Secondary skin involvement in classic Hodgkin lymphoma: Results of an international collaborative cutaneous lymphoma working group study of 25 patients

Abstract

Background: Cutaneous involvement by classic Hodgkin lymphoma (CHL) is an extraordinarily rare phenomenon in the current era. To date, no single large case series of cutaneous involvement by Hodgkin lymphoma has ever been reported in the literature.Methods: A comprehensive search for cases designated "skin" and "Hodgkin" was performed at different institutions between 1990 and 2020. Twenty-five cases were identified, and each case was independently reviewed by at least three boardcertified dermatopathologists and/or hematopathologists. Results: All cases represented examples of systemic CHL with secondary skin dissemination. A single lesion, usually a tumor, nodule or infiltrative plaque was observed in 56% of cases and multiple lesions were present in 28% of cases. Most patients (86%-12/14) had a diagnosis of stage IV disease at first diagnosis. The interval between the clinical (first) diagnosis of HL and the development of skin lesions ranged between 6 and 108 months (average 33.75 months). Comprehensive histopathologic evaluation of these cases (at the initial diagnosis) revealed a diagnosis of classic HL not otherwise specified (NOS) in 60% of cases (15/25), nodular sclerosis type in 24% (6/25), mixed cellularity in 12% (3/25), and lymphocyte depleted in 4% (1/25).Conclusions: We provide documentation of a large series of CHL with secondary skin

Neoplastic or inflammatory? A case report of Sweet syndrome with CD30+ cells in a patient with B‐lymphoblastic leukemia

“…The cytoplasmic/membrane expression of CD30 on lymphocytes may indicate a lymphoproliferative disorder such as lymphomatoid papulosis, 21 or anaplastic large cell lymphoma, 22 advanced mycosis fungoides, or borderline cases (collectively known as CD30+ lymphoproliferative disorders) 22,23 . Rarely, Hodgkin disease, which is also characterized by CD30 expression in large cells, has been reported to secondarily involve the skin and may be considered in the differential 24 . However, the absence of B‐cell and T‐cell lineage markers in the large cells (Figure 6) argued against a lymphoproliferative disorder including neutrophil‐rich/pyogenic CD30+ lymphoproliferative disorders.…”

“…22,23 Rarely, Hodgkin disease, which is also characterized by CD30 expression in large cells, has been reported to secondarily involve the skin and may be considered in the differential. 24 solid organ and germ cell malignancies, 1 systemic mastocytosis, 25 viral or drug eruption, 26 and arthropod assault (including nodular scabies). 27,28 One study has investigated the CD30 expression in neutrophil-rich inflammatory skin disorders and the expression was seen in large atypical cells that were lymphoid in origin and mostly T-cells, 2 which is not surprising, given the normal expression of the marker on activated T and B-cells.…”