Indolent CD8-positive lymphoid proliferation of the ear: a distinct primary cutaneous T-cell lymphoma?
The authors report 4 cases of cutaneous lymphoproliferation unusual by their histology and their clinical presentation. Each presented with a history of a slow growing nodule on the ear. Despite the indolent clinical evolution, the histology suggested a high-grade lymphoma. All lesions consisted of a dense, diffuse proliferation of monomorphous medium-sized T cells throughout the dermis and subcutis. There was no epidermotropism and a grenz zone was clearly present in each case. The tumor cells displayed irregular blastlike nuclei, with small nucleoli and clear chromatin and had a CD3+, CD8+, CD4+, TIA1+, granzyme B(-)immunophenotype with a loss of other T-cell antigens. The 3 cases with available material for polymerase chain reaction studies displayed a monoclonal T-cell rearrangement of the T-cell receptor-gamma chain. These cases do not correspond to a recognized cutaneous T-cell lymphoma as described in the recent WHO/EORTC classification. The apparent striking propensity for the ear suggests that they might represent a specific entity. Further cases are needed to confirm this hypothesis. It is important for such indolent lesions to be known to avoid over treatment.
Department of Pathology of Dijon's University Hospital and the Centre de Pathologie of Dijon, 2100-DIJON, France. tony.petrella@centre-de-pathologie.fr
Tony
T
Petrella
Eve
E
Maubec
Pascale
P
Cornillet-Lefebvre
Rein
R
Willemze
Michel
M
Pluot
Anne
A
Durlach
Eduardo
E
Marinho
Jean-Luc
JL
Benhamou
Patty
P
Jansen
Alistair
A
Robson
Florent
F
Grange
D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D004427:Ear Diseases / Q000276:immunology / Q000473:pathology*; D005260:Female; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology