The Cutaneous Lymphoid Proliferations: A Comprehensive Textbook of Lymphocytic Infiltrates of the Skin

569 Pages·2016·79.298 MB·English

by  Cynthia M. Magro, A. Neil Crowson, Martin C. Mihm Jr

The Cutaneous Lymphoid Proliferations

The Cutaneous
Lymphoid Proliferations
A Comprehensive Textbook of
Lymphocytic Infiltrates of the Skin
Second Edition
Cynthia M. Magro MD
Professor of Pathology and Laboratory Medicine
Department of Pathology, Cornell University
Weill Cornell Medicine
New York, NY, USA
A. Neil Crowson MD
Clinical Professor of Dermatology, Pathology, and Surgery
Director of Dermatopathology at the University of Oklahoma and Regional Medical Laboratory
President of Pathology Laboratory Associates
Tulsa, OK, USA
Martin C. Mihm MD
Clinical Professor of Pathology and Dermatology, Harvard Medical School
Director of Melanoma Program, Dermatology, Brigham and Women’s Hospital
Co-Director of Melanoma Program, Dana-Farber and Brigham and Women’s Cancer Center
Director, Mihm Cutaneous Pathology Consultative Service
Brigham and Women’s Hospital
Boston, MA, USA
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Published simultaneously in Canada
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ISBN: 9781118776261
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10 9 8 7 6 5 4 3 2 1
Contents
Acknowledgments, viii Other spongiotic/eczematous tissue reactions, 40
Other causes of subacute eczematous dermatitis, 40
Interface dermatitis: cell-poor vacuolar interface dermatitis, 42
1 Introduction to the Classification of Lymphoma, 1 Interface dermatitis: lichenoid pattern, 46
Kiel Lukes–Collins, and Working Formulation Diffuse and nodular lymphocytic dermal infiltrates
classifications, 1 without atypia, 51
WHO, REAL, EORTC, and the Combined WHO/EORTC Diffuse and nodular lymphocytic infiltrates associated
classifications, 2 with autoimmune disease, 53
Summary, 7 References, 57
References, 8
Appendix: Definitions of key terms and techniques, 9
5 Reactive Lymphomatoid Tissue Reactions Mimicking
Cutaneous T and B Cell Lymphoma, 59
2 The Therapy of Cutaneous T Cell Lymphoma, 14 Lymphomatoid drug eruptions, 59
Benjamin H. Kaffenberger, Mark A. Bechtel, and Pierluigi Porcu Molecular profile of lymphomatoid drug eruptions, 61
Introduction, 14 Pathogenetic basis of lymphomatoid drug reactions, 62
Diagnostic work-up and staging procedures, 14 Reactive lymphomatoid lesions encountered in lesions of
CTCL therapies, 15 collagen vascular disease, 63
Goals of therapy in advanced-stage CTCL, 16 Angiomatous Variants of Pseudolymphoma, 67
Extracorporeal photopheresis (ECP), 17 Case vignettes, 69
Interferons, 17 References, 86
Retinoids, 17
Immunotoxins, 18
6 Precursor Lesions of Cutaneous T Cell Lymphoma, 89
Monoclonal antibodies, 18
Cutaneous T cell lymphoid dyscrasia, 89
Histone deacetylase inhibitors (HDACi), 19
Large plaque parapsoriasis, 90
Antibody drug conjugates (ADC), 19
Hypopigmented interface T cell dyscrasia: a unique indolent T
Cytotoxic chemotherapy, 19
cell dyscrasia, 91
Investigational therapies, 20
Pigmented purpuric dermatosis (PPD), 92
TLR agonists and cytokines, 20
Pityriasis lichenoides, 94
Allogeneic hematopoietic stem cell transplantation (allo-HSCT), 20
Idiopathic erythroderma (pre-Sézary), 96
References, 21
Syringolymphoid hyperplasia with alopecia, 96
Folliculotropic T cell lymphocytosis/pilotropic T cell
3 Molecular Analysis in Cutaneous Lymphoid dyscrasia, 97
Proliferation, 23 Idiopathic follicular mucinosis/alopecia mucinosa, 98
Shabnam Momtahen, Cynthia Magro, and Carl Morrison Keratoderma-like T cell dyscrasia, 99
Introduction, 23 Atypical lymphocytic lobular panniculitis, 100
Immunoglobulin and T cell receptor structure, 23 Case vignettes, 102
PCR design for determination of clonality, 24 References, 132
Detection of PCR products for clonality, 24
Evaluation of results, 25 7 Marginal Zone Lymphoma and Other Related Post
