Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates
CONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemic...
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doaj-90cd2c3a282a44a8a20b57abda98700a2020-11-25T01:43:56ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-9460122416116510.1590/S1516-31802004000400006S1516-31802004000400006Reassessment of diagnostic criteria in cutaneous lymphocytic infiltratesAna Cristina Cotta0Maria Letícia Cintra1Elemir Macedo de Souza2Luis Alberto Magna3José Vassallo4Universidade Estadual de CampinasUniversidade Estadual de CampinasUniversidade Estadual de CampinasUniversidade Estadual de CampinasUniversidade Estadual de CampinasCONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. TYPE OF STUDY: Retrospective; histopathological and immunohistochemical analysis. SETTING: Referral center, university hospital. SAMPLE: 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. MAIN MEASUREMENTS: Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. RESULTS: The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. CONCLUSIONS: A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006&lng=en&tlng=enCutaneous T-cell lymphomaPseudolymphomaMycosis fungoidesImmunohistochemistryDifferential diagnosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ana Cristina Cotta Maria Letícia Cintra Elemir Macedo de Souza Luis Alberto Magna José Vassallo |
spellingShingle |
Ana Cristina Cotta Maria Letícia Cintra Elemir Macedo de Souza Luis Alberto Magna José Vassallo Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates São Paulo Medical Journal Cutaneous T-cell lymphoma Pseudolymphoma Mycosis fungoides Immunohistochemistry Differential diagnosis |
author_facet |
Ana Cristina Cotta Maria Letícia Cintra Elemir Macedo de Souza Luis Alberto Magna José Vassallo |
author_sort |
Ana Cristina Cotta |
title |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_short |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_full |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_fullStr |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_full_unstemmed |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_sort |
reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
publisher |
Associação Paulista de Medicina |
series |
São Paulo Medical Journal |
issn |
1806-9460 |
description |
CONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. TYPE OF STUDY: Retrospective; histopathological and immunohistochemical analysis. SETTING: Referral center, university hospital. SAMPLE: 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. MAIN MEASUREMENTS: Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. RESULTS: The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. CONCLUSIONS: A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates. |
topic |
Cutaneous T-cell lymphoma Pseudolymphoma Mycosis fungoides Immunohistochemistry Differential diagnosis |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006&lng=en&tlng=en |
work_keys_str_mv |
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1725030727417856000 |