Useful Parameters for Distinguishing Subcutaneous Panniculitis-like T-Cell Lymphoma From Lupus Erythematosus Panniculitis

The American Journal of Surgical Pathology
Robert E LeBlancJinah Kim

Abstract

Some cases of subcutaneous panniculitis-like T-cell lymphoma (SPTCL) and lupus erythematosus panniculitis (LEP) demonstrate clinical and histopathologic overlap, raising the possibility that they represent opposite ends of a disease spectrum. SPTCL, however, is typically associated with greater morbidity and risk for hemophagocytic lymphohistiocytosis (HLH); therefore, diagnostic distinction is clinically important. We present the histopathologic, immunophenotypic, and molecular findings with long-term clinical follow-up of 13 patients with SPTCL (median, 64 mo follow-up) and 7 with LEP (median, 50 mo follow-up) in our multidisciplinary cutaneous oncology clinic. Six SPTCL patients developed HLH, including 2 under the age of 21 years. In the SPTCL group, 2 of 13 patients died of disease. In contrast, we had no mortality or development of HLH in our LEP cohort. We demonstrate that a limited panel (Ki-67, CD3, CD4, and CD8 immunostains) reveals foci of "Ki-67 hotspots" enriched in cytotoxic atypical CD8+ T cells in SPTCL. Ki-67 hotspots were not identified in LEP, thus aiding the distinction of SPTCL from LEP. Lymphocyte atypia combined with adipocyte rimming of CD8+ T cells within Ki-67 hotspots was also highly specific for the ...Continue Reading

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Citations

Aug 20, 2016·F1000Research·Nooshin Bagherani, Bruce R Smoller
Jul 25, 2019·Archives of Pathology & Laboratory Medicine·Alejandro A GruAndrea L Salavaggione
May 16, 2019·Current Opinion in Rheumatology·Lisa M ArkinMarisa Klein-Gitelman
Mar 7, 2019·The American Journal of Dermatopathology·Aria ShakeriAlejandro Ariel Gru
Mar 26, 2019·The American Journal of Dermatopathology·Christine LeeRossitza Lazova
Nov 9, 2019·Applied Immunohistochemistry & Molecular Morphology : AIMM·Sebastian Fernandez-PolJinah Kim
Feb 13, 2020·JAMA Dermatology·Colleen K CorrellSheilagh M Maguiness
May 14, 2019·Journal of Cutaneous Pathology·Amrita GoyalElie Gertner
Nov 30, 2019·Virchows Archiv : an International Journal of Pathology·Ilske OschliesJohn R Goodlad
Jun 20, 2018·Frontiers in Oncology·Kazuyasu Fujii
Jun 28, 2018·American Journal of Clinical Dermatology·Siriorn UdompanichPoonkiat Suchonwanit
Feb 14, 2021·Indian Journal of Dermatology, Venereology and Leprology·Tara BardawilOssama Abbas

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Methods Mentioned

BETA
PCR
biopsies
electrophoresis
biopsy

Software Mentioned

GeneScan

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