Cutaneous immunocytomas: a clinicopathologic study of 26 cases

Abstract

The clinical and histological features of 16 patients with a primary cutaneous immunocytoma and 10 patients with a secondary cutaneous immunocytoma are reported. In all cases the diagnosis was based on the presence of monotypic plasma cells or lymphoplasmacytoid cells. Our data show that primary cutaneous immunocytomas are a distinct type of cutaneous lymphoma, characterized by (a) the presence of solitary or localized skin lesions (13 of 16 cases); (b) preferential localization on arms and legs (15 of 16 cases); (c) excellent response to local treatment (15 of 16 cases) and (d) a favourable prognosis. Histologically, these primary cutaneous immunocytomas are characterized by the presence of nodular or diffuse infiltrates with monotypic lymphoplasmacytoid/plasma cells located at the periphery of the infiltrates. Important clinical and histological differences were noted between primary and secondary immunocytomas. In the latter group more widespread skin disease was seen, often in the presence of paraproteins and/or autoimmune diseases. In contrast with the peripheral localization of the monotypic cells in primary cutaneous immunocytomas the monotypic lymphoplasmacytoid/plasma cells in secondary immunocytomas formed diffuse infiltrates or these cells were found dispersed throughout the infiltrate. There were no differences in clinical presentation or course between the different subtypes of cutaneous immunocytomas (lymphoplasmacytic, lymphoplasmacytoid and polymorphic immunocytomas). The differential diagnosis between primary cutaneous immunocytomas and cutaneous plasmacytomas, primary follicular centre cell lymphomas and cutaneous 'pseudolymphomas' is discussed.

Prognostic significance of Fas (CD95/APO‐1) positivity in patients with primary nodal diffuse large B‐cell lymphoma

“…Fas expression was correlated with node-negative status, reduced depth of invasion, smaller tumor size, and longer disease-free survival and overall survival in various types of carcinomas [7][8][9]. On the other hand, there are only limited number of studies on the effect of immunohistochemical Fas (APO-1 or CD95) positivity on patients' survival and therapeutic outcome in DLBCL [10,32,33].…”

WHO-EORTC classification for cutaneous lymphomas

“…Primary cutaneous marginal zone B-cell lymphoma (PCMZL) is an indolent lymphoma composed of small B cells, including marginal zone (centrocyte-like) cells, lymphoplasmacytoid cells, and plasma cells. It includes cases previously designated as primary cutaneous immunocytoma, 131 and cases of cutaneous follicular lymphoid hyperplasia with monotypic plasma cells. 132 Exceptional cases of primary cutaneous plasmacytoma without underlying multiple myeloma (extramedullary plasmacytoma of the skin) show considerable overlap with PCMZL and are therefore included in this category.…”

“…134,[138][139][140] Associated autoimmune diseases are uncommon in PCMZL, but rather suggest secondary cutaneous involvement of a systemic lymphoma. 131 Histopathology. These lymphomas show nodular to diffuse infiltrates with sparing of the epidermis.…”

“…PCMZLs have a tendency to recur in the skin, but dissemination to extracutaneous sites is exceedingly rare. 131,[134][135][136] In some cases spontaneous resolution of the skin lesions may be observed. The development of anetoderma in spontaneously resolving lesions has been observed.…”

Non-Hodgkin's Lymphoma of Mucosa-Associated Lymphoid Tissue

“…They present as single or multiple brown or redbrown papulonodular lesions or plaques, predominantly found on the extremities or the back [155,156]. They can be treated by surgical excision, radiation therapy, or observation (especially in the case of multiple lesions).…”