EBV+ mucocutaneous ulcers in the setting of pre-existing cutaneous T-cell lymphoproliferative disorders: A report of 2 cases

Craddock, Lauren; Inda, Jacob J.; Longley, B. Jack; Wood, Gary S.

doi:10.1016/j.jdcr.2018.10.013

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Patients responded well to reduction of immune suppression, with or without rituximab therapy, and no patient had recurrence of the EBV-driven process. More recently two cases of cutaneous MCU were reported in patients who had received therapy for another unrelated primary cutaneous T-cell lymphoproliferative disorder [44]. In this setting correct diagnosis was key to appropriate therapy, as rituximab led to regression in both cases.…”

Section: Mucocutaneous Ulcer (Mcu)mentioning

confidence: 98%

Navigating the cutaneous B-cell lymphomas: avoiding the rocky shoals

Jaffe

2020

Modern Pathology

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Section: Mucocutaneous Ulcer (Mcu)mentioning

confidence: 98%

Navigating the cutaneous B-cell lymphomas: avoiding the rocky shoals

Jaffe

2020

Modern Pathology

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“…6,27,[35][36][37][38] Predominantly, they develop in the context of autoimmune conditions treated with methotrexate, although they have also been reported to arise after treatment of T-cell neoplasms, including mycosis fungoides, Sézary syndrome, and T-cell acute lymphoblastic leukemia. 25,[39][40][41][42][43] MTX-LPD can represent a potential serious diagnostic pitfall because their histology may mimic high-grade lymphoma. They demonstrate variable association with EBV infection, with EBV-positive cases displaying surface ulceration, marked tumor cell polymorphism including HRS-like cells, reduced expression of B-cell markers, and/or expression of CD30 and MUM1.…”

Section: Discussionmentioning

confidence: 99%

Skin-Limited, Methotrexate-Associated Epstein–Barr Virus–Positive Mucocutaneous Ulcer—A Mimicker of High-Grade Lymphoma. A Report of 4 Cases and Review of the Literature

Macklin

Stonard

Matin

et al. 2023

The American Journal of Dermatopathology

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Immunodeficiency-associated lymphoproliferative disorders (IA-LPDs) constitute a diverse range of conditions including posttransplant lymphoproliferative disorders, other iatrogenic IA-LPDs, and lymphoproliferative disorders associated with an underlying primary immune disorder or HIV infection. IA-LPDs are clinically and pathologically heterogeneous, and there is a lack of standardization of diagnostic terminology. They can represent a potential serious diagnostic pitfall because the histological features of clinically indolent proliferations may mimic those of high-grade lymphoma. However, correct identification of these entities is essential given that complete remission may occur upon reversal of the underlying cause of immunosuppression without the need for systemic therapy. IA-LPDs presenting in the skin are rare but well documented. One form of iatrogenic IA-LPD, methotrexate-associated lymphoproliferative disorder (MTX-LPD), can present with cutaneous nodules, plaques, or ulcers. Predominantly, MTX-LPD develops in the context of long-term treatment of autoimmune conditions, such as rheumatoid arthritis, dermatomyositis, and Sjögren syndrome, and may be associated with underlying Epstein–Barr virus (EBV) infection. We present 4 cases of cutaneous EBV-positive B-cell MTX-LPD and describe their clinical and morphological findings. Comparison of our histological findings to the diagnostic criteria for EBV-positive mucocutaneous ulcer (EBVMCU) revealed significant overlap, highlighting the intersection between MTX-LPD and EBVMCU. Withdrawal of methotrexate resulted in healing of all lesions at a mean time of 2 months. In summary, close clinicopathological correlation is vital to identify MTX-LPD presenting as cutaneous EBVMCU given that the initial treatment strategy is that of withdrawal of methotrexate without the need for immediate systemic therapy.

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Methotrexate/prednisone

2019

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EBV+ mucocutaneous ulcers in the setting of pre-existing cutaneous T-cell lymphoproliferative disorders: A report of 2 cases

Cited by 3 publications

References 11 publications

Navigating the cutaneous B-cell lymphomas: avoiding the rocky shoals

Navigating the cutaneous B-cell lymphomas: avoiding the rocky shoals

Skin-Limited, Methotrexate-Associated Epstein–Barr Virus–Positive Mucocutaneous Ulcer—A Mimicker of High-Grade Lymphoma. A Report of 4 Cases and Review of the Literature

Methotrexate/prednisone

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