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The differential diagnosis of CD8‐positive (“type D”) lymphomatoid papulosis
Author(s) -
McQuitty Elizabeth,
Curry Jonathan L.,
Tetzlaff Michael T.,
Prieto Victor G.,
Duvic Madeleine,
TorresCabala Carlos
Publication year - 2014
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 - 10.1111/cup.12243
Subject(s) - lymphomatoid papulosis , cd30 , medicine , pathology , differential diagnosis , mycosis fungoides , anaplastic large cell lymphoma , lymphoma , cutaneous lymphoma , histopathology , lymphoproliferative disorders , biopsy , dermatopathology
Background Cutaneous CD8 + CD30 + lymphoproliferative lesions are difficult to classify and encompass entities that follow a benign course to overt lymphoma. In order to identify histopathologic criteria for lesions in this spectrum, a series of such cases was reviewed. Methods Twenty‐eight biopsies from 27 patients with CD8 + CD30 + cutaneous lymphoid proliferations were evaluated. Results Seventeen cases were classified as lymphomatoid papulosis ( LyP ) ‘type D’, eight as cutaneous anaplastic large cell lymphoma ( C‐ALCL ) and two as CD8 + mycosis fungoides ( MF ) with CD30 expression. Features of LyP included spongiosis and/or parakeratosis (90%), epidermotropism by large lymphocytes (90%), with (80%) or without (10%) small lymphocytes; wedge‐shaped infiltrate (70%) with perivascular (100%) and interstitial (80%) pattern; and relative uniformity of CD30 + large atypical cells (90%). C‐ALCL was characterized by ulceration (63%), epidermotropism restricted to small lymphocytes (100%), marked density (63%) and pleomorphism (62%) of CD30 + large atypical cells, and at least focal extension of infiltrate to subcutaneous tissue (88%). CD8 + CD30 + MF had vacuolar interface change and a lichenoid pattern (100%). Conclusions We concur with previous authors that distinction of CD8 + LyP from lymphoma in its differential diagnosis is difficult based on histopathology alone. Nonetheless, we propose that certain histopathologic clues may be helpful in this differential diagnosis.