI: 10.1097/dad.0000000000001693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Lymphomatoid papulosis (LyP) is a benign skin condition that typically presents with grouped or scattered lesions on the body that self-resolve within weeks or months of onset. LyP belongs to the group of CD30-positive lymphoproliferative disorders. Several histological variants of LyP exist, and the histological features of LyP can overlap with other lymphoproliferative disorders; therefore, both histological and clinical correlations are needed for a proper diagnosis of LyP. We report an unusual case of LyP displaying a T follicular helper cell-like phenotype and histopathologically resembling the primary cutaneous CD4-positive small-sized to medium-sized T-cell lymphoproliferative disorder.
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8
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Shi H, Zhang J, Xiong J, Gan L, Jiang Y, Xu X, Zhang W, Zeng X, Sun J, Chen H. Clinicopathological analysis of primary cutaneous CD4‐positive small/medium pleomorphic T‐cell lymphoproliferative disorder: a retrospective study of 22 patients. Int J Dermatol 2020; 60:497-502. [DOI: 10.1111/ijd.15372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/06/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Hao‐ze Shi
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Jing Zhang
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
- Department of Dermatology Central Theater General Hospital of Chinese People's Liberation Army Wuhan China
| | - Jing‐shu Xiong
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Lu Gan
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Yi‐qun Jiang
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Xiu‐lian Xu
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Wei Zhang
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Xue‐si Zeng
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Jian‐fang Sun
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
| | - Hao Chen
- Department of Pathology Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing China
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9
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Surmanowicz P, Doherty S, Sivanand A, Parvinnejad N, Deschenes J, Schneider M, Hardin J, Gniadecki R. The Clinical Spectrum of Primary Cutaneous CD4+ Small/Medium-Sized Pleomorphic T-Cell Lymphoproliferative Disorder: An Updated Systematic Literature Review and Case Series. Dermatology 2020; 237:618-628. [PMID: 33326960 DOI: 10.1159/000511473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoproliferative disorder (SMPLPD) is a provisional entity within the 2016 World Health Organization classification of primary cutaneous lymphomas. The condition is currently classified as a lymphoproliferative disorder to emphasize its benign course and discourage aggressive, systemic treatment modalities. OBJECTIVE To provide a relevant synthesis for the dermatological practitioner on the prevalence, presentation, and treatment of SMPLPD. METHODS We conducted an updated systematic literature review and a retrospective chart review of diagnosed cases of SMPLPD from 2 Canadian academic cutaneous lymphoma centers. RESULTS A total of 23 studies with 136 cases were extracted from the systematic review and 24 patients from our retrospective chart review. SMPLPD proved relatively common accounting for 12.5% of all cutaneous T-cell lymphomas encountered in our cutaneous lymphoma clinics, second in frequency only to mycosis fungoides. The typical clinical presentation was that of an older individual (median age 59 years) with an asymptomatic solitary lesion on their upper extremity. The most common clinical differentials were cutaneous lymphoid hyperplasia, basal cell carcinoma, and lymphoma unspecified. T follicular helper markers were reliably detected. The main treatment modalities were surgical excision, local radiation therapy, and topical or intralesional steroids. Cure was achieved in the vast majority of cases. CONCLUSIONS SMPLPD is an underdiagnosed T-cell lymphoma with an overtly benign clinical course. The condition has an excellent prognosis and responds well to skin-directed therapies. Practitioners should be aware of this condition to avoid aggressive systemic treatments.
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Affiliation(s)
- Philip Surmanowicz
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Sean Doherty
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Arunima Sivanand
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Nikoo Parvinnejad
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jean Deschenes
- Department of Pathology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Schneider
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jori Hardin
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada,
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10
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Magro CM, Ruan J, Grossman M, Hedayat AA. Monoclonal plasma cell infiltrates in the setting of cutaneous follicular helper T cell lymphoproliferative disorders. Ann Diagn Pathol 2019; 40:94-104. [PMID: 31077877 DOI: 10.1016/j.anndiagpath.2019.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/17/2022]
Abstract
There is a growing recognition that some primary cutaneous T cell lymphomas of the skin exhibit a follicular helper T cell phenotype best exemplified by primary cutaneous CD4+ small/medium sized pleomorphic T cell lymphoma. The follicular helper T cells is an evolutionary function in a common TH1 cell under the influence of other cell types most notably monocyte derived dendritic cells but also plasma cells. In addition, the skin defines a characteristic organ site of involvement for angioimmunoblastic T-cell lymphoma (AITL); the first recognized form of follicular helper T cell lymphoma. One of the hallmarks of the follicular helper T cell lymphomas a significant degree of post germinal center B cell hyperplasia. We encountered 7 cases of primary cutaneous follicular helper T cell and four cases of AITL, in which the biopsies contained a light chain restricted plasma cell infiltrate in the skin. There were no features that suggested an atypical or more aggressive clinical course in association with the identification of this light chain restricted plasmacytic infiltrates except one case of AITL in whom a diffuse large cell B cell lymphoma subsequently developed. There was no association with Epstein-Barr virus (EBV) infection light chain restricted plasma cell infiltrate in any of the eleven cases. The basis of these infiltrates is likely a reciprocal functional one reflecting the role of follicular helper T cells in the induction of B cell hyperplasia and the role of plasma cells as a countercheck balance controlling the extent of follicular helper T cell hyperplasia. B cell clonality, plasma cell atypia and blastic B cell transformation can occur without implying a malignant transformation.
