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Atci T, Yerlioğlu Ak D, Baykal C. Evaluation of secondary malignancies in a large series of mycosis fungoides. An Bras Dermatol 2024; 99:370-379. [PMID: 38262820 DOI: 10.1016/j.abd.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND An increased risk of Secondary Malignancies (SMs) in Mycosis Fungoides (MF) has been suggested previously. However, the relationship between this risk and the features of MF is not well-known. OBJECTIVE To investigate the rate and types of SMs in a large cohort of MF patients focusing on the associated features of these patients. METHODS The demographic features, subtype, and stage of MF, as well as the temporal relationship between the diagnosis of MF and the development of SMs were determined. Major clinical features of MF in this group were compared with MF patients without association of SMs. RESULTS Among 730 MF patients with a mean follow-up period of 67.9 ± 52.4 months, 56 SMs were identified in a total of 52 (7.1%) patients. While 28.8% of patients were previously diagnosed with other malignancies, then subsequently had a diagnosis of MF, it was vice versa in 53.8% of patients. Most of the SM-associated MF patients had early-stage (80.7%) and classical type of MF (86.5%) without a significant difference from MF patients without association of SMs; 85.5% and 72.5%, respectively. The most commonly identified SMs were hematologic malignancies (64.3%) including lymphomatoid papulosis (n = 22), Hodgkin's lymphoma (n = 4), non-Hodgkin's lymphoma (n = 5), polycythemia vera (n = 2). Other most commonly associated malignancies were breast cancer (n = 4), prostate cancer (n = 3), renal cell carcinoma (n = 2), melanoma (n = 2), and Kaposi's sarcoma (n = 2). STUDY LIMITATIONS A single tertiary dermatology center study with a retrospective design. CONCLUSION Apart from the well-known lymphomatoid papulosis association, systemic hematological malignancies were also quite common in the large cohort of MF patients.
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Affiliation(s)
- Tugba Atci
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Dilay Yerlioğlu Ak
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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2
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Verma D, Lakhani R, Mendiratta V, Chatterjee P. Lymphomatoid Papulosis: A Case Report. Indian Dermatol Online J 2024; 15:95-98. [PMID: 38283004 PMCID: PMC10810375 DOI: 10.4103/idoj.idoj_194_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 01/30/2024] Open
Abstract
Lymphomatoid papulosis (LYP) is a chronic CD 30 + lymphoproliferative disorder (LPD) which is characterized by chronic, recurrent, and self-healing papulonecrotic or papulonodular skin eruptions, which are clinically benign and histopathologically malignant. It can resolve spontaneously; however, long-term follow-up is essential as it can progress to malignant lymphoma in 10-20% of the patients. We hereby report a case of a 42-year-old male presenting with recurrent papulonecrotic lesions over the face, trunk, and extremities from the last 3 years which heal with post-inflammatory hyperpigmentation and atrophic scars with a history of treated pulmonary tuberculosis one year back. There was no systemic involvement. LYP, involving cosmetically sensitive area like face, is an infrequent finding.
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Affiliation(s)
- Damini Verma
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Ridhima Lakhani
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Vibhu Mendiratta
- Department of Dermatology, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Priti Chatterjee
- Department of Pathology, Lady Hardinge Medical College, New Delhi, Delhi, India
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3
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Montes-Moreno S. Primary cutaneous CD30+ lymphoproliferative disorders with DUSP22 translocation. Pathologie (Heidelb) 2023; 44:136-139. [PMID: 38010388 DOI: 10.1007/s00292-023-01258-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/29/2023]
Abstract
Primary cutaneous CD30+ lymphoproliferative disorders (LPD) encompass a broad category of clonal T cell proliferations with varied clinical presentations. Classically, lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large cell lymphoma (ALCL) have been recognized as distinct clinicopathological entities according to their differing clinical features. Recently, a subset of LyP and both cutaneous and systemic ALCL have been shown to carry a DUSP22 translocation [1-3], a defining molecular feature for the novel entity "LyP with DUSP22t" [1]. In cutaneous biopsies, both primary cutaneous DUSP22-translocated ALCL and LyP with DUSP22 rearrangements are characterized by a biphasic pattern with significant small cell epidermotropism. A distinct protein expression profile with preserved T Cell Receptor (TCR) expression, positivity for CD30, LEF1, HLA, and CD58, and negativity for cytotoxic marker expression as well as phospho-STAT3 protein is consistently found in these cases.
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Affiliation(s)
- Santiago Montes-Moreno
- Anatomic Pathology Service and Translational Hematopathology Lab, Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, IDIVAL, Santander, Spain.
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Calcaterra V, Cavalli R, Croci GA, Fiori L, Fabiano A, Lunardon L, Avanzini MA, Berti E, Zuccotti G. Type D lymphomatoid papulosis with pityriasis lichenoides et varioliformis acuta-like features in a child with parvovirus infection: a controversial diagnosis in the spectrum of lymphoid proliferations: case report and literature review. Ital J Pediatr 2022; 48:183. [PMID: 36307824 PMCID: PMC9616621 DOI: 10.1186/s13052-022-01371-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background Lymphomatoid papulosis (LyP) is a rare condition in pediatrics; LyP histological type D has been reported in only 7 children. The differential diagnosis of LyP in the spectrum of lymphoid proliferation remains controversial. Case presentation A 6-year-old boy presented to Emergency Department with a 3-week history of an erythematous papulo-vesicular itchy eruption over the submandibular regions, trunk and extremities. History, symptoms and laboratory tests were unremarkable. SARS-CoV-2 antigen was negative. The clinical suspicion of pityriasis lichenoides et varioliformis acuta (PLEVA) was posed, and topical steroids were introduced. One week after, he returned with an extensive painful scaly papulo-erythematous rash, with some ulcerated and necrotic lesions, and fever; therefore the child was hospitalized. Biochemical results were within reference limits, except for high level of C-reactive protein, aspartate aminotransferase, alanine transaminase and bilirubin. Due to a persistently high fever, systemic corticosteroid treatment was administered, with a good clinical response and an improvement of the skin lesions. Anti-PVB-19 Immunoglobulin M was detected. Elevated levels of IL-6, IL-10 and IFN-γ were also recorded. Five days post-admission, most of the lesions had cleared, and the child was discharged. Methotrexate was started, with a positive response. At skin biopsy a “PLEVA-like” pattern was apparent, with a dense, wedge shaped lymphoid infiltrate featuring epidermotropism and morphologically comprising pleomorphic and blastic cells. The pattern of infiltration was highlighted by immunohistochemical stains, which prove the process to feature a CD8+/CD30 + phenotype, the latter being intense on larger cells, with antigenic loss. Polymerase chain reaction for T-cell receptor gamma (TCRG) chain clonality assessment documented a monoclonal peak. A diagnosis of LyP type D was favored. Conclusion The reported case encompasses most of the critical features of two separated entities—PLEVA and LyP—thus providing further support to the concept of them representing declinations within a sole spectrum of disease. Studying the role of infectious agents as trigger potential in lymphoproliferative cutaneous disorders and detecting novel markers of disease, such as cytokines, could have a crucial impact on pathogenic disease mechanisms and perspective therapies.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy.,Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Riccardo Cavalli
- Pediatric Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Giorgio A Croci
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Laura Fiori
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Antonella Fabiano
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Luisa Lunardon
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy
| | - Maria Antonietta Avanzini
- Cell Factory, Pediatric Hematology Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Emilio Berti
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20154, Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, "V. Buzzi" Children's Hospital, Via Castelvetro n.52, 20154, Milan, Italy. .,Department of Biomedical and Clinical Science, University of Milan, 20157, Milan, Italy.
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5
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Jung JM, Lee MY, Won CH, Chang SE, Park CS, Lee MW, Lee WJ. Clinicopathological Factors Associated with the Prognosis and Chronicity of Lymphomatoid Papulosis: A Retrospective Cohort Study. Clin Lymphoma Myeloma Leuk 2022; 22:e541-e548. [PMID: 35307318 DOI: 10.1016/j.clml.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The clinical and pathological features of lymphomatoid papulosis (LYP) are diverse. The objective of this study is to evaluate the clinical and pathological features associated with the prognosis and clinical course of LYP. PATIENTS AND METHODS The clinical and pathological features of LYP in a medical center database were retrospectively retrieved. RESULTS Overall, 58 LYP patients were included in the study. The mean age at diagnosis was 39.1 years and the female-to-male ratio was 1:1.2. More than two-thirds (40/58, 69.0%) of the patients showed a chronic and recurrent disease course. A longer pre-diagnosis duration (odds ratio (OR), 1.01; 95% confidence interval (CI), 1.00-1.03) was significantly associated with secondary lymphoma development. Lower extremity involvement (OR, 10.40; 95% CI, 1.17-92.28) and the absence of eosinophils in the lesions (OR, 11.28; 95% CI, 1.01-126.24) were found to be significantly associated with the chronic and recurrent course of LYP. CONCLUSION A longer pre-diagnosis duration is associated with secondary lymphoma, while a lower extremity involvement and the absence of lesional eosinophil infiltration are associated with the chronicity of LYP.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Young Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chan-Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
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6
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Morita R, Kasai K. Lymphomatoid papulosis during immune checkpoint inhibitor treatment. Int J Hematol 2022; 116:155-157. [PMID: 35723861 DOI: 10.1007/s12185-022-03410-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rena Morita
- Division of Fundamental Health Sciences, School of Nursing and Social Services, Health Sciences University of Hokkaido, Kanazawa 1757, Tobetsu, Hokkaido, 061-0293, Japan.
- Department of Pathology, Otaru General Hospital, Otaru, Japan.
| | - Kiyoshi Kasai
- Department of Pathology, Otaru General Hospital, Otaru, Japan
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7
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Sumitani R, Harada T, Nakamura M, Mizuguchi M, Oura M, Sogabe K, Maruhashi T, Takahashi M, Fujii S, Nakamura S, Miki H, Kagawa K, Yada M, Matsudate Y, Uehara H, Abe M. [Primary cutaneous anaplastic large cell lymphoma with systemic progression responding to low-dose methotrexate therapy]. Rinsho Ketsueki 2022; 63:536-543. [PMID: 35831185 DOI: 10.11406/rinketsu.63.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The standard therapies for primary cutaneous anaplastic large cell lymphoma (pcALCL) in an advanced stage remain undefined. A 71-year-old man presented with multiple erythema and nodules. He was diagnosed with lymphomatoid papulosis (LyP) through a skin biopsy from the left postauricular area. All skin lesions achieved complete response by electron beam irradiation. However, nodular lesions appeared in both inner canthi 5 months later. Histopathological evaluation of the lesional biopsy revealed dominant infiltration of CD30-positive large cells. Positron emission tomography/computed tomography revealed fluorodeoxyglucose-positive cervical and inguinal lymph node swelling and right tonsillitis, followed by the diagnosis of pcALCL and TNM classification T3bN3M0. Since the patient had severe chronic obstructive pulmonary disease and recurrent pneumonia, he received low-dose methotrexate (MTX) (15 mg/week) therapy. Low-dose MTX effectively debulked the lymphadenopathies over time without particular adverse effects. Although the standard therapies for pcALCL are not established, low-dose MTX was effective and considered safe for patients with frailty and compromised respiratory function. Further study is warranted on the pathophysiology of pcALCL after the development of LyP and mechanisms of action of low-dose MTX against LyP and pcALCL.
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Affiliation(s)
- Ryohei Sumitani
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Takeshi Harada
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Masafumi Nakamura
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Makiko Mizuguchi
- Department of Hematology, Tokushima Prefectural Central Hospital
| | - Masahiro Oura
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Kimiko Sogabe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Tomoko Maruhashi
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Mamiko Takahashi
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Shiro Fujii
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
| | - Shingen Nakamura
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences
| | - Hirokazu Miki
- Division of Transfusion Medicine and Cell Therapy, Tokushima University Hospital
| | - Kumiko Kagawa
- Department of Hematology, Tokushima Prefectural Central Hospital
| | - Mio Yada
- Department of Dermatology, Tokushima University School of Medical Science
| | - Yoshihiro Matsudate
- Department of Dermatology, Tokushima University School of Medical Science
- Department of Dermatology, Ehime Prefectural Central Hospital
| | | | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences
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8
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Shirani A, Dalton SR, Avery EJ, Arcot Jayagopal L, Meyer C, Stuve O, Zabad R. Lymphomatoid papulosis in a patient treated with glatiramer acetate and the glatiramoid Glatopa for multiple sclerosis: A case report. J Cent Nerv Syst Dis 2021; 13:11795735211053784. [PMID: 34819759 PMCID: PMC8606967 DOI: 10.1177/11795735211053784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/29/2021] [Indexed: 11/25/2022] Open
Abstract
A 48-year-old Caucasian woman with history of multiple sclerosis (MS) presented with erythematous papulonodular lesions in her extremities and trunk. She was being treated with glatiramer acetate (GA) for the past 10 years and the glatiramoid, Glatopa, for 2 years prior to this presentation. A skin biopsy showed CD30+ lymphoproliferative disorder consistent with lymphomatoid papulosis (LyP). Three weeks after stopping Glatopa, her skin lesions were improved. It remains unclear whether GA’s or Glatopa’s capability to alter T-cell differentiation, may have a link with LyP. This case report is a reminder to be vigilant for skin lesions in patients with MS.
