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Heavy multinodular cutaneous lymphoid infiltrates: clinicopathologic features and B‐cell clonality
Author(s) -
Ceballos K. M.,
Gascoyne R. D.,
Martinka M.,
Trotter M. J.
Publication year - 2002
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1034/j.1600-0560.2002.290306.x
Subject(s) - pathology , lymphoma , population , lymphoid hyperplasia , medicine , cutaneous lymphoma , lymphatic system , lymphoproliferative disorders , b cell , lesion , biology , mycosis fungoides , immunology , antibody , environmental health
Background: Criteria for distinguishing between cutaneous lymphoid hyperplasia (CLH) and low‐grade B‐cell lymphoma are not well defined. We examined the hypothesis that the presence of a clonal B‐cell population in heavy multinodular lymphoid infiltrates correlates with clinical presentation and outcome. Methods: We identified 29 patients with skin lesions characterized histologically by a heavy dermal lymphocytic infiltrate with a multinodular architecture and extension into deep dermis and subcutaneous fat. Clonality was assessed immunophenotypically by light‐chain restriction and also by analysis for IgH‐gene rearrangement using PCR on DNA extracted from paraffin blocks. Results: Follow‐up (mean 80 months; median 45 months) was obtained in all patients. Twenty‐four patients (83%) presented with a solitary lesion: only four had solitary recurrences, and none developed multiple synchronous lesions or systemic B‐cell lymphoma. However, 9/24 of these solitary lesions (38%) were clonal by light‐chain restriction or IgH PCR; 5/29 patients (17%) presented with multiple recurrent lesions and continued to develop lesions during the period of follow‐up; 3/5 patients (60%) with multiple lesions demonstrated a B‐cell clone. No patient developed systemic B‐cell lymphoma. Conclusions: Heavy, multinodular cutaneous lymphoid infiltrates have an excellent prognosis. Multiple lesions at presentation are the best predictor of recurrent multiple lesions confined to the skin. The presence of a clonal B‐cell population does not correlate with clinical presentation or histology, nor does it predict development of further lesions or systemic lymphoma.