Session Summary session 6. Reactive Lymphoproliferations of the skin. Session 6 - case 211
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1 SH/EAHP Workshop 2011 Los Angeles, California, USA October 27-29, 2011 Session 6 Reactive Lymphoproliferations of the skin Rein Willemze Summary session 6 Atypical T-cell infiltrates (lymphomatoid; pseudo-t-cell lymphoma; PCSM-TCL). Atypical B-cell infiltrates (CLH; pseudo-bcell lymphoma). Reactive conditions mimicking C-ALCL/LyP (Lupus) panniculitis Special cases Another four cases Session Summary Session 6 - case 211 Submitted by Gulsah Kaygusuz and Isinsu Kuzu Ankara University, School of Medicine, Dept. of Pathology, Turkey 21 years old, female presented with subcutaneous, nodular lesion on right temporal region of the scalp for 2 months. H&E CD20 CD3 Bcl-6 H&E Bcl-2 CD21 Ki-67 1
2 Session 6 - case 211 Submitted by Gulsah Kaygusuz and Isinsu Kuzu Ankara University, School of Medicine, Dept. of Pathology, Turkey Reactive follicular hyperplasia due to bloodsucker (Annelida, Hirudinea) application. Multiple pseudolymphomas caused by Hirudo medicinalis therapy Smolle J. et al. J Am Acad Dermatol 43,867,2000 Cutaneous Lymphoid hyperplasia Etiology: Tick bites (Borrelia burgdorferi infection) Tattoo pigments Antigen injections; piercings; golden earrings, etc. Unknown In common: intradermal antigens bypassing epidermal LC network. Multiple pseudolymphomas caused by Hirudo medicinalis therapy Smolle J. et al. J Am Acad Dermatol 43,867,2000 Synonyms: Pseudo-B-cell lymphoma Lymphadenosis benigna cutis Lymphocytoma cutis Sarcoid of Spiegler-Fendt CLH tick bite - tattoo Session 6 - case 91 Submitted by Erick Jacobson-Dunlop, MD et al. Depts. of Dermatology and Pathology, Oregon Health and Science University as Scabies Bite Reaction Mimicking LyP A 51-year-old woman presenting with a two month history of pruritic lesions on her arms and trunk. 2
3 Session 6 - case 91 Submitted by Erick Jacobson-Dunlop, MD et al. CD3 Depts. of Dermatology and Pathology, Oregon Health and Science University CD2 0 Scabies Bite Reaction CD4 CD8 CD30 L U M C Benign cutaneous CD30+ conditions Viral infection: molluscum contagiosum Orf; milker s nodule Herpes virus infection HPV HIV Parasite infections (scabies) Atopic dermatitis Insect bites, patch tests, etc. Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE). Session 6 - case 303 Submitted by Patty Jansen and Rein Willemze Depts. of Pathology and Dermatology, LUMC, Leiden, The Netherlands Clinical History: 21-year-old female with an ulcerative lesion on mucosa upper lip since one week. 3
4 CD3 CD4 CD8 CD3 CD4 CD8 CD5 CD5 CD30 Ki-67 CD68 CD30 TIA-1 Ki-67 Case 303 main findings Ulcerative lesion of oral mucosa. Atypical T-cell infiltrate of medium-sized to large blast cells, admixed with small lymphocytes, histiocytes and eosinophils. Phenotype: CD30+/-, CD2+, CD3+, CD4+, CD5-, CD8-, CD56-, TIA-1+, GrB-. EBER: negative Clonal TCR gene rearrangement. Staging negative. Case 303 main findings Differential diagnosis: Counterpart spectrum cutaneous CD30+ LPD TUGSE 4
5 Session 6 - case 303 Case 303 TUGSE Submitted by Patty Jansen and Rein Willemze Depts. of Pathology and Dermatology, LUMC, Leiden, The Netherlands Traumatic Ulcerative Granuloma with Stromal Eosinophilia of the oral cavity (TUGSE) Ulcerative lesion of oral mucosa (tongue). Self-limiting; rapid regression (after biopsy). DD clinically: SCC; lymphoma; syphilis!! CD30+ large atypical cells (50%) Stromal eosinophilia May be clonal (25%) Session 6 - case 159 Submitted by Seble Chekol, MD and Nahid Nanaji MD Dept. of Pathology, University of Maryland Medical Center, Baltimore as Cutaneous anaplastic large cell lymphoma (ALK negative) 83-year-old female with an ulcerative lesion on her lower lip. Previously biopsied and diagnosed as poorly differentiated SCC. Examination: exophytic mass on the lower lip. 5
6 Session 6 - case 159 CD45 CD3 Submitted by Seble Chekol, MD and Nahid Nanaji MD Dept. of Pathology, University of Maryland Medical Center, Baltimore CD30 ALK Traumatic Ulcerative Granuloma with Stromal Eosinophilia of the oral cavity (TUGSE) 6
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