Unusual T Cell Pseudolymphoma with Features of So-Called Pseudolymphomatous Folliculitis

Dargent, Jean‐Louis; Debois, J. M.; Saß, Ursula; Theunis, Anne; André, Josette; Simonart, Thierry

doi:10.1159/000051843

Cited by 20 publications

(21 citation statements)

References 7 publications

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“…[9][10][11][12][13][14][15][16][17] The histopathologic hallmark of SMPTCL is dense infiltrates of small-/medium-sized pleomorphic T lymphocytes with a small proportion of large cells (not exceeding 30%). All our cases showed infiltration and sometimes destruction of the pilar units and sweat glands, features that have been described in other cases as well 22 and that are usually considered as a malignant trait. Partial destruction of adnexal structures was likely the cause of small granulomas that were observed in about 50% of our cases.…”

Section: Discussionsupporting

confidence: 81%

“…On the other hand, most published cases as well as ours are characterized by an indolent behavior, irrespective of the presence or absence of the criteria just mentioned. 19,20,22,26 In fact, only in one of the 3 most recent series 14,15,17 some of the patients died, and in this same study, cases seemed quite heterogeneous. 15 Although one may argue that skin lesions in these patients are managed (often excised surgically) in early stages, thus achieving a curative treatment, spontaneous regressions in absence of any therapy have been described, 14 thus the true potential for progression into overt malignant lymphoma, if any, is yet unclear.…”

mentioning

confidence: 55%

“…2 Only a few, small, probably, heterogeneous series of cases of SMPTCL have been reported. [10][11][12][13][14][15][16][17] It should be stressed that cases with overlapping clinicopathologic features have been described also under different names besides SMPTCL, including solitary lymphomatous papule, nodule, or tumor 18 ; cutaneous lymphoid hyperplasia 19 ; solitary nonepidermotropic T-cell pseudolymphoma 20 ; pseudolymphomatous folliculitis 21,22 ; and unilesional mycosis fungoides. 23 In this context, clinicopathologic features and prognosis of SMPTCL, as well as optimal treatment modalities, have not been well characterized.…”

Section: Discussionmentioning

confidence: 99%

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Primary Cutaneous CD4+ Small-/Medium-Sized Pleomorphic T-Cell Lymphoma: A Cutaneous Nodular Proliferation of Pleomorphic T Lymphocytes of Undetermined Significance? A Study of 136 Cases

Beltraminelli¹,

Leinweber²,

Kerl³

et al. 2009

The American Journal of Dermatopathology

197

224

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Patients with skin nodules characterized by the infiltrate of pleomorphic small/medium T lymphocytes are currently classified as "primary cutaneous CD4+ small-/medium-sized pleomorphic T-cell lymphoma" (SMPTCL) or as T-cell pseudolymphoma. The distinction is often arbitrary, and patients with similar clinicopathologic features have been included in both groups. We studied 136 patients (male:female = 1:1; median age: 53 years, age range: 3-90 years) with cutaneous lesions that could be classified as small-/medium-sized pleomorphic T-cell lymphoma according to current diagnostic criteria. All but 3 patients presented with solitary nodules located mostly on the head and neck area (75%). Histopathologic features were characterized by nonepidermotropic, nodular, or diffuse infiltrates of small- to medium-sized pleomorphic T lymphocytes. A monoclonal rearrangement of the T-cell receptor-gamma gene was found in 60% of tested cases. Follow-up data available for 45 patients revealed that 41 of them were alive without lymphoma after a median time of 63 months (range: 1-357 months), whereas 4 were alive with cutaneous disease (range: 2-16 months). The incongruity between the indolent clinical course and the worrying histopathologic and molecular features poses difficulties in classifying these cases unambiguously as benign or malignant, and it may be better to refer to them with a descriptive term such as "cutaneous nodular proliferation of pleomorphic T lymphocytes of undetermined significance," rather than forcing them into one or the other category. On the other hand, irrespective of the name given to these equivocal cutaneous lymphoid proliferations, published data support a nonaggressive therapeutic strategy, particularly for patients presenting with solitary lesions.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Primary Cutaneous CD4+ Small-/Medium-Sized Pleomorphic T-Cell Lymphoma: A Cutaneous Nodular Proliferation of Pleomorphic T Lymphocytes of Undetermined Significance? A Study of 136 Cases

