Rob McFarlane

University of Washington Seattle, Seattle, Washington, United States

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Publications (4)9.34 Total impact

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    ABSTRACT: Epidermodysplasia verruciformis (EV) is a rare autosomal-recessive condition associated with a predisposition to infection with specific types of human papillomaviruses. A spectrum of wart-like lesions on the face, dorsa of the hands, and legs are characteristic clinical findings. Lesions usually develop in early childhood, persist, and may eventuate in cutaneous squamous cell carcinoma, usually in sun-exposed areas. These lesions are locally destructive and sometimes metastasize. We present a case of a 34-year-old African American woman with EV with a 9-month history of a right index finger ungual longitudinal pigmented band and nail splitting. Biopsy showed hyperkeratotic and parakeratotic subungual epithelium with verrucous hyperplasia. The superficial keratinocytes showed koilocytic changes. In addition, there was extensive, focally full-thickness keratinocyte dysmaturation with variable nuclear atypia and numerous mitotic figures, without apparent invasion. An associated melanocytic hyperplasia (confirmed by Melan-A stain), composed of large, pigment-laden dendritic melanocytes, was present without appreciable atypia or pagetoid spread. The findings are of a squamous cell carcinoma in situ arising in association with EV with incidental melanocytic hyperplasia. To the best of our knowledge, this is first report of a subungual presentation of this condition with associated melanonychia.
    No preview · Article · Jan 2009 · The American Journal of dermatopathology
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    ABSTRACT: CD4+/CD56+ hematodermic neoplasm (HN), formerly known as a blastic natural killer (NK) cell lymphoma, is a rare subtype of a cutaneous dendritic cell neoplasm notable for highly aggressive behavior. The characteristic features are: expression of the T-helper/inducer cell marker CD4 and the NK-cell marker CD56 in the absence of other T cell or NK-cell specific markers. In particular, CD3 (surface or cytoplasmic) and CD2 are not expressed. Although T-cell receptor (TCR) genes are generally reported to be in a germline configuration, we present an unusual variant of a CD4+/CD56+ HN with a clonal rearrangement of TCR genes. This feature of a CD4+/CD56+ HN has been only rarely reported. Recognition of the presence of clonal TCR gene rearrangements in a small subset of CD4+/CD56+ HN is important to avoid misdiagnosis of this entity as an unusual variant of a cutaneous T-cell lymphoma.
    No preview · Article · Jul 2008 · Journal of Cutaneous Pathology
  • R McFarlane · S Hurst · D Sabath · E George · Z Argenyi
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    ABSTRACT: Post-transplant lymphoproliferative disorder (PTLD) is a lymphoid proliferation that develops as a complication of solid organ or bone marrow transplants. Most cases usually present in the gastrointestinal tract, liver, kidney or lymph nodes. Plasmacytoma-like PTLD is an uncommon variant, and presentation in the skin is exceedingly rare. We present a case of plasmacytoma-like PTLD presenting as a leg mass in a 58-year-old male. Biopsy from the lesion exhibited atypical plasmacytoid and plasmablastic cells that showed lambda light chain restriction and stained positive for CD138 and Epstain-Bar virus early RNA by in situ hybridization. These findings were diagnostic of plasmacytoma-like PTLD. Only a few similar cases have been reported in the literature. The majority of these cases occurred in heart and kidney transplant patients. To our knowledge, this is the first reported case to occur in a lung transplant patient.
    No preview · Article · Jul 2008 · Journal of Cutaneous Pathology
  • Erin Moore · Rob McFarlane · John Olerud

    No preview · Article · Jun 2008 · Archives of dermatology