Intralymphatic Cutaneous Anaplastic Large Cell Lymphoma/Lymphomatoid Papulosis

Autor: Rhett P. Ketterling, Abner Louissant, Mark A. Samols, Seong H. Ra, Youn H. Kim, Jinah Kim, Andrew L. Feldman, Albert Su, Dita Gratzinger, Ryan A. Knudson, Nancy L. Harris, Jonathan W. Said, Mark A. Cappel, Scott W. Binder
Rok vydání: 2014
Předmět:
Adult
Male
CD30 positive
Pathology
medicine.medical_specialty
Skin Neoplasms
Biopsy
T-Lymphocytes
Ki-1 Antigen
Lymphoproliferative disorders
Translocation
Genetic
Pathology and Forensic Medicine
Lymphoma
Primary Cutaneous Anaplastic Large Cell
Lymphomatoid Papulosis
immune system diseases
hemic and lymphatic diseases
Biomarkers
Tumor
medicine
Humans
Anaplastic Lymphoma Kinase
Genetic Predisposition to Disease
Lymphomatoid papulosis
Anaplastic large-cell lymphoma
Aged
Cell Proliferation
Lymphatic Vessels
Aged
80 and over
business.industry
Clinical course
Receptor Protein-Tyrosine Kinases
Middle Aged
Prognosis
medicine.disease
Immunohistochemistry
United States
Lymphoma
Phenotype
Lymphatic system
Interferon Regulatory Factors
Blood Vessels
Dual-Specificity Phosphatases
Mitogen-Activated Protein Kinase Phosphatases
Female
Surgery
Anatomy
business
Zdroj: American Journal of Surgical Pathology. 38:1203-1211
ISSN: 0147-5185
DOI: 10.1097/pas.0000000000000217
Popis: Intravascular large B-cell lymphomas and EBV NK/T-cell lymphomas commonly follow an aggressive clinical course. We recently reported an entirely intravascular anaplastic large cell lymphoma (ALCL) in the skin with a surprisingly indolent clinical course; interestingly, this lymphoma involved the lymphatic rather than the blood vasculature. We hypothesized that intravascular skin-limited ALCL is distinct from aggressive systemic intravascular lymphomas in its intralymphatic localization and clinical course. We now describe 18 cases of cutaneous intravascular large cell lymphoproliferations from 4 institutions. All 12 intravascular large T-cell lesions were intralymphatic; the majority (9) were CD30 T-cell lymphoproliferative disorders (TLPDs), 5 further classified as intravascular ALK ALCL. One ALK ALCL and 2 benign microscopic intravascular T-cell proliferations were also intralymphatic. A single case of otherwise typical cutaneous follicle center lymphoma contained intralymphatic centroblasts. The clinical and pathologic characteristics of the CD30 TLPDs were similar to those of their extravascular counterparts, including extralymphatic dermal involvement in a subset, DUSP22-IRF4 translocations in half of tested ALK ALCLs, and associated mycosis fungoides in 1; most were skin-limited at baseline and remained so at relapse. All 5 cases of intravascular large B-cell lymphoma involved the blood vasculature and behaved in a clinically aggressive manner; the ALK ALCL, although intralymphatic, was systemic and clinically aggressive. We propose that cutaneous ALK ALCL and related CD30 ALK TLPDs involving the lymphatics are part of an expanding spectrum of CD30 TLPDs. The identification of intralymphatic as distinct from blood vascular localization may provide critical prognostic and therapeutic information.
Databáze: OpenAIRE
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