Beltraminelli¹,

Leinweber²,

Kerl³

et al. 2009

The American Journal of Dermatopathology

197

224

View full text Add to dashboard Cite

show abstract

“…To date, only a few, small, heterogeneous series of cases of SMPTCL have been published [3,4,5,6,7,8]; thus, clinical features, prognosis and optimal treatment modalities are not well characterized. In this context, it should be underlined that precise diagnostic criteria for the differentiation of SMPTCL from benign lesions (pseudolymphomas) are lacking, and cases with clinicopathological features overlapping with those of SMPTCL have been reported under different names, including ‘solitary lymphomatous papule, nodule or tumour’ [13], ‘cutaneous lymphoid hyperplasia’ [14], ‘solitary non-epidermotropic T-cell pseudolymphoma’ [15], ‘pseudolymphomatous folliculitis’ [16, 17] and ‘unilesional mycosis fungoides’ [18]. Cases reported recently as ‘indolent CD8+ lymphoid proliferation of the ear’ [19] or ‘pleomorphic CD8+ small/medium size cutaneous T-cell lymphoma’ [20] may represent a phenotypic variant of the same pathological process, too.…”

Section: Discussionmentioning

confidence: 99%

Solitary Small- to Medium-Sized Pleomorphic T-Cell Nodules of Undetermined Significance: Clinical, Histopathological, Immunohistochemical and Molecular Analysis of 26 Cases

Leinweber

Beltraminelli²,

Kerl³

et al. 2009

Dermatology

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Background: Solitary skin nodules composed of pleomorphic T lymphocytes are often the source of diagnostic problems. Objective: To characterize the clinicopathological features, prognosis and optimal treatment modalities of patients with solitary lymphoid nodules of small- to medium-sized pleomorphic T lymphocytes. Methods: Twenty-six patients were analysed for clinical, histopathological, immunophenotypical, molecular and follow-up data. Results: Lesions were located mainly on the head and neck (n = 16; 61.5%) or trunk (n = 8; 30.8%). Histopathology showed non-epidermotropic nodular or diffuse infiltrates of small- to medium-sized pleomorphic T lymphocytes. Monoclonality was found by PCR in 54.2% of cases (n = 13/24). After a mean follow-up of 79.7 months, a local recurrence could be observed only in 1 patient. Conclusions: Our patients have a specific cutaneous lymphoproliferative disorder characterized by reproducible clinicopathological features. The incongruity between the indolent clinical course and the worrying histopathological features poses difficulties in classifying these cases unambiguously as benign or malignant. We suggest to describe these lesions as ‘solitary small- to medium-sized pleomorphic T-cell nodules of undetermined significance’. Irrespective of the name given to these equivocal cutaneous lymphoid proliferations, follow-up data support a non-aggressive therapeutic strategy.

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“…In comparison with the various forms of CLH, there exist some similarities between PLF and pseudo-T-cell lymphoma. Indeed, pseudo-T-cell lymphoma may have a nodular appearance and be composed of a dense T cell infiltrate that may comprise numerous histiocytes and B cells [7]. …”

Section: Discussionmentioning

confidence: 99%

Pseudolymphomatous Folliculitis on the Nose

Kakizaki¹,

Fujimura²,

Numata³

et al. 2012

Case Rep Dermatol

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Pseudolymphomatous folliculitis (PLF), which sometimes mimicks cutaneous lymphoma, is a rare manifestation of cutaneous pseudolymphoma and cutaneous lymphoid hyperplasia. We describe a 57-year-old Japanese woman with PLF on the nose that resembled cutaneous lymphoma clinically. The biopsy specimen revealed dense lymphocytes, especially CD1a+ cells, infiltrated around the hair follicles. Without any additional treatment, her nodule rapidly decreased before we performed a second biopsy for analysis of the clonal gene rearrangement. Though PLF typically behaves as benign lymphohyperplasia, differentiation from cutaneous lymphoma is necessary.

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Unusual T Cell Pseudolymphoma with Features of So-Called Pseudolymphomatous Folliculitis

Cited by 20 publications

References 7 publications

Primary Cutaneous CD4+ Small-/Medium-Sized Pleomorphic T-Cell Lymphoma: A Cutaneous Nodular Proliferation of Pleomorphic T Lymphocytes of Undetermined Significance? A Study of 136 Cases

Primary Cutaneous CD4+ Small-/Medium-Sized Pleomorphic T-Cell Lymphoma: A Cutaneous Nodular Proliferation of Pleomorphic T Lymphocytes of Undetermined Significance? A Study of 136 Cases

Solitary Small- to Medium-Sized Pleomorphic T-Cell Nodules of Undetermined Significance: Clinical, Histopathological, Immunohistochemical and Molecular Analysis of 26 Cases

Pseudolymphomatous Folliculitis on the Nose

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