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.
Petrella
Tony
T
Department of Pathology of Dijon's University Hospital and the Centre de Pathologie of Dijon, 2100-DIJON, France. tony.petrella@centre-de-pathologie.fr
Maubec
Eve
E
Cornillet-Lefebvre
Pascale
P
Willemze
Rein
R
Pluot
Michel
M
Durlach
Anne
A
Marinho
Eduardo
E
Benhamou
Jean-Luc
JL
Jansen
Patty
P
Robson
Alistair
A
Grange
Florent
F
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