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Affiliation(s)
- Afsaneh Shirani
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | | | - Olaf Stuve
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX; VA North Texas Health Care System, Dallas VA Medical Center, Dallas, TX, USA
| | - Rana Zabad
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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9
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Oura K, Sato T, Iguchi A, Toriumi N, Sarashina T. Lymphomatoid Papulosis Development in Acute Lymphoblastic Leukemia. J Med Cases 2021; 12:306-309. [PMID: 34434478 PMCID: PMC8383590 DOI: 10.14740/jmc3718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 11/11/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is a chronic, recurrent benign skin disease characterized by histological features of a CD 30-positive cutaneous T-cell lymphoproliferative disorder. It is rare, with an annual, worldwide incidence of 1.2 - 1.9 per million, and accounts for 16-47% of pediatric cutaneous lymphoproliferative disorders. It often occurs on the extremities or the trunk and rarely affects the face or genitals. Its onset may be triggered by irradiation therapy, immunomodulating agents, infection or atopic dermatitis. It has a benign course but is associated with certain hematological malignancies. Mycosis fungoides and primary cutaneous anaplastic large cell lymphoma are the most commonly associated hematological malignancies. The incidence of lymphoma in children with LyP has been reported to be 8.5% at most. Most patients who develop lymphomas do so within 4 years of the LyP onset; therefore, patients with LyP should be carefully followed up. Herein, we report a case in which tumors appeared in the left scrotum and under the left lip during maintenance therapy for precursor B-cell acute lymphoblastic leukemia. We needed to distinguish the tumor from extramedullary recurrence of ALL or de novo other cutaneous lymphoma; however, the histological findings of a tumor biopsy resulted in a diagnosis of LyP.
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Affiliation(s)
- Kazumi Oura
- Department of Pediatrics, Kitami Red Cross Hospital, Hokkaido, Japan
| | - Tomonobu Sato
- Department of Pediatrics, Kitami Red Cross Hospital, Hokkaido, Japan
| | - Akihiro Iguchi
- Department of Pediatrics, Hokkaido University Hospital, Hokkaido, Japan
| | - Naohisa Toriumi
- Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan
| | - Takeo Sarashina
- Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan
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10
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Abstract
The cutaneous lymphomas are malignancies of T-cell and B-cell lymphocytes in which the skin is the primary organ of involvement. The cutaneous T-cell lymphomas include variants that can mimic the presentation of common skin diseases or arthropod bites. Mycosis fungoides, the most common cutaneous T-cell lymphoma, usually presents as fixed asymptomatic patches or plaques in sun-protected areas. The cutaneous B-cell lymphomas have fewer variants that often present as papules or nodules that can mimic nonmelanoma skin cancers. Some therapies for cutaneous lymphoma have unique side effects such as central hypothyroidism, hyperlipidemia, and peripheral neuropathy.
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MESH Headings
- Aged
- Aged, 80 and over
- Animals
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents, Immunological/adverse effects
- Arthropods
- Bexarotene/adverse effects
- Bites and Stings/diagnosis
- Brentuximab Vedotin/adverse effects
- Diagnosis, Differential
- Humans
- Hyperlipidemias/chemically induced
- Hypothyroidism/chemically induced
- Lymphoma, Primary Cutaneous Anaplastic Large Cell/diagnosis
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/therapy
- Lymphomatoid Papulosis/diagnosis
- Mycosis Fungoides/diagnosis
- Peripheral Nervous System Diseases/chemically induced
- Prognosis
- Sezary Syndrome/diagnosis
- Skin Diseases/diagnosis
- Skin Diseases/pathology
- Skin Neoplasms/pathology
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Affiliation(s)
- John A Zic
- Department of Dermatology, VU Cutaneous Lymphoma Clinic, Vanderbilt University Medical Center, Vanderbilt Dermatology, One Hundred Oaks, 719 Thompson Lane, Suite 26300, Nashville, TN 37204-3609, USA.
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11
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Truong K, Janz-Robinson E, Khan T, Curtin P, Wells J. Lymphomatoid papulosis presenting on a finger. Australas J Dermatol 2021; 62:e414-e416. [PMID: 34021584 DOI: 10.1111/ajd.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/24/2021] [Accepted: 03/05/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Kelvin Truong
- Department of Dermatology, Westmead Hospital, Sydney
| | | | - Tayyaba Khan
- Department of Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney
| | - Paul Curtin
- Department of Plastic Surgery, Auburn Hospital, Sydney
| | - Jillian Wells
- Department of Dermatology, Westmead Hospital, Sydney
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12
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Baykal C, Kılıç Sayar S, Yazganoğlu KD, Büyükbabani N. Evaluation of Associated Lymphomas and Their Risk Factors in Patients with Lymphomatoid Papulosis: A Retrospective Single-Center Study from Turkey. Turk J Haematol 2021; 38:49-56. [PMID: 33389922 PMCID: PMC7927440 DOI: 10.4274/tjh.galenos.2020.2020.0685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Lymphomatoid papulosis (LyP) is an indolent skin disease with variable clinical features classified among the primary cutaneous CD30+ T-cell lymphoproliferative disorders. It may show association with cutaneous and systemic lymphomas. We aimed to identify the frequency and characteristics of associated lymphomas among Turkish patients with LyP and to determine the risk factors for secondary lymphomas. Materials and Methods: The files of patients diagnosed with LyP between 1998 and 2018 in a tertiary dermatology clinic were retrospectively analyzed. Univariate and multivariate models were used to assess the possible risk factors for secondary lymphomas, such as demographic and clinical characteristics of the patients. Results: Among 61 patients (47 adults, 14 children) with LyP, a total of 22 secondary lymphomas were observed in 20 patients. Nineteen of them were adults. Mycosis fungoides (MF) was the major associated lymphoma (n=19) followed by systemic anaplastic large cell lymphoma (ALCL) (n=2) and primary cutaneous ALCL (n=1). The most common stage in patients with accompanying MF was stage IB (n=11). While 18 patients showed the classical type of MF, one patient had folliculotropic MF. When the risk factors for association between LyP and other lymphomas were evaluated, only older age was found to be a significant risk factor and existence of ulcerated lesions was found to be a negative indicator. Conclusion: LyP is not rare in the pediatric population. MF is the most common associated lymphoma in patients with LyP. Adult LyP patients are more commonly associated with secondary lymphomas than pediatric patients. Older age at the time of diagnosis of LyP is a significant risk factor for associated lymphomas.
