Indolent CD8-positive lymphoid proliferation of the ear: a distinct primary cutaneous T-cell lymphoma?

Am J Surg Pathol. 2007 Dec;31(12):1887-92. doi: 10.1097/PAS.0b013e318068b527.

Abstract

The authors report 4 cases of cutaneous lymphoproliferation unusual by their histology and their clinical presentation. Each presented with a history of a slow growing nodule on the ear. Despite the indolent clinical evolution, the histology suggested a high-grade lymphoma. All lesions consisted of a dense, diffuse proliferation of monomorphous medium-sized T cells throughout the dermis and subcutis. There was no epidermotropism and a grenz zone was clearly present in each case. The tumor cells displayed irregular blastlike nuclei, with small nucleoli and clear chromatin and had a CD3+, CD8+, CD4+, TIA1+, granzyme B(-)immunophenotype with a loss of other T-cell antigens. The 3 cases with available material for polymerase chain reaction studies displayed a monoclonal T-cell rearrangement of the T-cell receptor-gamma chain. These cases do not correspond to a recognized cutaneous T-cell lymphoma as described in the recent WHO/EORTC classification. The apparent striking propensity for the ear suggests that they might represent a specific entity. Further cases are needed to confirm this hypothesis. It is important for such indolent lesions to be known to avoid over treatment.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • CD8-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / pathology*
  • Ear Diseases / immunology
  • Ear Diseases / pathology*
  • Female
  • Gene Rearrangement, T-Lymphocyte
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization
  • Lymphoma, T-Cell, Cutaneous / immunology
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Lymphoma, T-Cell, Cutaneous / physiopathology
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Skin Neoplasms / immunology
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / physiopathology