Journal
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 72, Issue 3, Pages 508-515Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2014.11.021
Keywords
CD30(+) cutaneous lymphoproliferative disorders; cytokine profile; granulocytes; pseudocarcinomatous hyperplasia; squamous cell carcinoma; T-helper-17/22
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Funding
- Norko-Jon Family Foundation
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Background: The pathogenetic mechanism of CD30(+) cutaneous lymphoproliferative disorders (CLPD) associated with pseudocarcinomatous hyperplasia (PCH) and granulocytic inflammation surrounding atypical CD30(+) lymphocytes remains unclear. Objective: We sought to characterize clinical and pathological findings of a cohort of patients with PCH associated with CD30(+) CLPD and to analyze the cytokine profile of the atypical lymphocytes. Methods: We retrospectively reviewed medical records and pathological material of CD30(+) CLPD with PCH. Immunohistochemistry for T-helper (Th) 17 cytokine profile was performed. Results: In all, 25 patients with a median age of 52 years were included. The median follow-up was 3.7 years. Histologically, an infiltrating pattern of PCH was observed in 14 cases with a neutrophilic-rich infiltrate (P = .21), and epidermal pattern in 11 cases with eosinophil-rich infiltrate (P = .03). Th17 or Th22 cytokines were detected in tumor cells in 81% cases tested. Tumor cells expressed Th17 transcription factor retinoic acid receptor (ROR)-related orphan receptor gamma-2 in 2 of 7 samples tested and 1 was positive for aryl hydrocarbon receptor. Limitations: This is a retrospective study of a small sample. Conclusions: PCH in CD30(+) CLPD is associated with Th17/Th22 cytokine expression in the atypical lymphocytes. Although these lesions commonly regress spontaneously and are associated with an indolent course, some cases develop a generalized process and tumor progression.
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