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Lymphomatoid papulosis: reappraisal of clinicopathologic presentation and classification into subtypes A, B, and C El Shabrawi-Caelen L; Kerl H; Cerroni LArch Dermatol 2004[Apr]; 140 (4): 441-7OBJECTIVES: To analyze clinicopathologic features of lymphomatoid papulosis and delineate the characteristics of histopathologic variants (types A, B, and C). DESIGN: Retrospective nonrandomized study. SETTING: University-based dermatologic referral center. PATIENTS: Eighty-five patients with lymphomatoid papulosis. Clinical data and 1 or more biopsy specimens were available for review in all cases. When possible, immunophenotypic and molecular analyses were carried out. RESULTS: Of these patients, 78 presented only 1 histopathologic subtype of lymphomatoid papulosis (64 had type A, 3 had type B, and 11 had type C). The last 7 patients presented more than 1 subtype (1 had A and B, 5 had A and C, and 1 had A, B, and C). Two patients had regional lymphomatoid papulosis, an unusual clinical presentation characterized by groups of lesions localized to 1 anatomic region. We observed, we believe for the first time, that some histopathologic patterns, ie, follicular mucinosis (n = 1), syringotropic infiltrates (n = 1), epidermal vesicle formation (n = 2), and syringosquamous metaplasia (n = 1), were associated with lymphomatoid papulosis. A distribution along hair follicles, or follicular lymphomatoid papulosis, was observed in 5 biopsy specimens. A bandlike rather than a wedge distribution of the infiltrate was seen in 5 specimens from patients with lymphomatoid papulosis type A. Of 8 patients who had associated lymphoid malignancies, 4 had Hodgkin disease and 4 had mycosis fungoides. CONCLUSIONS: Lymphomatoid papulosis is a cutaneous disorder with multiple clinicopathologic features. Differentiating between mycosis fungoides and anaplastic large cell lymphoma may be very difficult and sometimes impossible. In the spectrum of CD30(+) cutaneous lymphoproliferative disorders, boundaries between these 2 entities are not clear-cut.|Adult[MESH]|Age Distribution[MESH]|Aged[MESH]|Biopsy, Needle[MESH]|Cell Transformation, Neoplastic/*pathology[MESH]|Female[MESH]|Humans[MESH]|Immunohistochemistry[MESH]|Incidence[MESH]|Lymphomatoid Papulosis/*classification/*pathology[MESH]|Male[MESH]|Middle Aged[MESH]|Precancerous Conditions/pathology[MESH]|Prognosis[MESH]|Retrospective Studies[MESH]|Risk Assessment[MESH]|Sampling Studies[MESH]|Severity of Illness Index[MESH]|Sex Distribution[MESH]|Skin Neoplasms/*pathology/prevention & control[MESH] |
