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

University of Southampton, Southampton, England, United Kingdom
Histopathology (Impact Factor: 3.3). 10/2007; 51(3):401-2. DOI: 10.1111/j.1365-2559.2007.02758.x
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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 · 1.56 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 · 1.56 Impact Factor
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    ABSTRACT: The incidence of extrathymic malignancies in patients with thymoma is significantly higher than in the general population. Non-Hodgkin lymphoma represents the most commonly associated tumor type. We report the concurrence of primary thymic squamous cell carcinoma and disseminated intravascular large B-cell lymphoma (IVL) in a 78-year-old man characterized by a rapidly fatal clinical course. To our knowledge, this is the first time that such an association is reported. Due to its rarity and the multiplicity of presentations, it is very difficult to diagnose this type of extranodal lymphoma antemortem. The intravascular lymphoma should be included in the differential diagnosis when a patient presents signs of a systemic disease and marked elevation of serum LDH. In this case the lymphoma may have been developed as a result of defective immunologic surveillance or impaired immunoregulation caused by the thymic carcinoma. In our case as in some other cases of IVL, diagnosis could only be conclusively confirmed on autopsy.ResumenLa incidencia de tumores malignos extratímicos en pacientes con timoma es significantivamente más alta que en la población general. El linfoma no Hodgkin es la neoplasia más comúnmente asociada. En esta revisión, informamos la concurrencia de un carcinoma epidermoide tímico y un linfoma intravascular de células B grandes diseminado, caracterizado por presentación clínica rápidamente progresiva y fatal, en un hombre de 78 años. Este caso constituye la primera asociación informada entre ambas neoplasias. Debido a su rareza y a la multiplicidad de presentaciones, es muy difícil diagnosticar este tipo de linfoma antemortem, por lo que debería ser incluido en el diagnóstico diferencial de todo paciente que presente enfermedad sistémica y elevación marcada de la deshidrogenada láctica sérica. En el presente caso pensamos que el linfoma pudiera haberse desarrollado como resultado de un defecto en la vigilancia inmunológica o una alteración de la inmunorregulación causada por el carcinoma tímico. En casos como el actual la autopsia es el único método de diagnostico seguro.
    01/2013; 46(1):45–50. DOI:10.1016/j.patol.2012.04.005