Epidermotropic CD8 positive lymphoproliferative diseases: histological and immunophenotypic similarities but markedly differing clinical behaviour (original) (raw)

Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis

Journal of Cutaneous Pathology, 2016

Lymphomatoid papulosis (LyP) belongs to the group of CD30+ lymphoproliferative disorders in the WHO/EORTC Classification of Cutaneous T-cell lymphomas.(1) Clinical manifestation of LyP is characterized by waxing and waning papules, small nodules with varying degrees of central haemorrhage, ulceration and necrosis.(2) LyP eruptions evolve and regress within weeks without significant systemic symptoms. The prognosis is favourable except cases with preceding, simultaneous or subsequent association of secondary lymphomas. Mycosis fungoides (MF), anaplastic large cell lymphoma (ALC) and Hodgkin lymphoma occur in 10-30 per cent of LyP cases.(3-7) Three classic subtypes (A,B,C) of LyP with distinct histopathologic characteristics were defined.(8) The atypical cell component of types A and C are large cells with CD4+/CD30+ phenotype(8), while in type B the characteristic epidermotropic infiltrate is composed of CD4+ atypical small lymphoid cells that express weak CD30 antigen or may show CD30 negativity.

Lymphomatoid papulosis: a study of 18 cases*

Journal of the European Academy of Dermatology and Venereology, 1992

Lymphomatoid papulosis (LyP) is a cutaneous eruption that is clinically benign but histologically malignant. To date, more than 300 cases have been published. About 10-20% of the patients develop a lymphoma. The purpose of this study was to make a clinicopathological study of 18 patients diagnosed with LyP in our hospital from 1973 to 1990, to characterize cellular infiltrates in the lesions, to find clonal populations of T-cells and to look for predictive factors of malignant lymphoma in LyP patients. Mean age was 48.7 years. The most frequent clinical lesions were papules (88.8%) followed by plaques (38.8%). The localizations were on extremities (loo%), trunk (88%), face (22%), palms or soles (ll%), perigenital(ll%) and scalp (5%). Two patients have been free of disease for more than 5 years. IgA levels are increased in LyP patients. Neither HTLV I nor 111 can be considered as a cause of the LyP in any of our patients. Associated diseases were found in 6 cases (1 mycosis fungoides, 1 Hodgkin's disease, 2 anaplastic large-cell lymphoma and 2 large plaque parapsoriasis). Some types of parapsoriasis should be included in the 'spectrum of Ki-1 lymphomas'. 52 skin biopsies were studied. 17% were type A of Willemze, 67% were type B and 15% were transitional. In 12 of the samples follicular or perifollicular infiltration was found. Follicular LyP should not be considered as a distinct type of LyP. Vasculitis is an uncommon finding in LyP. In all the cases studied, large atypical cells were CD30 + ; 5/7 cases had lost CD5 and 4/5 cases had lost CD7. In one case, all T-cell antigens were negative. Cerebriform mononuclear cells were always recognized by T-cell antibodies and they were CD30 positive in only two cases. In one case there were more

The importance of histopathology findings in lymphomatoid papulosis

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2014

Lymphomatoid papulosis, part of the controversial group of cutaneous lymphoproliferative pseudolymphoma disorders, raises important clinical and histopathological problems. It is a chronic, recurrent, clinically characterized by popular necrotic lesions and papulo-pustular nodules, sometimes self-limiting and characterized by histopathological changes suggestive of cutaneous lymphoma (CD30-positive). Since its introduction, in 1968, the term "lymphomatoid papulosis" was subject to dispute in terms of classification in malignancies, premalignant or benign skin disease. We submit for consideration the case of a man with papulo-necrotic skin lesions evolving for about one year with post therapeutic remission and relapses, with histopathology of lymphomatoid papulosis. The evolution under systemic glucocorticoids has been favorable, with remission of skin lesions in about three months without relapses to date.

Dermoscopy of different stages of lymphomatoid papulosis

frequent occurrence in the elderly population, who otherwise are at risk of developing both, malignancies and BP independently. BP presenting at a relatively younger age, as in our patient supports the concept of 'pemphigoid associated with malignancy'. 10 Our patient also fulfilled the criteria described for paraneoplastic disorders. At the time of writing this report, the index case is not receiving any active treatment for his BP (which has not relapsed), and is currently receiving radiotherapy for his penile lesion.

Type D Lymphomatoid Papulosis: An uncommon Variant. A case report and review of the literature

Lymphomatoid papulosis (LyP) is an indolent form of primary cutaneous T-cell lymphoma, currently classified together with primary cutaneous anaplastic large T-cell lymphoma within the spectrum of CD30-positive lymphoproliferative disorders. It is characterized by presenting as a clinically benign but histopathological malignant disease. Clinical features consist in recurrent waxing and waning red papules. Histopathologically, there are 4 variants recognized, Type A or Hystiocitic type, being the most frecuent of all, Type B or Mycosis fungoides-like, Type C or Anaplastic large-cell lymphoma-like and Type D, the most recently described and uncommon variant with features similar to Cutaneous Aggressive CD8-Positive Cytotoxic T-Cell Lymphoma. We present a case of a 22-year-old female with multiple papules and nodules in trunk and limbs that after histopathological and immunochemical examination was compatible with Type D LyP. It is important to report this case, as a perfect example of an uncommon variant of LyP, with emphasis in its typical clinical, histopathological and inmunohistochemical findings and review of the literature.