Eosinophil-rich CD30+ lymphoproliferative disorder of the oral mucosa. A form of "traumatic eosinophilic granuloma".
We describe 3 patients who had oral mucosal lesions with features of traumatic eosinophilic granuloma (TEG) and containing CD30+ atypical cells. In 1 patient, the oral lesion was followed by skin nodules. All lesions were evaluated histologically, by immunohistochemical analysis, and by polymerase chain reaction (PCR) analysis of the T-cell receptor (TCR) gamma chain gene. All oral lesions were characterized by a dense and deeply infiltrative lymphoproliferation, showing epitheliotropism and massive eosinophilia. They contained atypical large lymphoid cells, which expressed T-cell markers and CD30. PCR analysis showed a monoclonal rearrangement of the TCR gamma chain gene in all lesions and, in 1 patient, the same rearrangement in the oral and cutaneous specimens. The lesions in these patients seem to be the oral counterpart of the spectrum of primary cutaneous CD30+ lymphoproliferative disorders and should be recognized as such to avoid a diagnosis of large T-cell lymphoma and possible consequent overtreatment. However, they represent only a subset among several others within the complex and heterogeneous category of disorders referred to as TEG.
Alobeid
Bachir
B
Department of Pathology, Columbia University, New York, NY, Biotechnology Division, Bayer, Berkeley, CA, USA.
Pan
Lang-Xing
LX
Milligan
Laura
L
Budel
Leo
L
Frizzera
Glauco
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004247:DNA / Q000032:analysis; D004803:Eosinophilic Granuloma / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics; D006801:Humans; D016130:Immunophenotyping; D017730:Ki-1 Antigen / Q000378:metabolism; D008232:Lymphoproliferative Disorders / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D009059:Mouth Diseases / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D009061:Mouth Mucosa / Q000293:injuries / Q000378:metabolism / Q000473:pathology*; D016133:Polymerase Chain Reaction; D014947:Wounds and Injuries / Q000150:complications / Q000473:pathology*
D017730:Ki-1 Antigen; D004247:DNA