The value and utility of molecular diagnostics in primary Germinal Center B Cell Lymphoproliferative Disorders of
cutaneous lymphomas, 26 The Skin, 134
Limitations of clonality assessment by PCR, 27 Marginal zone lymphoma, 134
Case vignettes, 29 Blastic marginal zone lymphoma, 140
References, 36 Epidermotropic marginal zone lymphoma, 140
Castleman disease, 141
4 Benign Lymphocytic Infiltrates, 37 Primary cutaneous plasmacytoma, 142
Introduction, 37 Case vignettes, 145
Spongiotic and eczematous dermatitis, 37 References, 166
v
vi Contents
8 Primary Cutaneous Follicle Center Cell Lymphoma, 169 Lymphoma, and T-Cell-Rich CD30-Positive Large B Cell
Clinical features, 169 Lymphoma, 274
Pathology, 169 Introduction, 274
Phenotypic profile, 171 Lymphomatoid papulosis, 274
Molecular studies, 172 CD8+ lymphomatoid papulosis, including the type
Pathogenesis, 172 D variant, 278
Cytogenetics, 172 Type E lymphomatoid papulosis
Case vignettes, 174 (Case vignette 15), 278
Additional molecular and cytogenetic study, 185 Borderline CD30-positive lymphoproliferative disorders
References, 186 (type C LYP) (Case vignette 9), 279
Lymphomatoid papulosis with a rearrangement of
9 Primary Cutaneous Diffuse Large B-Cell Lymphoma chromosome 6p25.3, 279
Including the Leg Type and Precursor B Cell Lymphoblastic Cutaneous anaplastic large cell lymphoma, 280
Lymphoma, 187 Small cell ALCL, 282
Primary cutaneous diffuse large B cell lymphoma, 187 Additional unusual histologic variants of anaplastic large cell
Systemic diffuse large B cell lymphomas with a propensity to lymphoma, 282
involve the skin, 197 Breast-implant-associated anaplastic large cell
Case vignettes, 200 lymphoma, 282
Additional light microscopic, phenotypic, molecular, Intravascular anaplastic large cell lymphoma, 282
cytogenetic studies, 210 Sarcomatoid anaplastic large cell lymphoma
References, 215 (Case vignette 14), 283
CD30-positive large B cell lymphoma, 285
Case vignettes, 286
10 Intravascular Lymphoma, 218
References, 309
Clinical features, 218
Light microscopic findings, 219
Phenotypic profile, 219 14 CD4+ Peripheral T Cell Lymphoma, Not Otherwise
Molecular and cytogenetic studies, 219 Specified, Including Primary Cutaneous Cd4+ Small/
Pathogenesis, 219 Medium-Sized Pleomorphic T Cell Lymphoma, 312
Differential diagnosis, 219 Introduction, 312
Intravascular anaplastic large cell lymphoma, 219 Primary cutaneous CD4+ small/medium-sized pleomorphic
Benign intravascular proliferations of histiocytes and reactive T cell lymphoma, 312
T cells, 220 CD30-negative large cell T cell lymphoma, 313
Case vignettes, 221 Cutaneous follicular helper T cell lymphoma, 314
References, 224 Overview of overall prognosis of primary cutaneous peripheral
T cell lymphoma, unspecified, 315
Evolution of the nomenclature of primary cutaneous CD4+
11 Cutaneous Mantle Cell Lymphoma, 225
small/medium-sized pleomorphic T cell lymphoma, 319
Clinical features, 225
Case vignettes, 320
Light microscopic findings, 225
References, 333
Phenotypic profile, 226
Molecular studies, 227
Cytogenetic profile, 227 15 Subcutaneous Panniculitis-Like T Cell Lymphoma, 334
Pathogenesis, 227 Clinical features, 334
Case vignettes, 229 Morphology, 336
Additional molecular and cytogenetic studies, 233 Phenotype, 337
References, 234 Molecular studies, 337
Differential diagnosis, 337
Case vignettes, 340
12 Mycosis Fungoides and Sézary Syndrome, 236
References, 349
Definition, 236
Mycosis fungoides, 236
Sézary syndrome and erythrodermic mycosis fungoides, 243 16 CD8 T Cell Lymphoproliferative Disease of the Skin, 351
Large cell transformation of mycosis fungoides, 251 Overview, 351
Extracutaneous involvement in mycosis fungoides, 254 Introduction, 351
Case vignettes, 259 Classification of primary CD8+ cutaneous
References, 271 T cell lymphomas, 352
Histomorphology of primary cutaneous CD8+ T cell