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Affiliation(s)
- Can Baykal
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul, Turkey
| | - Sıla Kılıç Sayar
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul, Turkey
| | - Kurtuluş Didem Yazganoğlu
- İstanbul University, İstanbul Faculty of Medicine, Department of Dermatology and Venereology, İstanbul, Turkey
| | - Nesimi Büyükbabani
- İstanbul University, İstanbul Faculty of Medicine, Department of Pathology, İstanbul, Turkey
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13
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Georgesen C, Magro C. Lymphomatoid papulosis in children and adolescents: A clinical and histopathologic retrospective cohort. Ann Diagn Pathol 2020; 46:151486. [PMID: 32172217 DOI: 10.1016/j.anndiagpath.2020.151486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND, AIMS AND OBJECTIVES Lymphomatoid papulosis (LyP) is a CD30+ lymphoproliferative disorder that is rare and not well described within the pediatric subpopulation. We sought to review the literature and characterize clinical and pathologic features among pediatric and adolescent patients diagnosed with LyP at a tertiary care center. MATERIALS AND METHODS A retrospective cohort of 27 pediatric and adolescent patients (defined as <20 years old) diagnosed with LyP at the Weill Cornell Medicine Dermatopathology division from 2006 to 2016 was identified. Subsequently, we reviewed the histopathologic characteristics and collected clinical follow-up data from patients and their providers. The parameters assessed included the pathological LyP subtype including the immunohistochemical staining pattern, the development of secondary lymphoma, disease duration and rate of remission. RESULTS While type A was the most prevalent subtype, B and C subtypes were also frequently observed. CD8 predominance was a common finding, especially among type B LyP patients and those with eccrinotropic granulomatous features. None of the patients with clinical follow-up have developed secondary lymphoma, and some patients experienced remission of their disease. CONCLUSION While type A appears to be the dominant variant described in children, types B, C, and even the newly described variants E and F may occur more often than previously reported. Pediatric LyP may be more indolent than the adult variant, but close clinical follow-up is still warranted.
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Affiliation(s)
- Corey Georgesen
- Weill Cornell Medical College, Department of Pathology & Laboratory Medicine, New York, NY, United States of America.
| | - Cynthia Magro
- Weill Cornell Medical College, Department of Pathology & Laboratory Medicine, New York, NY, United States of America
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14
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Abstract
This review describes the latest advances in the diagnosis of cutaneous T-cell lymphoma focusing on the most clinically useful features introduced since the publication of the World Health Organization revision in 2017. Clinical entities described include mycosis fungoides, Sézary syndrome, lymphomatoid papulosis, primary cutaneous anaplastic large cell lymphoma, primary cutaneous gamma delta T-cell lymphoma, primary cutaneous acral CD8+ T-cell lymphoma, primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, and hydroa-vacciniforme-like lymphoproliferative disorder. Distinguishing histologic clues to diagnosis are discussed, and important molecular advances are described. Key prognostic indicators that may assist clinicians with timely and appropriate management options are presented.
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Affiliation(s)
- Margaret Cocks
- Department of Pathology, University of Virginia, PO Box 800214, 1215 Lee Street, Hospital Expansion Building Room 2015, Charlottesville, VA 22908, USA
| | - Pierluigi Porcu
- Division of Medical Oncology and Hematopoietic Stem Cell Transplantation, Jefferson University, Suite 420A, 925 Chestnut Street, Philadelphia, PA 19107, USA
| | - Mark R Wick
- Department of Pathology, University of Virginia, PO Box 800214, 1215 Lee Street, Hospital Expansion Building Room 3020, Charlottesville, VA 22908, USA
| | - Alejandro A Gru
- Department of Pathology, University of Virginia, PO Box 800214, 1215 Lee Street, Hospital Expansion Building Room 3018, Charlottesville, VA 22908, USA.
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15
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Maggio A, Climent F, Turégano P, Sirvent JJ. [Multisystem histiocytosis of Langerhans cells associated with Lymphomatoid papulosis: An accidental finding? Case report and literature review]. Rev Esp Patol 2019; 52:130-135. [PMID: 30902378 DOI: 10.1016/j.patol.2018.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/24/2018] [Accepted: 04/29/2018] [Indexed: 10/28/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a disease characterized by proliferation of CD1a+dendritic cells with local or diffuse organ compromise. The identification of recurrent gene mutations has confirmed the hypothesis of LCH as a true neoplasm. Lymphomatoid papulosis (LyP) belongs to the spectrum of CD30+primary cutaneous lymphomas. LCH has been described in association with other lymphoproliferative disorders. However, lesions constituted by Langerhans cells (LC) have been commonly considered reactive, related to cytokines produced by the lymphoma-microenvironment interaction. Some authors designate these lesions as "Langerhans cells-like lesions". We present the case of a 28-years-old woman with multisystem LCH and simultaneous PyL lesions with reactive LC hyperplasia.
