Cockerell C J, Stetler L D
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas 75235-9072.
Am J Dermatopathol. 1991 Feb;13(1):20-5. doi: 10.1097/00000372-199102000-00005.
This study was undertaken to assess the accuracy of histologic diagnosis of lymphomatoid papulosis (LyP), which may be confused with malignant lymphoma or other entities. It is essential that accurate diagnoses be made because LyP may be a marker for malignant lymphoma. All 15 examples of LyP reviewed in a dermatopathology laboratory during a 14-year period and 180 histologic sections of tissue that could be confused with LyP were reviewed. Criteria for diagnosis of LyP were applied without benefit of clinical history, and revised diagnoses were made where indicated. Clinical follow-up information was obtained and original accuracy of diagnosis was assessed by comparing clinical courses with original histologic diagnoses. In cases of LyP in which numerous atypical lymphoid cells were present, 100% accuracy was noted. When fewer atypical lymphoid cells were present and inflammatory cell infiltrates were less dense, the diagnosis was less certain. Overall, a 64% correlation of clinical course and histologic diagnosis of LyP was noted. We conclude that the histologic diagnosis of LyP is generally reliable and accurate; however, in some cases a precise diagnosis cannot be made with certainty. Cases with fewer atypical lymphoid cells may fail to correlate well with the classic course of LyP and may represent a variant or histologic simulator.
本研究旨在评估淋巴瘤样丘疹病（LyP）组织学诊断的准确性，LyP可能会与恶性淋巴瘤或其他病变相混淆。准确诊断至关重要，因为LyP可能是恶性淋巴瘤的一个标志物。回顾了一家皮肤病理学实验室在14年期间所检查的15例LyP病例，以及180例可能与LyP混淆的组织学切片。在不参考临床病史的情况下应用LyP的诊断标准，并在必要时做出修订诊断。获取了临床随访信息，并通过将临床病程与原始组织学诊断进行比较来评估原始诊断的准确性。在存在大量非典型淋巴细胞的LyP病例中，诊断准确率为100%。当非典型淋巴细胞数量较少且炎症细胞浸润密度较低时，诊断的确定性较低。总体而言，LyP的临床病程与组织学诊断的符合率为64%。我们得出结论，LyP的组织学诊断总体上是可靠且准确的；然而，在某些情况下无法做出确切的诊断。非典型淋巴细胞数量较少的病例可能与LyP的经典病程相关性不佳，可能代表一种变异型或组织学模拟物。
