Lymphomatoid Papulosis With T-cell Receptor-Gamma Delta Expression: A Clinicopathologic Case-series of 26 Patients of an Underrecognized Immunophenotypic Variant of Lymphomatoid Papulosis.


Journal

The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904

Informations de publication

Date de publication:
27 Mar 2024
Historique:
medline: 27 3 2024
pubmed: 27 3 2024
entrez: 27 3 2024
Statut: aheadofprint

Résumé

Lymphomatoid papulosis (LyP) has several histopathologic presentations. LyP featuring gamma-delta (γδ) T-cell receptor expression may masquerade as and may be misdiagnosed as aggressive cutaneous T-cell lymphoma, particularly primary cutaneous γδ T-cell lymphoma (PCGDTL) or γδ mycosis fungoides. We performed a clinicopathologic analysis of the largest series of LyP featuring γδ T-cell expression. We identified 26 patients with a diagnosis of LyP with γδ T cells from our institutions, as well as through a comprehensive review of the literature, and characterized these cases. Most cases were treated with topical steroids or not treated at all. The majority of cases showed a CD4-CD8+ phenotype and featured at least one cytotoxic marker. Histopathologic features included an intraepidermal or dermal infiltrate with large cells and frequent angiotropism. One case was initially misdiagnosed as PCGDTL, requiring further therapy. Our case series, the largest international cohort of γδ T cell predominant LyP cases, confirms marked clinicopathologic heterogeneity that may contribute to misdiagnosis, reasserting the need to identify classic clinical features, CD30+ T-cell components, and markers of cytotoxicity when dealing with this differential diagnosis. A limitation of this study includes somewhat limited follow-up, histologic, and immunophenotypic information for some cases.

Identifiants

pubmed: 38533681
doi: 10.1097/PAS.0000000000002200
pii: 00000478-990000000-00320
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest and Source of Funding: A.L.F. receives research funding from Seattle Genetics, is an inventor of technology for which Mayo Clinic holds an unlicensed patent, and has intellectual property licensed to Zeno Pharmaceuticals. A.A.G. is an investigator for StemLine Therapeutics, Innate Pharma, and Dren Bio. He is also consultant for Kyowa Kirin and BluePrints Medicine. For the remaining authors none were declared.

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Auteurs

Erica Mark (E)

Department of Pathology.

Werner Kempf (W)

Department of Dermatology, Kempf und Pfaltz Histologische Diagnostik, University of Zurich, Zurich, Switzerland.

Joan Guitart (J)

Department of Dermatology, Northwestern University, Chicago, IL.

Melissa Pulitzer (M)

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York City, NY.

Christina Mitteldorf (C)

Department of Dermatology, University Medical Center Göttingen, Venereology and Allergology, Göttingen, Germany.

Alexandra Hristov (A)

Departments of Pathology and Dermatology, University of Michigan, Ann Arbor, MI.

Carlos Torres-Cabala (C)

Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX.

Enrica Marchi (E)

Division of Hematology and Oncology.

Thomas Cropley (T)

Department of Dermatology, University of Virginia, Charlottesville, VA.

Socorro Maria Rodriguez Pinilla (SM)

Department of Pathology, Fundacion Jimenez Diaz, Madrid, Spain.

Teresa Griffin (T)

Department of Dermatology, Northwestern University, Chicago, IL.

Rony Fernandez (R)

Department of Dermatology, Northwestern University, Chicago, IL.

Stefano Pileri (S)

Department of Pathology, European Institute of Oncology IRCCS, Hematopathology Division, Milan.

Alessandro Pileri (A)

Department of Surgical and Medical Science, Bologna University, Bologna, Italy.
Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.

Valentina Tabanelli (V)

Department of Pathology, University of Bologna.

Lisa Borretta (L)

Department of Pathology.

Antonio Subtil (A)

Department of Pathology, University of British Columbia, Royal Jubilee Hospital, Victoria, Canada.

Jose Antonio Plaza (JA)

Departments of Pathology and Dermatology, The Ohio State University, Columbus, OH.

Jose A Miguel Angel Piris (JAMA)

Department of Pathology, Fundacion Jimenez Diaz, Madrid, Spain.

Andrew L Feldman (AL)

Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN.

Lorenzo Cerroni (L)

Department of Dermatology, Medical University of Graz, Graz, Austria.

Alejandro A Gru (AA)

Department of Pathology.
Department of Dermatology, University of Virginia, Charlottesville, VA.

Classifications MeSH