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Affiliation(s)
- Antonio Maggio
- Servicio de Anatomía Patológica, Hospital Universitario Joan XXIII, Tarragona, España.
| | - Fina Climent
- Servicio de Anatomía Patológica, Hospital Universitario de Bellvitge-IBIDELLL, L'Hospitalet de Llobregat , España
| | - Pilar Turégano
- Servicio de Dermatología, Hospital Universitario Joan XXIII, Tarragona, España
| | - Juan Jose Sirvent
- Servicio de Anatomía Patológica, Hospital Universitario Joan XXIII, Tarragona, España; Universidad Rovira i Virgili, Tarragona, España; Institut d'Investigació Sanitària Pere Virgili, Tarragona, España
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16
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Menter T, Ballova V, Caspar C, Wolff T, Kasenda B, Singer G, Juskevicius D, Tzankov A, Dirnhofer S. ALK-negative anaplastic large cell lymphoma arising in the thrombus of an aortic prosthesis preceeded by clonally related lymphomatoid papulosis. Virchows Arch 2019; 474:763-767. [PMID: 30685783 DOI: 10.1007/s00428-019-02531-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 12/15/2022]
Abstract
We report on a 73-year-old male patient with recurrent thrombosis of his infrarenal aortic prosthesis. Histologically, the thrombus contained cells of an ALK-negative anaplastic large cell T cell lymphoma (ALCL). Imaging studies were negative for other lymphoma manifestations; however, 3 months before, the patient had developed skin lesions consistent with lymphomatoid papulosis type A (LypA) which were clonally related to the ALCL. Due to recurrent thrombosis of larger peripheral arteries with the presence of ALCL cells in the thrombi, the patient is now referred to systemic chemotherapy. We present the first case of ALCL manifesting in the thrombus of an aortic prosthesis. This case shows similarities to the well-established entity of breast implant-associated ALCL and anecdotal reports of ALCL occurring at the site of foreign material implants. These cells show a peculiar propensity to aggregate in vessels and thrombi, known primarily from subtypes of diffuse large B cell lymphomas associated with chronic inflammation.
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Affiliation(s)
- Thomas Menter
- Institute of Pathology and Medical Genetics, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland
| | - Veronika Ballova
- Department of Medical Oncology, Cantonal Hospital Baden, Baden, Switzerland
| | - Clemens Caspar
- Department of Medical Oncology, Cantonal Hospital Baden, Baden, Switzerland
| | - Thomas Wolff
- Department of Vascular Surgery, University Hospital Basel, Basel, Switzerland
| | - Benjamin Kasenda
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - Gad Singer
- Institute of Pathology, Cantonal Hospital Baden, Baden, Switzerland
| | - Darius Juskevicius
- Institute of Pathology and Medical Genetics, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Pathology and Medical Genetics, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland
| | - Stefan Dirnhofer
- Institute of Pathology and Medical Genetics, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, Switzerland.
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17
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Abstract
Primary cutaneous CD30-positive lymphoproliferative disorders (CD30+ LPD) encompass lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (pcALCL), and borderline lesions [1]. CD30+ LPD are the second most common cutaneous T-cell lymphomas (CTCL) after mycosis fungoides (MF) and represent approximately 25% of all CTCL cases [2]. Their common phenotypic hallmark is an expression of the CD30 antigen, a cytokine receptor belonging to the tumor necrosis factor (TNF) receptor superfamily. Both LyP and pcALCL show numerous clinical, histological and immunophenotypic variants, and generally have an indolent course with a favorable prognosis. Overlapping features of LyP and pcALCL with other CD30+ T-cell lymphomas, inflammatory, and/or infectious conditions emphasize the importance of careful clinicopathologic correlation and staging.
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Affiliation(s)
- Liana Nikolaenko
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA.
| | - Jasmine Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Steven T Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA
| | - Christiane Querfeld
- Division of Dermatology, City of Hope National Medical Center, Duarte, CA, USA
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA
- Toni Stephenson Lymphoma Center, City of Hope National Medical Center, Duarte, CA, USA
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18
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Affiliation(s)
- Ahmed Bouhamidi
- Department of Dermatology, Ibn Sina University Hospital, Rabat, Morocco
| | - Badreddine Hassam
- Department of Dermatology, Ibn Sina University Hospital, Rabat, Morocco
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19
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Mallet V, Bruneau J, Zuber J, Alanio C, Leclerc-Mercier S, Roque-Afonso AM, Kraft ARM, Couronné L, Roulot D, Wedemeyer H, Albert ML, Hillon P, Laroche L, Pol S, Hermine O. Hepatitis E virus-induced primary cutaneous CD30(+) T cell lymphoproliferative disorder. J Hepatol 2017; 67:1334-1339. [PMID: 28860025 DOI: 10.1016/j.jhep.2017.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 08/07/2017] [Accepted: 08/17/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIM Several types of unexplained extra-hepatic manifestations, including haematological disorders, have been reported in the context of hepatitis E virus (HEV) infection. However, the underlying mechanism(s) of these manifestations are unknown. We provide evidence that HEV has an extra-hepatic endothelial tropism that can engage cutaneous T cells towards clonality. METHODS A patient with a CD30(+) cutaneous T cell lymphoproliferative disorder (T-LPD) and biopsy-proven chronic HEV infection received three rounds of oral ribavirin treatment, administered either without or with interferon, and eventually achieved a sustained virologic response (SVR). Pathologic, virologic and immunologic investigations were carried out on biopsied skin lesion, and peripheral blood mononuclear cells between the 2nd and 3rd round of antiviral treatment and biopsied liver. RESULTS Remission of T-LPD was observed upon antiviral treatment, and the patient remained in complete remission after achieving SVR. The T cell analysis showed large CD30(+) lymphocytes surrounding the blood vessels within the CD8(+) T cell infiltrate. HEV was detected within dermal microvascular endothelial cells using immunofluorescence staining, in situ hybridisation and electron microscopy. Infiltrating T cells mostly comprised memory CD8(+) T cells with a tissue-resident memory T cell phenotype. Overall, 98% of extracted T cells were CD8(+) T cells with aVβ signature skewed towards Vβ4 and with an oligoclonal profile. T cell clones from T-LPD were more like T cells in the liver than T cells in the blood [odds ratio=4.55, (3.70-5.60), p<0.0001]. No somatic mutations were found in the T-LPD exomes. CONCLUSION HEV has an extra-hepatic tissue tropism in humans, including dermal endothelium, and can induce CD30(+) T-LPD that is sensitive to antivirals. LAY SUMMARY Hepatitis E virus (HEV) has an extra-hepatic tissue tropism and should be added to the list of viruses associated with lymphoproliferative disorders. As such, HEV should be part of the laboratory workup of any lymphoproliferation, particularly those of the T cell phenotype that involve the skin. In the context of HEV-associated cutaneous T cell lymphoproliferative disorders, antiviral treatment could be considered a first-line treatment instead of chemotherapy.
