title: Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis.
abstract: Lymphomatoid papulosis (LyP) belongs to CD30+ lymphoproliferative disorders with indolent clinical course. Classic histological subtypes, A, B and C are characterized by the CD4+ phenotype, while CD8+ variants, most commonly classified as type D, were reported in recent years. We present 14 cases of CD8+ LyP. In all patients, self-resolving or treatment-sensitive papules were observed. Of 14 cases 7 produced results with typical microscopic features of LyP type D mimicking primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma. The infiltration pattern in 4 of 14 cases were consistent with classic LyP type B, without CD30 expression in two cases, resembling mycosis fungoides (MF). The morphology of 2 of 14 cases shared a certain consistency with classic type A and C, lacking eosinophils and neutrophils. Extensive folliculotropism characteristic to type F was observed in 1 of 14 case. Significant MUM1 and PD1 expression were detected in 2 of 14 and 3 of 14 cases, respectively. We concluded that CD8+ LyP may present with different histopathological features compared with type D, similar to CD4+ LyP variants. Differential diagnoses include CD8+ papular MF, folliculotropic MF and anaplastic large cell lymphoma in addition to primary cutaneous aggressive epidermotropic T-cell lymphoma. We emphasise that rare CD8+ LyP cases may exist with CD30-negativity.
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Márta
authors.initials: M
authors.lastname: Marschalkó
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Nóra
authors.initials: N
authors.lastname: Gyöngyösi
authors.affiliation: Department of Dermatology, Heim Pál Childrens Hospital, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Noll
authors.affiliation: Department of Dermatology, Semmelweis Hospital, Miskolc, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Károlyi
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Norbert
authors.initials: N
authors.lastname: Wikonkál
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Hársing
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Enikő
authors.initials: E
authors.lastname: Kuroli
authors.affiliation: 1st Department of Pathology and Experimental Cancer Research Institute, Semmelweis University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Csomor
authors.affiliation: 1st Department of Pathology and Experimental Cancer Research Institute, Semmelweis University, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Matolcsy
authors.affiliation: Department of Dermatology Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.
authors.forename: Kárpáti
authors.initials: K
authors.lastname: Sarolta
authors.affiliation: 1st Department of Pathology and Experimental Cancer Research Institute, Semmelweis University, Budapest, Hungary. agotaszepesi@gmail.com.
authors.forename: Ágota
authors.initials: Á
authors.lastname: Szepesi
mesh_terms: D000328:Adult; D000368:Aged; D016827:CD8 Antigens / Q000378:metabolism*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D050835:Interferon Regulatory Factors / Q000378:metabolism; D017731:Lymphomatoid Papulosis / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061026:Programmed Cell Death 1 Receptor / Q000378:metabolism; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology*; D000099218:Interferon Regulatory Factor-4
chemical_list: D016827:CD8 Antigens; D050835:Interferon Regulatory Factors; D061026:Programmed Cell Death 1 Receptor; D000099218:Interferon Regulatory Factor-4; C105992:PDCD1 protein, human
keywords: CD30 antigen expression; CD8 positive cutaneous T-cell lymphoma; CD8 positive lymphomatoid papulosis type A,B,C,D,F; cutaneous CD30+ lymphoproliferative disorders; lymphomatoid papulosis