Cutaneous Involvement of Angioimmunoblastic T-Cell Lymphoma Masquerading as B-Cell Reactive Lymphoid Hyperplasia. (28th April 2022)

• Record Type: Journal Article
• Authors: Pesqué, David; Marcantonio, Orianna; Vázquez, Ivonne; Papaleo, Natalia; Sánchez-González, Blanca; Gallardo, Fernando; Colomo, Luis; Pujol, Ramon M.
• Is Part Of: American journal of dermatopathology. Volume 44:Number 4(2022)
• Page Start: e41
• Page End: e45
• Publication Date: 2022-04-28
• Subjects: angioimmunoblastic -- cutaneous -- agminated -- T-cell lymphoma -- reactive lymphoid hyperplasia; Skin -- Diseases -- Periodicals; Histology, Pathological -- Periodicals; 616.50705
• DOI: 10.1097/DAD.0000000000002110
• Languages: English
• ISSNs: 0193-1091

Abstract

Abstract: A 59-year-old woman presented with a persistent eruption manifested as multiple agminated miliary facial papules. Histopathological examination showed prominent nodular dermal lymphoid infiltrates with hyperplastic follicles that were initially interpreted as B-cell reactive lymphoid hyperplasia. Several years later, an additional biopsy showed a dense perifollicular infiltrate with reactive primary and secondary follicles. Accompanying T cells corresponded to CD3/CD4/PD1/CXCL13-positive cells and scattered Epstein–Barr virus–positive B cells were identified by in situ hybridization. A monoclonal T-cell population was demonstrated by TCRγ and TCRβ Polymerase Chain Reaction amplification, as well as a minor abnormal circulating T-cell population by flow cytometry (0.62% of the white blood cells, CD4 + CD3s-CD7 − ). A biopsy specimen from an enlarged right supraclavicular lymph node disclosed nodal involvement by angioimmunoblastic T-cell lymphoma. The observation of B-cell dermal nodular infiltrates with well-demarcated lymphoid aggregates forming primary lymphoid follicles may lead to overlook the T-cell component in some cases of angioimmunoblastic T-cell lymphoma. In such cases, a careful assessment of the apparently minor T-cell component is important to establish a correct diagnosis.