Statistical Evaluation of Diagnostic and Prognostic Features of CD30+ Cutaneous Lymphoproliferative Disorders

Abstract

Several clinical and histopathologic features of 65 CD30+ cutaneous lymphoproliferations were evaluated for their diagnostic value between CD30+ primary versus secondary cutaneous lymphomas and for their prognostic significance. Primary cutaneous disease, spontaneous regression, and absence of extracutaneous spreading (but not age < or =60 years) were associated with a better prognosis. Epithelial membrane antigen, BNH9, CD15 or CBF.78 antigen were expressed in all types of cutaneous lymphoproliferations. However, epithelial membrane antigen immunoreactivity was more frequently expressed in CD30+ secondary cutaneous large-cell lymphoma. Among CD30+ primary cutaneous large-cell lymphoma, CD15 expression was only seen in localized skin lesions. P53 expression was not associated with spontaneous regression, extracutaneous spreading, or survival. Nested reverse transcriptase-polymerase chain reaction allowed the detection of NPM-ALK transcripts in 10 of 26 CD30+ primary and in 3 of 11 secondary cutaneous large-cell lymphomas. The ALK protein was detected in only 1 of 50 primary and in 4 of 15 secondary cutaneous CD30+ lymphoproliferations. In CD30+ primary cutaneous lymphoproliferation, NPM-ALK transcripts might be expressed by very rare normal or tumoral cells that are undetectable by immunohistochemistry. However, the expression of either NPM-ALK transcripts or ALK-protein was not correlated with prognosis or age in CD30+ cutaneous lymphoproliferations.

Primary Cutaneous T-Cell–Rich B-Cell Lymphoma: Clinically Distinct from Its Nodal Counterpart?

“…ϩ anaplastic large-cell lymphoma has an excellent prognosis, with an estimated 5-year survival of Ͼ90% (14,15). Therefore, correct diagnosis and appropriate staging of primary cutaneous lymphomas are essential to avoid unnecessarily aggressive treatment.…”

Pathobiology of NPM-ALK and variant fusion genes in anaplastic large cell lymphoma and other lymphomas

“…With regard to primary cutaneous ALCL, one study came to the conclusion that NPM-ALK does not appear to be a prognostic factor. 248 An interesting finding is the recent evidence of an immune response to the ALK protein: autologous antibodies against For additional abbreviations see legend to Table 13.…”

A Phase II Study of SGN-30 in Cutaneous Anaplastic Large Cell Lymphoma and Related Lymphoproliferative Disorders

“…thology, they have different clinical presentations (1,2,5). LyP lesions are small pink or red papules (≤2.0 cm) that regress spontaneously in 3 to 4 months without therapy, whereas pc-ALCL is characterized by larger tumors (>2 cm) that may not spontaneously regress.…”

“…For patients with pc-ALCL or LyP, it is difficult to induce complete remissions because new lesions reappear, especially after chemotherapy (1,2,4). For patients with single or localized ALCL tumors, local radiotherapy is often the treatment of choice and is effective but it does not prevent new lesions from emerging.…”