Primary cutaneous Hodgkin's disease with evolution to systemic disease. Association with the Epstein-Barr virus.
Hodgkin's disease rarely involves the skin and when it does is an indication of advanced stage disease. Primary cutaneous Hodgkin's disease is exceedingly rare, and only a few cases are reported. We describe a patient who developed multiple cutaneous lesions of Hodgkin's disease 2 years before manifesting nodal disease of mixed cellularity subtype. Reed-Sternberg cells in the skin as well as lymph nodes and bone marrow were positive for Epstein-Barr viral transcripts and expressed viral latent membrane protein. Epstein-Barr virus has not previously been demonstrated in primary cutaneous Hodgkin's disease, and its presence in lesions in all sites in this case supports a diagnosis of primary cutaneous disease with subsequent evolution into systemic disease.
Kumar
S
S
Hematopathology Section, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA.
Kingma
D W
DW
Weiss
W B
WB
Raffeld
M
M
Jaffe
E S
ES
D000368:Aged; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006566:Herpesviridae Infections / Q000276:immunology / Q000473:pathology*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006689:Hodgkin Disease / Q000276:immunology / Q000473:pathology / Q000821:virology*; D006801:Humans; D007124:Immunoenzyme Techniques; D017730:Ki-1 Antigen / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology / Q000821:virology; D016539:Reed-Sternberg Cells / Q000276:immunology / Q000473:pathology / Q000821:virology; D012871:Skin Diseases / Q000276:immunology / Q000473:pathology / Q000821:virology*; D014412:Tumor Virus Infections / Q000276:immunology / Q000473:pathology*
D015415:Biomarkers; D017730:Ki-1 Antigen