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Affiliation(s)
- Vincent Mallet
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin - Port Royal, Hepatology Service, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité 1223, Institut Pasteur, Paris, France.
| | - Julie Bruneau
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker - Enfants Malades, Pathology Department, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité 1163, Centre National de la Recherche Scientifique, Equipes de Recherche Labellisées 8254, Institut Imagine, Paris, France
| | - Julien Zuber
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker - Enfants Malades, Renal Transplantation Service, Paris, France
| | - Cécile Alanio
- Institut National de la Santé et de la Recherche Médicale, Unité 1223, Institut Pasteur, Paris, France; Immunobiology of Dendritic Cells Unit, Institut Pasteur, Paris, France
| | - Stéphanie Leclerc-Mercier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker - Enfants Malades, Pathology Department, Paris, France
| | - Anne-Marie Roque-Afonso
- Université Paris-Sud, Orsay, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Virology Department, Hôpital Paul Brousse, Villejuif, France; Institut National de la Santé et de la Recherche Médicale Unite, Unite 1193, Villejuif, France
| | - Anke R M Kraft
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School; German Center for Infection Research (DZIF), Hannover, Germany
| | - Lucile Couronné
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité 1163, Centre National de la Recherche Scientifique, Equipes de Recherche Labellisées 8254, Institut Imagine, Paris, France; Assistance Publique-Hopitaux de Paris (AP-HP), Hôpital Necker - Enfants Malades, Haematology Service, Paris, France
| | - Dominique Roulot
- Assistance Publique-Hopitaux de Paris (AP-HP), Hôpital Avicenne, Hepatology Service, Bobigny, France
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School; German Center for Infection Research (DZIF), Hannover, Germany
| | - Matthew L Albert
- Institut National de la Santé et de la Recherche Médicale, Unité 1223, Institut Pasteur, Paris, France; Immunobiology of Dendritic Cells Unit, Institut Pasteur, Paris, France; Department of Cancer Immunology, Genentech, South San Francisco, CA, USA
| | - Patrick Hillon
- Université Bourgogne Franche-Comté, Dijon, France; Hôpîtal Le Bocage, Hepatology and Gastroenterology Service, Dijon, France
| | - Liliane Laroche
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Avicenne, Department of Dermatology, Bobigny, France
| | - Stanislas Pol
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin - Port Royal, Hepatology Service, Paris, France; Institut National de la Santé et de la Recherche Médicale, Unité 1223, Institut Pasteur, Paris, France
| | - Olivier Hermine
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Institut National de la Santé et de la Recherche Médicale Unité 1163, Centre National de la Recherche Scientifique, Equipes de Recherche Labellisées 8254, Institut Imagine, Paris, France; Assistance Publique-Hopitaux de Paris (AP-HP), Hôpital Necker - Enfants Malades, Haematology Service, Paris, France
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20
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Abstract
Cutaneous T-cell lymphomas comprise a heterogeneous group of diseases characterized by monoclonal proliferations of T lymphocytes primarily involving skin, modified skin appendages, and some mucosal sites. This article addresses the basic clinical, histologic, and immunohistochemical characteristics of this group of diseases, with additional attention to evolving literature on dermoscopy, reflectance confocal microscopy, flow cytometry, and molecular data that may increasingly be applied to diagnostic and therapeutic algorithms in these diseases. Select unusual phenotypes or diagnostic examples of classic phenotypes are demonstrated, and flags for consideration while making a pathologic diagnosis of cutaneous T-cell lymphoma are suggested.
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Affiliation(s)
- Melissa Pulitzer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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21
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Wang TT, Xie Y, Li L, Wang L. [ Lymphomatoid papulosis: a clinicopathologic analysis and whole exome sequencing]. Zhonghua Bing Li Xue Za Zhi 2017; 46:601-606. [PMID: 28910869 DOI: 10.3760/cma.j.issn.0529-5807.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To study the clinicopathologic characteristics and immunophenotype of lymphomatoid papulosis(LyP), followed by exon mutation analysis with focus on gene mutations involved in apoptosis pathway and other possible pathogenic genes. Methods: Clinical data analysis and immunohistochemical staining were carried out in 20 cases of LyP. Whole exome sequencing technology was employed in 2 cases of type C of LyP. Results: Of the 20 cases, there were 9 males and 11 females with a median age of 28.6 years. Nineteen patients presented with multiple papules and nodules, and one case presented with only one tumor nodule. Of the fifteen cases with available followed-up data, all were alive (20-155 months). Histologically, the tumors primarily involved the dermis and subcutaneous layer, in which 6 were type A, 3 were type B, 10 were type C and 1 was type D. Main infiltration patterns included wedge-shaped, band-like, sheets and large nodular. Immunohistochemistry showed that most cases expressed CD30 in the large tumor cells. Sixteen cases expressed CD3, 17 cases expressed CD4 and 8 cases expressed CD8. Sixteen cases expressed TIA1. Ten cases expressed GrB and 1 case expressed CD15. All but one case did not expressed CD20. All cases did not express ALK1.A total of 101 common non-synonymous mutations were detected in 2 cases of LyP type C by whole exome sequencing, including 87 missense mutations, 6 missense mutation/frame-shift deletions, 2 missense mutation/nonframe-shift deletions, 5 frame-shift deletions, 1 missense mutations/synonymous mutation. Syndecan-1(SDC1), COL4A1, Laminin-5 were involved in the extracellular matrix receptor pathway. Conclusions: Clinical presentations are crucial for the diagnosis of LyP. LyP has a favorable prognosis. SDC1, COL4A1 and Laminin-5 gene mutations may be associated with tumor recurrence or progression into a higher gradelymphoma.
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Affiliation(s)
- T T Wang
- Department of Dermatovenereology, West China Hospital, Sichuan University, Chengdu 610041, China
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22
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Abstract
Primary cutaneous CD30+ lymphoproliferative disorders encompass lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (pcALCL), and indeterminate cases. LyP is a benign disorder characterized by recurrent crops of red or violaceous papulonodules. Patients with LyP are at an increased risk of a secondary malignancy. pcALCL is characterized by a solitary red to violaceous nodule or tumor larger than 20 mm. LyP is benign, is limited to the skin, and self-resolves, with a 5-year survival rate of 100%; pcALCL is limited to the skin and responsive to directed therapies, with a 5-year survival rate of over 95%. Aggressive chemotherapeutic regimens should be avoided.
