Department of Anatomic Pathology, Oakland University William Beaumont School of Medicine and Beaumont Health Systems, Royal Oak, MI.
Adv Anat Pathol. 2019 Mar;26(2):93-113. doi: 10.1097/PAP.0000000000000208.
Cutaneous lymphoproliferative disorders remain a challenging aspect of dermatopathology, in part due to the rarity of the entities and extreme variability in clinical outcomes. Although many of the entities remain unchanged, the approach to some of them has changed in the new 2016 classification scheme of the World Health Organization. Chief among these are Epstein-Barr virus-associated lymphoproliferative disorders such as Epstein-Barr virus-associated mucocutaneous ulcer and hydroa vacciniforme-like lymphoproliferative disorder, primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, primary cutaneous acral CD8+ T-cell lymphoma, primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, and breast implant-associated anaplastic large cell lymphoma. In addition, translocations and gene rearrangements such as those involving the 6p25.3 locus have started to inform diagnosis and classification of anaplastic large cell lymphoma and lymphomatoid papulosis. In this review, we will examine what is new in the diagnostic toolbox of cutaneous lymphoproliferative disorders.
皮肤淋巴组织增生性疾病仍然是皮肤病理学中的一个具有挑战性的方面,部分原因是这些疾病的罕见性和临床表现的极端可变性。尽管许多疾病的实体保持不变,但在世界卫生组织的新的 2016 年分类方案中,对其中一些疾病的处理方法已经发生了变化。其中最重要的是 EBV 相关的淋巴组织增生性疾病,如 EBV 相关的黏膜皮肤溃疡和水疱样疹样淋巴组织增生性疾病、原发性皮肤 CD8+侵袭性表皮细胞毒性 T 细胞淋巴瘤、原发性皮肤肢端 CD8+T 细胞淋巴瘤、原发性皮肤 CD4+小/中 T 细胞淋巴组织增生性疾病和乳房植入物相关间变性大细胞淋巴瘤。此外,易位和基因重排,如涉及 6p25.3 位点的易位和基因重排,已经开始为间变性大细胞淋巴瘤和淋巴瘤样丘疹病的诊断和分类提供信息。在这篇综述中,我们将探讨皮肤淋巴组织增生性疾病诊断工具包中的新内容。