Atypical lymphoproliferative disorder-clinical and pathological features
Wilmas, K.; Duvic, M.; Oki, Y.
Dermatology Online Journal 22(9)
2016
ISSN/ISBN: 1087-2108 PMID: 28329608 Document Number: 688462
Definitive diagnosis of cutaneous lymphoproliferative disorders is one of the most challenging issues in dermatopathology owing to the broad spectrum of clinical and histopathological presentations. We report a case of a 73-year-old woman who presented with a single, asymptomatic plaque limited to her left collarbone. This was followed by the appearance of several plaques and patches in addition to a tumor. Her initial biopsy suggested a CD4/CD8 double negative mycosis fungoides (MF). However, the rapidly progressive course of her disease is worrisome for peripheral T-cell lymphomas-not otherwise specified (PTCL-NOS). Subsequent biopsies revealed epidermal spongiosis with subepidermal edema and possible nodal involvement by cutaneous T-cell lymphoma. The rare combination of these pathologic features demonstrates the difficulty of diagnosing atypical lymphoproliferative disorders.