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Affiliation(s)
- Cynthia M Magro
- Weill Cornell Medicine- New York Presbyterian Hospital, Department of Dermatopathology, 1300 York Avenue, New York, NY 10065, United States of America.
| | - Jia Ruan
- Weill Cornell Medicine- New York Presbyterian Hospital, Hematology/Oncology, 1300 York Avenue, New York, NY 10065, United States of America
| | - Marc Grossman
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, United States of America; Department of Dermatology, Donald and Barbara Zucker School of Medicine, At New Hyde Park, N.Y., United States of America
| | - Amin A Hedayat
- Weill Cornell Medicine- New York Presbyterian Hospital, Department of Dermatopathology, 1300 York Avenue, New York, NY 10065, United States of America; Memorial Sloan Kettering Cancer Center, Section of Dermatopathology, 1275 York Avenue, New York, NY 10065, United States of America
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11
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Salah E. Primär kutane CD4+ klein- bis mittelgroßzellige pleomorphe T-Zell-Lymphoproliferation: Wo stehen wir? Eine systematische Übersicht. J Dtsch Dermatol Ges 2019; 17:123-137. [DOI: 10.1111/ddg.13691_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Eman Salah
- Department of Dermatology; Venereology & Andrology; Faculty of Medicine; Zagazig University; Zagazig Egypt
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12
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Valentim FDO, Oliveira CC, Miot HA. Case for diagnosis. Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. An Bras Dermatol 2019; 94:99-101. [PMID: 30726474 PMCID: PMC6360982 DOI: 10.1590/abd1806-4841.20198513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/19/2018] [Indexed: 11/22/2022] Open
Abstract
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease, with an indolent evolution and benign course. The classic presentation is a solitary nodule on the face or trunk. The disorder's rarity and clinical and histopathological characteristics, can make the diagnosis difficult. We present the case of a 36-year-old Caucasian woman with a purplish erythematous nodule, hardened, shiny, asymptomatic, on the left nasal ala, which had grown progressively for 45 days. Histopathological examination and immunohistochemistry panel demonstrated alterations consistent with primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was complete remission of the condition within 60 days of treatment with potent occlusive corticosteroids.
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Affiliation(s)
- Flávia de Oliveira Valentim
- Department of Dermatology, Faculdade de Medicina de Botucatu,
Universidade Estadual Paulista, Botucatu (SP), Brazil
| | - Cristiano Claudino Oliveira
- Department of Pathology, Faculdade de Medicina de Botucatu,
Universidade Estadual Paulista, Botucatu (SP), Brazil
- Department of Pathological Anatomy, Hospital São Luiz/D’Or,
São Paulo (SP), Brazil
| | - Hélio Amante Miot
- Department of Dermatology, Faculdade de Medicina de Botucatu,
Universidade Estadual Paulista, Botucatu (SP), Brazil
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13
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Salah E. Primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoproliferative disorder: Where do we stand? A systematic review. J Dtsch Dermatol Ges 2018; 17:123-136. [DOI: 10.1111/ddg.13691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/10/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Eman Salah
- Department of Dermatology; Venereology & Andrology; Faculty of Medicine; Zagazig University; Zagazig Egypt
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14
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Su C, Nguyen KA, Bai HX, Cao Y, Tao Y, Karakousis G, Zhang PJ, Zhang G, Xiao R. Disease site as a determinant of survival outcome in patients with primary cutaneous peripheral T-cell lymphoma, unspecified: an analysis of 4057 cases from the US National Cancer Database. Leuk Lymphoma 2017; 59:2105-2112. [PMID: 29214867 DOI: 10.1080/10428194.2017.1410886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Primary cutaneous peripheral T-cell lymphoma, unspecified (PCPTL) accounts for <6% of cutaneous T-cell lymphoma cases. Due to its rarity, no large study exists in the literature on PCPTL. Among 4057 patients with PCPTL diagnosed from 2004 to 2014 in the National Cancer Database, 428, 913, 517, 754, and 1435 had lesions localized primarily to the upper extremity, head and neck, lower extremity, trunk, and overlapping lesion or unspecified site, respectively. PCPTL that primarily involved the head and neck had the longest overall survival (OS), followed by PCPTL that primarily involved the trunk, upper extremity, and lower extremity. Patients with lesions localized to the lower extremity had significantly shorter OS when compared to those with disease localized to other primary sites after adjusting for confounding factors. The difference in OS among disease sites was only significant in stage I disease, but not higher stages, and persisted in younger patients.
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Affiliation(s)
- Chang Su
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China.,b Yale School of Medicine , New Haven , CT , USA
| | - Kevin A Nguyen
- c Department of Molecular Biophysics and Biochemistry , Yale School of Medicine , New Haven , CT , USA
| | - Harrison X Bai
- d Department of Radiology , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Ya Cao
- e School of Basic Medicine , Central South University Cancer Research Institute , Changsha , People's Republic of China
| | - Yongguang Tao
- e School of Basic Medicine , Central South University Cancer Research Institute , Changsha , People's Republic of China
| | - Giorgos Karakousis
- f Department of Surgery , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Paul J Zhang
- g Department of Pathology and Laboratory Medicine , Hospital of the University of Pennsylvania , Philadelphia , PA , USA
| | - Guiying Zhang
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
| | - Rong Xiao
- a Department of Dermatology , The Second Xiangya Hospital, Central South University , Changsha , China
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