Reuven Bergman1, Khozayma Khamaysi, Ziad Khamaysi, Yehudit Ben Arie. 1. Department of Dermatology, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. r_bergman@rambam.health.gov.il
Abstract
BACKGROUND: Cutaneous lymphoid hyperplasia (CLH) is generally classified according to clinicopathologic entities or put into broad spectrums of B-cell or T-cell predominance or co-dominance. OBJECTIVE: We sought to discern histologic features and immunohistochemical staining patterns in CLH that may form a basis for a histologic classification system. METHODS: We studied the clinical, histologic, immunophenotypical, and molecular characteristics of 24 consecutive patients with CLH. RESULTS: The 24 cases were classified according to characteristic histologic features and immunophenotypical staining patterns as follows: presence of germinal center (GC) cell clusters forming well-defined lymphoid follicles (n = 10); presence of clusters of GC cell clusters not forming well-defined lymphoid follicles (n = 6); persistent arthropod assault type CLH (n = 1); CLH with a prominent histiocytic component (n = 4); and CLH without specific histologic and immunophenotypical features, that is, nonspecific mixed T-cell and B-cell CLH (n = 3). Most of the CLH cases did not demonstrate clonal T-cell receptor and/or immunoglobulin heavy chain gene rearrangements except for 3 cases in which the long-term follow-up was uneventful. LIMITATIONS: There were a limited number of cases in our study. CONCLUSIONS: A classification based on characteristic histologic features and immunophenotypical staining patterns, along with pertinent clinical and molecular data, may enhance the diagnosis of CLH.
BACKGROUND:Cutaneous lymphoid hyperplasia (CLH) is generally classified according to clinicopathologic entities or put into broad spectrums of B-cell or T-cell predominance or co-dominance. OBJECTIVE: We sought to discern histologic features and immunohistochemical staining patterns in CLH that may form a basis for a histologic classification system. METHODS: We studied the clinical, histologic, immunophenotypical, and molecular characteristics of 24 consecutive patients with CLH. RESULTS: The 24 cases were classified according to characteristic histologic features and immunophenotypical staining patterns as follows: presence of germinal center (GC) cell clusters forming well-defined lymphoid follicles (n = 10); presence of clusters of GC cell clusters not forming well-defined lymphoid follicles (n = 6); persistent arthropod assault type CLH (n = 1); CLH with a prominent histiocytic component (n = 4); and CLH without specific histologic and immunophenotypical features, that is, nonspecific mixed T-cell and B-cell CLH (n = 3). Most of the CLH cases did not demonstrate clonal T-cell receptor and/or immunoglobulin heavy chain gene rearrangements except for 3 cases in which the long-term follow-up was uneventful. LIMITATIONS: There were a limited number of cases in our study. CONCLUSIONS: A classification based on characteristic histologic features and immunophenotypical staining patterns, along with pertinent clinical and molecular data, may enhance the diagnosis of CLH.