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MESH Headings
- Disease-Free Survival
- Humans
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, Large-Cell, Anaplastic/metabolism
- Lymphoma, Large-Cell, Anaplastic/mortality
- Lymphomatoid Papulosis/diagnosis
- Lymphomatoid Papulosis/drug therapy
- Lymphomatoid Papulosis/metabolism
- Lymphomatoid Papulosis/mortality
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/mortality
- Risk Factors
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/metabolism
- Skin Neoplasms/microbiology
- Survival Rate
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Affiliation(s)
- Maxwell B Sauder
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - John T O'Malley
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA.
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23
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Abstract
Cutaneous CD30+ T-cell lymphoproliferative disorders (CD30+ T-LPD) represent a spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL) and borderline lesions. They share the expression of CD30 as a common phenotypic marker. They differ however in their clinical presentation, the histological features and clinical course. Moreover, LyP and PcALCL show numerous clinical, histological and phenotypic variants. Overlapping features of LyP and pcALCL with themselves and with other cutaneous and systemic lymphomas emphasize the importance of careful clinicopathologic correlation and staging in the diagnosis of CD30+ T-LPD. Furthermore, an increasing number of inflammatory and infectious skin disorders harboring medium-sized to large CD30+ cells have to be considered in the differential diagnosis. Whereas the expression of CD30 in cutaneous CD30+ T-LPD stands for a favourable prognosis, its expression in other cutaneous and systemic lymphomas has a divergent impact. The assessment of CD30 expression does not only provide prognostic information, but is of potential therapeutic relevance as CD30 can serve as a therapeutic target. This review focuses on the clinicopathological and phenotypic spectrum of CD30+ T-LPD, its differential diagnoses and the role of CD30 as a diagnostic, prognostic and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091, Zurich, Switzerland.
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24
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Lange HJ, Agertoft L, Møller MB, Clemmensen O, Kristensen T, Vestergaard H, Mørtz CG, Bindslev-Jensen C, Broesby-Olsen S. A child with mastocytosis and lymphomatoid papulosis. Clin Case Rep 2016; 4:517-9. [PMID: 27190619 PMCID: PMC4856249 DOI: 10.1002/ccr3.551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 01/06/2016] [Accepted: 03/09/2016] [Indexed: 11/11/2022] Open
Abstract
A change in clinical behavior of a disease should prompt search for differential diagnoses. Here, the appearance of ulcerated skin nodules in a preexisting cutaneous mastocytosis revealed a concurrent lymphomatoid papulosis – a CD30+ lymphoproliferative skin disease with histological features of a malignant lymphoma, but with a benign self‐healing course.
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Affiliation(s)
- Henriette Juel Lange
- Department of Dermatology and Allergy Centre Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Lone Agertoft
- Hans Christian Andersen Children's Hospital Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Michael Boe Møller
- Department of Pathology Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Ole Clemmensen
- Department of Pathology Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Thomas Kristensen
- Department of Pathology Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Hanne Vestergaard
- Department of Haematology Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Charlotte G Mørtz
- Department of Dermatology and Allergy Centre Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
| | - Sigurd Broesby-Olsen
- Department of Dermatology and Allergy Centre Odense University Hospital Sdr. Boulevard 29, 5000 Odense C Denmark
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25
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Cordel N, Tressières B, D'Incan M, Machet L, Grange F, Estève É, Dalac S, Ingen-Housz-Oro S, Bagot M, Beylot-Barry M, Joly P. Frequency and Risk Factors for Associated Lymphomas in Patients With Lymphomatoid Papulosis. Oncologist 2015; 21:76-83. [PMID: 26668250 DOI: 10.1634/theoncologist.2015-0242] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is classified as an indolent cutaneous lymphoma, but outcome dramatically worsens if LyP is associated with lymphoma. The frequency of this association remains unclear in the literature. Here, we assess the frequency and risk factors of association between LyP and another lymphoma in an 11-year retrospective study conducted in 8 dermatology departments belonging to the French Study Group on Cutaneous Lymphoma (FSGCL). PATIENTS AND METHODS Patients with LyP were identified and data extracted from the FSGCL registry between 1991 and 2006. Patients were followed up to January 2014. Age, sex, number of skin lesions, histologic subtype, and genotype were recorded at baseline. Risk factors were determined using univariate and multivariate analysis. Cumulative probability of association was calculated using the Kaplan-Meier method. RESULTS We observed 52 cases of lymphomas (cutaneous, n = 38; systemic, n = 14) in 44 of 106 patients (41%). Lymphoma diagnosis was concomitant with or prior to LyP diagnosis in 31 cases and occurred during the course of LyP in 21 cases (cutaneous, n = 14; systemic, n = 7; median delay: 5 years; interquartile range: 1.5-7 years). In multivariate analysis, main prognostic factors for association between LyP and another lymphoma were older age (odds ratio [OR]: 1.05 per year; 95% confidence interval [CI]: 1.01-1.08; p = .011) and presence of a T-cell clone in LyP lesions (OR: 7.55; 95% CI: 2.18-26.18; p = .001). CONCLUSION Older age and presence of a T-cell clone in LyP lesions are risk factors for associated lymphomas in patients with LyP. These findings should help to identify patients who require close management in clinical practice. IMPLICATIONS FOR PRACTICE The management of lymphomatoid papulosis (LyP) is that of an indolent cutaneous lymphoma, based on its excellent prognosis. However, this good prognosis is altered if LyP is associated with lymphoma. Furthermore, risk factors for and frequency of this association remain unclear in the literature. The results presented here demonstrate a high rate of association between LyP and other lymphomas (41%) as well as a long median delay of occurrence (5 years), which emphasizes the need for prolonged follow-up of patients with LyP. Moreover, two main risk factors (i.e., older age and presence of a T-cell clone in LyP lesions) are highlighted, which should help clinical practitioners to identify patients who require close management.
