Monoclonal plasma cell infiltrates in the setting of cutaneous follicular helper T cell lymphoproliferative disorders

Magro, Cynthia M.; Ruan, Jia; Grossman, Marc E.; Hedayat, A.

doi:10.1016/j.anndiagpath.2019.04.013

Cited by 12 publications

(15 citation statements)

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“…15 Nevertheless, Cyclin D1 expression in lymphatic cells is a typical feature of several lymphatic neoplasias. 16 Interestingly we detected Cyclin D1positive cells in PCSM-LPD by immunohistochemistry. The number and distribution of Cyclin D1(+)-cells were suggestive for lymphatic PD1(+)-cells to be the positive population (Figure 1).…”

Section: Y C L I N D 1 E X P R E S S I O N I N P D 1 ( + ) C E L L S ...mentioning

confidence: 72%

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder

et al. 2022

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Aims The aim was to gain insight into the biology of primary cutaneous CD4+ small/medium T‐cell lymphoproliferative disorder (PCSM‐LPD). Methods We describe the histopathological and clinical characteristics of 177 PCSM‐LPD diagnosed at our consultation centre. We performed immunohistochemical multistaining in a subset of cases (n = 46) including PD1, Cyclin D1, and multiple markers of proliferation. We evaluated clonal T‐cell‐receptor‐(TCR) rearrangements and used tissue microdissection to analyse TCR‐clonality of PD1(+) cells. Results The cohort of n = 177 PCSM‐LPD included 84 males and 93 females (median age 57, range 13–85). Clinical presentation was as a solitary nodule or plaque (head and neck > trunk > extremities). Most patients were treated by local excision or steroids (96%, 69/72); relapses occurred in 12/65 (18%) of patients with follow up. Histopathology revealed the predominance of a nodular pattern (75%, 134/177) and frequent clustering of PD1(+) large cells (70%, 103/147). We detected Cyclin D1 and PD1 coexpression (>10% of PD1(+)‐cells) in 26/46 (57%), which was not associated with CCND1 breaks or amplifications. PD1(+)‐cells in PCSM‐LPDs showed a significantly higher expression of proliferation‐associated proteins compared to PD1(−)‐cells. A clonal TCR‐rearrangement was present in 176/177 (99%), with a clonal persistence in 7/8 patients at relapse including distant sites. Tissue‐microdissection revealed PD1(+)‐cells as the source of clonality, whilst PD1(−)‐cells remained polyclonal. Conclusion PCSM‐LPD is a clinically indolent, albeit neoplastic, disease driven by clonal expansion of PD1(+)‐cells. We demonstrate Cyclin D1‐expression associated with accelerated proliferation as a surprising new biological feature of the disease.

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Section: Y C L I N D 1 E X P R E S S I O N I N P D 1 ( + ) C E L L S ...mentioning

confidence: 72%

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder

et al. 2022

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“…AITL is often histologically obscured by a significant degree of B cell infiltration, including small immunoblastic collections of EBV-positive B cells, Reed-Sternberg-like cells, and many plasma cells, including cases where the plasma cells can be light chain-restricted. 2 Uncommonly, a B-cell lymphoma can emerge. The pathogenetic events that underlie the development of malignant B cell lymphoma in the setting of AITL include EBV infection of transformed B cells coupled with iatrogenic and endogenous immune dysfunction and promotion of B-cell hyperplasia through the neoplastic follicular helper T cell-enriched microenvironment.…”

Section: Discussionmentioning

confidence: 99%

Epstein-Barr virus-positive, CD30-positive, diffuse large B-cell lymphoma in a patient with angioimmunoblastic T-cell lymphoma

Grossman¹,

Ruan²,

Magro³

2022

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“…Typically, FHT contributes to SHM through germinal cell interactions. With neoplastic proliferation of these cells, an excessive, robust, B‐cell expansion would result in emerging clonally restricted B‐cells, which represent a benign clonal expansion of plasma cells under the influence of the enhanced FHT microenvironment 12 . It is likely that the FHT signature that characterizes AITL contributes to the excessive expansion of IgA elaborating plasma cells including an immunoglobulin that recognizes select epidermal basement membrane zone epitopes.…”

Section: Discussionmentioning

confidence: 99%

Linear IgA bullous dermatosis in the setting of angioimmunoblastic T‐cell lymphoma

Andriano

Tannenbaum

et al. 2022

J Cutan Pathol

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We report an 80‐year‐old male developing linear IgA bullous dermatosis (LAD) in the setting of angioimmunoblastic T‐cell lymphoma (AITL). This phenomenon is rare, as only three cases have been described in the literature. The pathophysiologic process can be attributed to dysregulation in somatic hypermutation and the expression of chemokine receptor 5 in AITL, contributing to increased IgA. Immunoglobulin production resulting from clonal plasma cell expansion may be because of the B‐cell promotional effect by neoplastic follicular helper T‐cells. Beyond providing a pathophysiologic platform for AITL‐associated LAD, we also briefly summarized prior cases. This report demonstrates the importance of considering LAD in the differential diagnosis for patients with a bullous eruption in the setting of AITL.

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Monoclonal plasma cell infiltrates in the setting of cutaneous follicular helper T cell lymphoproliferative disorders

Cited by 12 publications

References 36 publications

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder

Epstein-Barr virus-positive, CD30-positive, diffuse large B-cell lymphoma in a patient with angioimmunoblastic T-cell lymphoma

Linear IgA bullous dermatosis in the setting of angioimmunoblastic T‐cell lymphoma

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Monoclonal plasma cell infiltrates in the setting of cutaneous follicular helper T cell lymphoproliferative disorders

Cited by 12 publications

References 36 publications

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4+ small or medium T‐cell lymphoproliferative disorder

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4+ small or medium T‐cell lymphoproliferative disorder

Epstein-Barr virus-positive, CD30-positive, diffuse large B-cell lymphoma in a patient with angioimmunoblastic T-cell lymphoma

Linear IgA bullous dermatosis in the setting of angioimmunoblastic T‐cell lymphoma

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Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder

Cyclin D1 expression, cell proliferation, and clonal persistence characterize primary cutaneous CD4⁺ small or medium T‐cell lymphoproliferative disorder