13 CD30-Positive Lymphoproliferative Disorders Including lymphoma: primary cutaneous aggressive epidermotropic
Lymphomatoid Papulosis, Borderline CD30-Positive CD8+ T cell lymphoma, and CD8+ variants of
Lymphoproliferative Disease, Anaplastic Large Cell peripheral T cell lymphoma, NOS, including primary
Contents vii
cutaneous CD8+ granulomatous T cell lymphoma, 353 methotrexate or cyclosporine, 421
CD8 variant of lymphomatoid papulosis and other related Case vignettes, 423
CD30-positive T cell lymphoproliferative disorders of CD8 References, 432
subtype, 354
20 Hodgkin Lymphoma of the Skin, 435
Light microscopic findings, 354
Clinical features, 435
Indolent CD8 positive lymphoid proliferation of the face and
Subtypes of Hodgkin lymphoma, 436
other body sites including acral surfaces, 355
References, 447
CD8 prolymphocytic leukemia, 355
CD8 pseudolymphoma related to underlying HIV disease, 356
21 Chronic Lymphocytic Leukemia of B Cell and T Cell
Drug-associated CD8+ pseudolymphoma, 356
Prolymphocytic Leukemia, 449
Actinic reticuloid as a unique form of CD8+
B cell chronic lymphocytic leukemia, 449
pseudolymphoma, 356
T cell prolymphocytic leukemia, 452
Case vignettes, 357
Case vignettes, 455
References, 375
References, 471
17 Nasal and Related Extranodal Natural Killer Cell/T Cell
22 Adult T Cell Leukemia/Lymphoma, 473
Lymphomas and Blastic Plasmacytoid Dendritic Cell
Clinical features, 473
Neoplasm, 377
Pathology, 474
Introduction, 377
Phenotypic studies, 475
Biology of NK and NK-like T cells, 377
Pathogenesis, 475
NK/T-cell lymphoma, 379
Infective dermatitis of childhood, 476
Nasal NK/T cell lymphoma, 379
Case vignettes, 477
Nasal type NK/T cell lymphoma, 380
References, 484
Aggressive NK cell lymphoma, 380
Role of Epstein–Barr virus in the evolution of NK/T cell
lymphomas, 382 23 Angioimmunoblastic Lymphadenopathy/
Blastic plasmacytoid dendritic cell neoplasm, 382 Angioimmunoblastic T Cell Lymphoma, 486
CD56-positive γ δ lymphoma involving the subcutaneous fat, Clinical features, 486
383 Light microscopic findings, 487
Chronic granular lymphocytosis/large granular cell leukemia, 384 Phenotypic studies, 488
Natural killer-like CD4+ T cell lymphoma, 384 Molecular studies, 488
EBV-associated NK/T cell lymphomas of the elderly, 385 Pathogenesis, 489
Hydroa vaccineforme (HV)-like lymphoma, 385 Case vignettes, 491
Cutaneous intravascular NK T cell lymphoma, 386 References, 497
Case vignettes, 387
References, 401 24 Lymphomatoid Granulomatosis, 499
Introduction, 499
18 Primary Cutaneous γ δ T Cell Lymphoma, 404 Clinical features, 499
Introduction, 404 Histopathology, 500
Case vignettes, 409 Histogenesis, 501
Additional supplemental figures, 411 Clonality studies, 501
References, 414 Differential diagnosis, 501
Treatment, 502
Case vignette, 503
19 Epstein–Barr Virus-Associated Lymphoproliferative
References, 506
Disease, 415
Introduction, 415
Hydroa vacciniforme-like EBV-associated T cell 25 Cutaneous Infiltrates of Myeloid Derivation 507
lymphoproliferative disease/mosquito bite hypersensitivity, 416 Introduction, 507
EBV+ cutaneous B cell lymphoproliferative disorder of the Leukemia cutis, 507
elderly, 420 Clonal histiocytopathy syndromes, 509
EBV-associated mucocutaneous ulcer, 421 Histiocytopathy of factor XIIIA perivascular dermal dendritic
EBV + T cell lymphoproliferative disease of the elderly, 421 cell origin, 514
General principles regarding EBV-associated Case vignettes, 517
lymphomagenesis, 421 References, 537
Pathogenetic link between EBV-associated B cell lymphoma
and iatrogenic immune dysregulation related to either Index, 541
Acknowledgments
The authors would like to express special thanks for editorial support to Arthi Kumar at New York-Presbyterian/Queens Hospital and
Shabnam Momtahen of Weill Cornell Medicine. Their assistance has been invaluable.
Cynthia M. Magro
A. Neil Crowson
Martin C. Mihm
viii