Atlas of dermatopathology: Lymphomatoid papulosis

+ Introduction

+ Literature

+ Support

+ Skin biopsy

+ Non-tumorous skin diseases

+ Skin tumors

+ Mesenchymal tumors

+ Cysts of the skin and subcutis

+ Soft tissue lesions

+ Some lesions of the oral cavity

+ Dermatovenerology

+ Collection of histological slides by prof. Günter Burg

+ Collection of histological slides by prof. Werner Kempf

+ Collection of histological slides of dr. Ram Chandra Adhikari

Lymphomatoid papulosis

Introduction

Chronic lymphoproliferative disease with benign course over decades, but malignant histologic appearance is based upon cytomorphology of atypical lymphocytes.

Clinical signs

papulo-nodular or patchy, self regressing eruptions (from only a few to hundreds)
healing with hyperpigmented scars
duration of eruption: several weeks or months
duration of the disease: between 3 months up to 40 years, benign
location: trunk, proximal parts of the limbs, sometimes on the head
preferentially affects females in the third or fourth decades
in about 10 – 20% of the cases development of mycosis fungoides, CD30+ CTCL or Hodgkin disease

Lymphomatoid papulosis (4014)

Pictures

Lymphomatoid papulosis (the case with CD56 positive cells, see bellow): Lymphomatoid papulosis with CD30 and CD56 positive cells, Clinical picture (4014) Lymphomatoid papulosis with CD30 and CD56 positive cells, Clinical picture (4016)

Histology

Histology depends on the stage of the disease:

Fully developed lesion (2 – 3 weeks after initial manifestation; type A):
nodular superficial and deep, sometimes wedge shaped dermal infiltrate, which may invade the subcutaneous fat. Variable epidermotrophism. Prominent inflammatory infiltrate with eosinophils. Medium to large, pleomorphic tumor cells. Erythrocyte extravasation.

Resolving lesions (6 – 8 weeks old): necrosis with erosion and neutrophils; scar formation

Medium-sized or large pleomorphic cells. Atypical mitoses (in 70%)

Immunophenotype and genetic features: