Lymphocyte markers on formalin‐fixed tissue in Jessner's lymphocytic infiltrate and lupus erythematosus

Abstract

Clinical and histological differentiation between Jessner's lymphocytic infiltration of the skin (JLI) and lupus erythematosus (LE) may be difficult. Previous immunohistochemical studies using monoclonal antibodies on frozen sections have shown that the majority of inflammatory cells in JLI and LE are T lymphocytes, whereas B lymphocytes are few or absent. We have performed an immunohistochemical study on formalin-fixed, paraffin-embedded tissue sections from seven patients with JLI and five with LE using monoclonal antibodies MT1 (pan T-cells), OPD4 (helper/inducer T-cells CD4), MT2 (mantle zone B and some T-cells), MB2 (pan B-cells), L26 (pan B-cells), and LN1 (germinal centre B-cells). In both diseases, the-majority of the inflammatory cells were T lymphocytes (MT1 positive), confirming the results others have obtained on frozen material. OPD4 positive cells were detected in varying numbers in all cases. However, the percentage of B lymphocytes tended to be higher in JLI than LE. LN1 was the most useful B-cell marker in distinguishing JLI from LE. However, a combination of MT2 and LN1 gave the most significant difference. We conclude that immunohistochemical analysis using a panel of monoclonal antibodies to T and B lymphocytes may be useful in differentiating JLI from LE, although there is still considerable overlap.

Immunohistochemical characterization of the cellular infiltrate in discoid lupus erythematosus

“…Previous studies reported that B lymphocytes were rare or absent (< 5%) in DLE lesions (11,(16)(17)(18). However, Akasu et al observed B lymphocytes accounted for > 25% in one of his five DLE cases (19). Wolfgang et al found B lymphocytes were over 5% of the inflammatory cells in 31% of their DLE cases and in 8 of 49 cases, and that B lymphocytes accounted for > 20% of the inflammatory cell infiltrate.…”

Lupus Erythematosus Tumidus

“…In contrast to LET, histological features of Jessner's lymphocytic infiltration of the skin show no interstitial mucin deposition, but varying numbers of plasma cells may be present. 39,61 However, Jessner's lymphocytic infiltration of the skin is not always considered as a specific disease entity, 47,62 and some of the cases described in the literature might, in our opinion, represent LET. 63 There is only one study to date comparing Jessner's lymphocytic infiltration of the skin with LET.…”

Immunopathology of Nonneoplastic Skin Disease:A Brief Review

“…In the former group, one has such lesions as Jessner's infiltrate, dermal or subcutaneous lupus erythematosus, lymphadenoma benigna cutis, lymphocytoma cutis (of Spiegler-Fendt), chronic lichenoid and spongiotic dermatitides, drug-induced pseudolymphomas, actinic reticuloid, inflammatory pseudotumor, Kikuchi's disease, and cutaneous lymphoid hyperplasia, not further specified. [94][95][96][97] These have been summarized recently in a thorough review by Smoller and Glusac. 97 Malignant lymphoid lesions of the skin that may be deviously bland-looking are also quite common among selected members of the small-lymphocytic, small cleavedcell, and mixed small and large-cell categories.…”

“…Such lesions include Jessner's infiltrates, active cutaneous lupus erythematosus, and inflammatory cutaneous "pseudotumors." 95 ' 991 " However, other infiltrates such as lymphadenoma benigna cutis, lymphocytoma cutis, and follicular variants of cutaneous lymphoid hyperplasia (CLH) do, in fact, contain a large number of B lymphocytes and are capable of causing substantial diagnostic consternation. 94 ' 97 '' 09 " 2 Frozen section studies are helpful if they show restriction of X or K light chain immunoglobulin expression by the constituent B cells."…”

“…97 Malignant lymphoid lesions of the skin that may be deviously bland-looking are also quite common among selected members of the small-lymphocytic, small cleavedcell, and mixed small and large-cell categories. [94][95][96][97][98] Immunohistologic evaluation is variably effective at resolving differential diagnostic problems and can be applied best after subclassification of the constituent disorders into three broad groups.…”