Intravascular proliferation of reactive lymphoid blasts mimicking intravascular lymphoma - A diagnostic pitfall

University of Southampton, Southampton, England, United Kingdom
Histopathology (Impact Factor: 3.45). 10/2007; 51(3):401-2. DOI: 10.1111/j.1365-2559.2007.02758.x
Source: PubMed
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    ABSTRACT: Herein, we present the first report of a reactive atypical intravascular CD30+ T-cell proliferation. Our patient developed the condition after trauma, and he has followed a benign clinical course. This observation represents a potential diagnostic pitfall for intravascular lymphoma and adds to the list of reactive conditions that may be associated with an atypical CD30+ T-cell infiltrate. Baum CL, Stone MS, Liu V. Atypical intravascular CD30+ T-cell proliferation following trauma in a healthy 17-year-old male: first reported case of a potential diagnostic pitfall and literature review.J Cutan Pathol 2009; 36: 350-354. (C) Blackwell Munksgaard 2008.
    Journal of Cutaneous Pathology 04/2009; 36(3):350-4. DOI:10.1111/j.1600-0560.2008.01033.x · 1.58 Impact Factor
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    ABSTRACT: We report an unusual case of atypical T-cell proliferation involving the lymphatic vessels within a cutaneous hemangioma from an elderly woman. Despite the blastic morphology, the CD4 restricted phenotype and the very high proliferation index, the clinical presentation (single skin lesion in a healthy woman), the benign clinical course and the absence of T-cell receptor (TCR) clonal rearrangement favored a reactive nature of the process. Since the atypical cells showed an effector/memory-like regulatory T-phenotype (CD45RO+, CD25+ and FOXp3+), expressed the migration-associated molecule CCR7 and were exclusively located within podoplanin+ lymphatic vessels, we speculate that the process might reflect an unusual local immune response, with migration of T-cells to draining lymph nodes.
    Journal of Cutaneous Pathology 08/2009; 37(4):497-503. DOI:10.1111/j.1600-0560.2009.01327.x · 1.58 Impact Factor
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    ABSTRACT: To study the significance and differential diagnosis of intralymphatic accumulation of lymphocytes. The clinical and pathologic features of 4 cases of intralymphatic accumulation of lymphocytes were reviewed retrospectively. Immunohistochemical study was carried out and follow-up data were analyzed. The sites of involvement included tonsil (2 cases), pharynx (1 case) and appendix (1 case). The duration of disease ranged from 1 week to 3 months. Follow up of the patients (from 3 to 84 months) showed no evidence of disease recurrence. Gross examination of the tissues (except in the case of appendiceal involvement) showed polypoid changes. Histologically, the lymphatic channels were filled up with small lymphocytes and associated with fibrosis in the vicinity. Immunohistochemical study revealed a T-cell phenotype of the intralymphatic lymphoid cells. The accumulation of lymphocytes in lymphatic channels is associated with a benign clinical course. This phenomenon may be due to retention of lymphocytes secondary to the perilymphatic chronic inflammation and fibrosis. Although the lesion simulates intravascular lymphomatosis morphologically and shows a uniform T-cell phenotype, the lymphoid cells lack obvious cellular pleomorphism and mitotic activity. The solitary nature of the lesion, when coupled with the indolent clinical behavior, is also helpful in the differential diagnosis.
    Zhonghua bing li xue za zhi Chinese journal of pathology 08/2010; 39(8):518-21. DOI:10.3760/cma.j.issn.0529-5807.2010.08.004
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