Epidermotropic CD30 Positive Mycosis Fungoides (MF) with an Indolent Biologic Course.
Igor Shendrik, Neil A Crowson, Cynthia M Magro. University of Oklahoma, Tulsa; St John Medical Center, Tulsa, OK; Cornell University, New York, NY
Background: The acquisition of a CD30 positive phenotype in a lesion of MF is often associated with transformation to a more aggressive neoplasm with adverse prognostic significance. Cases with isolated intraepidermal CD30 positive cells may bear a relationship to the Woringer-Kolopp form of pagetoid reticulosis, a generally indolent epidermotropic cutaneous T-cell neoplasm.
Design: We encountered four cases of atypical lymphoid infiltration characterized by a population of atypical intraepidermal CD30 positive cells. The light microscopic appearance was correlated with immunohistochemical results, molecular studies and clinical features.
Results: All cases showed a population of hyperchromatic CD30 positive lymphocytes in a distribution resembling pagetoid reticulosis. All cases had a significant reduction of CD7 expression and one showed deletion of CD5 in the atypical clone. The previous and subsequent biopsies demonstrated dermal nodules of atypical CD30 positive lymphocytes, histologically suggestive of lymphomatoid papulosis in two of four cases. In two of three cases where subsequent biopsies were performed, intraepidermal CD30 positive cells were absent. The clinical behavior of all 4 cases was that of an indolent process.
Conclusions: CD30 positive cells may be expressed as a transient dominant phenotype in cases of otherwise indolent MF with a pagetoid reticulosis morphology and appear to have no biological significance.
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 105, Wednesday Afternoon