背景:先前的研究表明,至少一种口内嗜酸性粒细胞性溃疡最好归类为CD30+T细胞淋巴增生性疾病(LPD),与组织病理学让人想起淋巴瘤样丘疹病(LyP)的皮肤。微观上,混合的炎症细胞群,通常包括嗜酸性粒细胞和不同数量的非典型淋巴样细胞,经常表达CD30,是典型的LyP,其临床病理范围包括A型,B,C,D,E,和LyP与DUSP22/IRF4重排。迄今为止,报告了约27例口内LyP病例。其中,7例确诊为LyPC型,在组织病理学上经常与间变性大细胞淋巴瘤(ALCL)混淆。
方法:一名60岁男性因舌溃疡1个月病史被转诊。
结果:显微镜检查显示大量上皮下非典型大淋巴样细胞,表达CD4(部分失去CD3,CD5和CD7),CD8(少数细胞),CD30(约50%,在具有大小可变性的非扩散模式中),TIA-1和Ki-67(85%),不染色CD56,ALK,LMP1和EBER1/2,考虑诊断ALCL。然而,三周后,病变完全愈合。
结论:我们在此介绍了一种罕见的口腔内CD30T细胞LPD,我们认为它是皮肤LyP型C的口腔对应物。
BACKGROUND: Previous studies have shown that at least a of intraoral eosinophilic ulcer is best classified as a CD30 + T-cell lymphoproliferative disorder (LPD), with histopathology reminiscent of
lymphomatoid papulosis (LyP) of the skin. Microscopically, a mixed population of inflammatory cells, often including eosinophils and varying numbers of atypical lymphoid cells, frequently expressing CD30, is typical for LyP, whose clinicopathological spectrum includes type A, B, C, D, E, and LyP with DUSP22/IRF4 rearrangement. To date, about 27 intraoral LyP cases have been reported. Of them, 7 cases were diagnosed as LyP type C, which is frequently confused with anaplastic large cell
lymphoma (ALCL) on histopathology.
METHODS: A 60-year-old male was referred for a one-month history of a tongue ulcer.
RESULTS: Microscopy showed numerous subepithelial atypical large lymphoid cells, which expressed CD4 (with partial loss of CD3, CD5, and CD7), CD8 (few cells), CD30 (about 50%, in non-diffuse pattern with size variability), TIA-1, and Ki-67 (85%), without staining for CD56, ALK, LMP1, and EBER1/2, concerning for a diagnosis of ALCL. However, after three weeks, the lesion completely healed.
CONCLUSIONS: We present here a rare case of intraoral CD30+ T-cell LPD that we believe is the oral counterpart of cutaneous LyP type C.