Premium
Cutaneous localization of angioimmunoblastic T‐cell lymphoma may masquerade as B‐cell lymphoma or classical Hodgkin lymphoma: A histologic diagnostic pitfall
Author(s) -
Szablewski Vanessa,
Dereure Olivier,
René Céline,
Tempier Ariane,
Durand Luc,
Alame Melissa,
Cacheux Valère,
CostesMartineau Valérie
Publication year - 2019
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.13382
Subject(s) - lymphoma , pathology , cd30 , cd15 , medicine , cd20 , angioimmunoblastic t cell lymphoma , immunophenotyping , histiocyte , anaplastic large cell lymphoma , b cell , b cell lymphoma , t cell , immunology , biology , antibody , flow cytometry , cd34 , stem cell , genetics , immune system
Background We report the cases of three patients presenting skin lesions whose biopsies showed nodular polymorphic infiltrates consisting of lymphocytes, plasma cells, histiocytes, eosinophils, B blasts, and Hodgkin Reed‐Sternberg (HRS)‐like cells. Two of them were initially diagnosed as classical Hodgkin lymphoma (cHL), on the other hand, the last one as a B‐cell lymphoma. All patients have been treated for angioimmunoblastic T‐cell lymphoma (AITL). Methods We performed a second review of the skin biopsies with further immunophenotypic molecular analyses. Scrupulous observation revealed, in the background of the three cases, atypical small to medium‐sized lymphocytes carrying a CD3+, CD4+ T‐cell phenotype and expressing PD1 and CXCL13 follicular helper T‐cell markers. The two lesions initially diagnosed as cHL showed scattered HRS‐like cells with CD30+, CD15+, PAX5+, CD20−, Epstein Barr Virus (EBV) + classical phenotype. The case initially diagnosed as B‐cell lymphoma showed a diffuse B‐cell proliferation associated with small B‐cell and medium to large‐sized B blasts that were positive for EBV. Conclusion Those cases highlighted that atypical T‐cells may be obscured by B‐cell proliferation mimicking cHL or B‐cell lymphoma in cutaneous localization of AITL and confirmed the requirement of collecting clinical information before performing a diagnosis.