Atypical fibroxanthoma with lymphomatoid reaction

作者：Zheng, Rui; Ma, Linglei; Bichakjian, Christopher K.; Lowe, Lori; Fullen, Douglas R.^*

来源：Journal of Cutaneous Pathology, 2011, 38(1): 8-13.

DOI：10.1111/j.1600-0560.2010.01622.x

• SPONTANEOUS REGRESSION
• LYMPHOPROLIFERATIVE DISORDERS
• GIANT-CELLS
• VARIANT
• KERATOACANTHOMAS
• CARCINOMA
• RECURRENT

Background: Atypical fibroxanthoma (AFX) represents an uncommon skin tumor typically occurring on sun-damaged skin of the elderly. Histopathologic variants include spindled, clear cell, osteoid, osteoclastic, chondroid, pigmented, granular cell and myxoid lesions. To date, an atypical lymphoid infiltrate, including CD30-positive large cells mimicking lymphomatoid papulosis, has not been described in association with AFX.
Methods: The clinical and histopathological characteristics of two AFX cases inciting an atypical lymphoid infiltrate, along with immunohistochemical profiles and T-cell receptor gamma (TCR gamma) gene rearrangement results, were reviewed.
Results: Lesions in both cases occurred as solitary nodules in elderly patients. Microscopically, both lesions showed a cellular proliferation composed of pleomorphic spindle cells, associated with a prominent intralesional atypical lymphoid infiltrate. The spindle cells expressed CD10 but lacked the expression of S-100, cytokeratins and muscle markers, thereby confirming the diagnosis of AFX. CD30 highlighted a significant subset of large mononuclear cells in the lymphoid infiltrate of one case. TCR. gene rearrangement analyses were negative for both cases.
Conclusion: An atypical lymphoid infiltrate, including the one resembling lymphomatoid papulosis, associated with AFX has not been previously described. It is important to recognize the reactive nature of the infiltrate to avoid a misdiagnosis of lymphoma.

• 出版日期2011-1
• 单位山西医科大学