Smoller B R, Longacre T A, Warnke R A
Department of Pathology, Stanford University Medical Center, California.
Mod Pathol. 1992 Sep;5(5):492-6.
Lymphomatoid papulosis (LP) is an uncommon cutaneous T-cell lymphoproliferative disorder that can mimic arthropod bite reactions clinically and histologically. Erythematous, crusted papules and nodules occur mainly on extremities of young adults and, when biopsied, display a superficial and deep perivascular infiltrate characterized by atypical lymphocytes and scattered eosinophils. Arthropod bite reactions may show an identical histologic pattern. It has been suggested that up to 10% of patients with LP will eventually develop lymphoma. We examined biopsies from 10 cases of LP and six cases of arthropod bite reactions diagnosed by clinical history and prolonged follow-up, with BerH2, an antibody directed against the Ki-1 antigen (CD30) and found it to be useful in helping distinguish between the two entities. All cases of LP examined showed scattered Ki-1-positive large, atypical lymphocytes in the dermis. In the arthropod bite reactions, there was virtually no staining with BerH2 antibody. This suggests that the abnormal activated T-cells, which comprise the cellular infiltrate in LP, are not present in arthropod bite reactions.
淋巴瘤样丘疹病（LP）是一种罕见的皮肤T细胞淋巴增殖性疾病，在临床和组织学上可模仿节肢动物叮咬反应。红斑、结痂丘疹和结节主要发生在年轻成年人的四肢，活检时显示以非典型淋巴细胞和散在嗜酸性粒细胞为特征的浅层和深层血管周围浸润。节肢动物叮咬反应可能显示相同的组织学模式。有人提出，高达10%的LP患者最终会发展为淋巴瘤。我们检查了10例LP和6例根据临床病史和长期随访诊断为节肢动物叮咬反应的病例的活检标本，使用了一种针对Ki-1抗原（CD30）的抗体BerH2，发现它有助于区分这两种疾病。所有检查的LP病例在真皮中均显示散在的Ki-1阳性大的非典型淋巴细胞。在节肢动物叮咬反应中，BerH2抗体几乎没有染色。这表明构成LP细胞浸润的异常活化T细胞在节肢动物叮咬反应中不存在。