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Affiliation(s)
- Nadège Cordel
- Unit of Dermatology and Internal Medicine, Guadeloupe University Hospital and EA 4546, Antilles University, Pointe-à-Pitre, Guadeloupe
| | - Benoît Tressières
- Centre d'investigation clinique Antilles-Guyane, INSERM CIC 1424, Pointe-à-Pitre, Guadeloupe
| | - Michel D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, University of Auvergne, Clermond-Ferrand, France
| | - Laurent Machet
- Department of Dermatology, Tours University Hospital and François Rabelais University, Tours, France
| | - Florent Grange
- Department of Dermatology, Robert Debré Hospital and EA 7319, University of Reims Champagne-Ardennes, Reims, France
| | - Éric Estève
- Department of Dermatology, Orléans Regional Hospital, Orléans, France
| | - Sophie Dalac
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | | | - Martine Bagot
- Department of Dermatology, Paris University Hospitals-St Louis and INSERM U 976, Denis Diderot University, Sorbonne Paris Cité, Paris, France
| | - Marie Beylot-Barry
- Department of Dermatology, Bordeaux University Hospital and EA 2406, University of Bordeaux, Bordeaux, France
| | - Pascal Joly
- Department of Dermatology, Rouen University Hospital and INSERM U 519, Institute for Research and Innovation in Biomedicine, Rouen University, Rouen, Normandy, France
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26
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Abstract
Primary cutaneous CD30⁺ lymphoproliferative disorders (LPDs) account for approximately 25% of cutaneous lymphomas. Although these LPDs are clinically heterogeneous, they can be indistinguishable histologically. Lymphomatoid papulosis rarely requires systemic treatment; however, multifocal primary cutaneous anaplastic large cell cutaneous lymphoma and large cell transformation of mycosis fungoides are typically treated systemically. As CD30⁺ LPDs are rare, there is little published evidence to support a specific treatment algorithm. Most studies are case reports, small case series, or retrospective reviews. This article discusses various treatment choices for each of the CD30⁺ disorders and offers practical pearls to aid in choosing an appropriate regimen.
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Affiliation(s)
- Lauren C Hughey
- University of Alabama at Birmingham, 1530 3rd Avenue South, EFH 414, Birmingham, AL 35294, USA.
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27
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Nasit JG, Patel SC. Primary Cutaneous CD8(+) CD30(+) Anaplastic Large Cell Lymphoma: An Unusual Case with a High Ki-67 index-A Short Review. Indian J Dermatol 2015; 60:373-7. [PMID: 26288406 PMCID: PMC4533536 DOI: 10.4103/0019-5154.160483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a part of the spectrum of CD30+ cutaneous lymphoproliferative disorder, characterized by variable degrees of CD2, CD3, CD4 and CD5 expression by lymphoid cells. PCALCLs with an expression of cytotoxic phenotype (CD8+) and cytotoxic proteins are uncommon. Cutaneous CD8+ CD30+ lymphoproliferative lesions are difficult to classify, diagnose and may be the cause of misdiagnose. CD8+ PCALCL must be distinguished from CD8+ mycosis fungoides, lymphomatoid papulosis type D and primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma. Usually CD8+ PCALCL is an indolent disease with a favorable prognosis, except few cases can show poor outcomes. The high Ki-67 index points toward advanced PCALCL. Treatment modalities include surgical excision, radiotherapy and clinical monitoring. Chemotherapy is reserved for disseminated disease. We report a 59-year-old male presented with rapid development of multiple painful reddish-brown plaques and nodular ulcerative skin lesions over the left thigh region since 2 months. A diagnosis of CD8+ PCALCL with a high Ki-67 index was made on the basis of histology and immunohistochemistry, in co-relation with clinical presentation.
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Affiliation(s)
- Jitendra G Nasit
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
| | - Smita C Patel
- Department of Pathology, Medical College and Sir Sayajirao General Hospital, Baroda, Gujarat, India
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28
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Benslama L, Andre CV, Charlotte F, Agbo-Godeau S, Goudot P. [Mucosal lymphomatoid papulosis: 2 cases]. ACTA ACUST UNITED AC 2015; 116:111-3. [PMID: 25800967 DOI: 10.1016/j.revsto.2015.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 01/22/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Lymphomatoid Papulosis (LP) is a chronic dermatosis progressing by flare-up. According to the WHO-EORTC classification, LP is a form of CD30+ primitive cutaneous lympho-proliferation. Mucosal lesions are rare, with 15 published cases. We report two new cases of oral localizations, without any cutaneous involvement. PATIENTS AND METHODS Two women, 32 and 63 years old, presented with an isolated painful oral ulceration, of the maxillary tuberosity and of the inner side of the cheek respectively. The general state of health was preserved. Immunohistochimical analysis of the biopsies showed two Type A LPs. Lesions spontaneously resolved. DISCUSSION Among the rare published cases, oral localization involved exclusively the tongue and the labial mucosa and almost all patients presented with previous cutaneous lesions. Isolated maxillary tuberosity or cheek involvements were not described yet.
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29
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Abstract
Cutaneous CD30+ lymphoproliferative disorders are the second most common types of cutaneous T-cell lymphomas. They represent a well-defined spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL), and borderline lesions. They share the expression of CD30 as a common phenotypic hallmark, but they differ in their clinical presentation, course, and histologic features. New variants have been recently identified, including CD8+ epidermotropic LyP type D, angioinvasive LyP type E, and ALK-positive pcALCL. This review describes clinical, histopathologic, and phenotypic variants; their differential diagnoses (benign and malignant); and the role of CD30 as a diagnostic, prognostic, and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Seminarstrasse 1, Zürich CH-8042, Switzerland; Department of Dermatology, University Hospital, Zürich CH-8091, Switzerland.
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30
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Abstract
Lymphomatoid papulosis (LyP) is defined as a histologically malignant, but clinically benign condition. It can appear as erythematous pink to purple papules or nodules. Immunophenotyping studies of the lymphomatoid papulosis lesions have shown a predominance of a CD4 expression and negativity for CD8. However, a positive CD8 expression has rarely been reported for LyP. Herein we report on a case of CD8 positive lymphomatoid papulosis in a 43-year-old man. The patient presented with erythematous, asymptomatic papules on the left axilla and thigh. Histopathologically, there was a wedge-shaped infiltrate composed of a mixture of various cell types, including lymphocytes, histiocytes, neutrophils and large atypical lymphoid cells. Immunophenotyping revealed the neoplastic cells were positive for CD3, CD8 and CD30 and they were negative for CD4, CD20 and CD56.
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Affiliation(s)
- Ji Hyun Sim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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31
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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