The differential diagnosis of CD8‐positive (“type D”) lymphomatoid papulosis

Abstract

We concur with previous authors that distinction of CD8(+) LyP from lymphoma in its differential diagnosis is difficult based on histopathology alone. Nonetheless, we propose that certain histopathologic clues may be helpful in this differential diagnosis.

Characterization of Primary Cutaneous CD8+/CD30+ Lymphoproliferative Disorders

“…There was also 1 case of mycosis fungoides associated with CD8 + PCALCL. 13,14 Our case 3 also had a diagnosis of multiple myeloma.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][25][26][27] Clinical characteristics are shown in Table 3. Patients with CD8 + LyP were significantly younger than patients with PCALCL (mean = 39.14 vs. 54.12 years, P = 0.0013).…”

“…4 LyP "type D" has been used to describe a growing number of cases of LyP demonstrating predominantly CD8 + atypical infiltrates, in contrast to LyP types A, B, and C, which are CD4 + . [5][6][7][8][9][10][11][12][13][14][15][16][17][18] LyP type D was first described by Saggini et al, 15 demonstrating features of dense infiltrates of medium-sized, pleomorphic epidermotropic lymphocytes in addition to the cytotoxic phenotype. 15 Cutaneous PCALCL with a CD8 + phenotype has also been described, 6,[19][20][21][22][23] which presents a particularly difficult diagnostic challenge since differentiation from primary cutaneous aggressive epidermotropic CD8 + cytotoxic T-cell lymphoma (CTCL) and CD8 + gamma/delta and natural killer/T-cell lymphoma is key to management.…”

“…15 Cutaneous PCALCL with a CD8 + phenotype has also been described, 6,[19][20][21][22][23] which presents a particularly difficult diagnostic challenge since differentiation from primary cutaneous aggressive epidermotropic CD8 + cytotoxic T-cell lymphoma (CTCL) and CD8 + gamma/delta and natural killer/T-cell lymphoma is key to management. 13,14 Furthermore, the term LyP "type E" has also been proposed to describe angiocentric and angiodestructive patterns in LyP. Many of the cases first described were also predominantly CD8 + .…”

“…24 Clinical and histologic characteristics of these recently described variants of CD8 + /CD30 + lymphoproliferative disorders are not yet well characterized, given the heterogenous findings in several large case series. [13][14][15] We report the clinical, histologic, and immunohistochemical (IHC) characteristics of 7 additional cases of these rare cutaneous CD8 + /CD30 + lymphoproliferative disorders, including CD8 + LyP and CD8 + PCALCL. We also present a unique case representing CD30 2 /CD8 + LyP (with features similar to LyP type B).…”