Plaza Jose A, Ortega Pablo, Lynott James, Mullane Michael, Kroft Steve, Olteanu Horatiu
Department of Dermatopathology, Medical College of Wisconsin, Milwaukee, WI, USA.
Am J Dermatopathol. 2010 Jul;32(5):489-91. doi: 10.1097/DAD.0b013e3181c57ec2.
Primary cutaneous anaplastic large T-cell lymphoma (PCALCL) is a well-defined CD30-positive lymphoproliferative disorder with relatively good prognosis and response to treatment. We describe a case of PCALCL expressing CD8. The patient is a 57-year-old man that clinically presented with an ulcerated nodule in his left middle finger. Histopathologic sections showed an ulcerated epidermis with a diffuse lymphocytic infiltrate in the superficial dermis with focal epidermotropism. The large cohesive atypical cells were admixed with a reactive infiltrate composed of neutrophils, eosinophils, and small lymphocytes. Immunohistochemical studies showed the tumor cells to be strongly positive for CD8, CD30, and TIA-1, focally positive for CD3, and negative for CD4, CD20, CD56, Anaplastic Lymphoma Kinase (ALK-1), and HSV. Epstein-Barr virus by in situ hybridization was negative. The diagnosis of a CD8+ PCALCL was confirmed. There is limited precedent literature regarding CD8-positive PCALCL and this case falls within the clinical and histopathologic spectrum of CD30+ lymphoproliferative disorders. CD8/CD30 coexpression is rare in PCALCL and may have important clinical and prognostic implications. To the best of our knowledge there are only 4 previously reported cases describing similar findings.
原发性皮肤间变性大T细胞淋巴瘤(PCALCL)是一种明确的CD30阳性淋巴增殖性疾病,预后相对较好,对治疗反应良好。我们描述了一例表达CD8的PCALCL病例。患者为一名57岁男性,临床上表现为左手中指出现一个溃疡结节。组织病理学切片显示表皮溃疡,浅层真皮有弥漫性淋巴细胞浸润,并伴有局灶性亲表皮现象。大的聚集性非典型细胞与由中性粒细胞、嗜酸性粒细胞和小淋巴细胞组成的反应性浸润混合存在。免疫组织化学研究显示肿瘤细胞CD8、CD30和TIA-1呈强阳性,CD3局灶性阳性,CD4、CD20、CD56、间变性淋巴瘤激酶(ALK-1)和单纯疱疹病毒(HSV)呈阴性。原位杂交检测爱泼斯坦-巴尔病毒为阴性。CD8+ PCALCL的诊断得到证实。关于CD8阳性PCALCL的先例文献有限,该病例属于CD30+淋巴增殖性疾病的临床和组织病理学范畴。CD8/CD30共表达在PCALCL中罕见,可能具有重要的临床和预后意义。据我们所知,此前仅有4例报道描述了类似的发现。