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Open Access Publications from the University of California

Atypical lymphoproliferative disorder-clinical and pathological features

  • Author(s): Wilmas, Kelly
  • Duvic, Madeleine
  • Oki, Yasuhiro
  • et al.
Creative Commons 'BY-NC-ND' version 4.0 license

Definitive diagnosis of cutaneous lymphoproliferative disorders is one of the most challenging issues in dermatopathology owing to the broad spectrum of clinical and histopathological presentations. We report a case of a 73-year-old woman who presented with a single, asymptomatic plaque limited to her left collarbone. This was followed by the appearance of several plaques and patches in addition to a tumor. Her initial biopsy suggested a CD4/CD8 double negative mycosis fungoides (MF). However, the rapidly progressive course of her disease is worrisome for peripheral T-cell lymphomas-not otherwise specified (PTCL-NOS). Subsequent biopsies revealed epidermal spongiosis with subepidermal edema and possible nodal involvement by cutaneous T-cell lymphoma. The rare combination of these pathologic features demonstrates the difficulty of diagnosing atypical lymphoproliferative disorders.

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