desordenes linfoproliferativos cd30 positivos

LYMPHOPROLIFERATIVE DISORDERS CD30 POSITIVE

Daniela Dueñas Hancco. ResidentCarlos Barrionuevo Cornejo MD. MgSandro Casavilca Zambrano MD. Mg

Large CD30 positive cells in bening atypical lymphoid infiltrates of the skin

• Lymphomatoid drug eruption• Milker’s Nodule• Herpes simplex virus infection• Varicella zoster virus infection• Molluscum contagiosum• Nodular scabies• Leshmaniasis• Syphilis• Pernio

Case 1Age: 8 y/o.Sex: MFrom: HuarochiriTime of disease: 4 ms Antecedents: Sun exposure: Yes

(Without protection)

CASO 16-7108

TIMELINE

Papular lesion(Like

“granito”) and blister with

crust in lower limbs

4 mb

Came INEN

Crusting lesions in face. F°40°C.Pruritic leasionsFacial Edema,

cervical adenopaty.

3 mb 2 mb

Generalized lesions:

Abdomen, trunk, lower

limbs.

New Bx

Facial edema, with increased volume in lower lip right.

Some deep crusted lesions 0.5-1 cm diameter, painless, nonpruritic uninfected in upper and lower extremities. Cervical lymphadenopaties < 2 cm.

Physical Exam

Hb 11.8Leucocitos 4110

Linfocitos 66Monocitos 6Eosinofilos 1Basofilos 0Segmentados 26Abastonados 0Metamielocitos 0Promielocitos 0Blastos 0Celulas neoplásicas 0

Hematologic

LABORATORY TESTS

LDH: 709 ( )

BIOCHEMICAL

LDH, Lactate Dehydrogenase, Lactic Dehydrogenase

Summary

• Morphology:– Compromise of the dermis, epidermis, annexes, vessels and

nerves.– Small to medium sizes cells, with hyperchromatic nuclei and

irregular contours.• Immunohistochemistry:

– CD3+, CD56+, TIA1+, GR/B+, CD30+/-, CD4-, CD8-, LMP1-, Ki67 70%

• CISH:– EBER positive

LYMPHOPROLIFERATIVE DISORDER OF T/NK CELLS HYDROA-VACCINIFORME LIKE

CASO 16-5387

Time of disease: 1 year.Consumptive Syndrome, fever, vomiting, abdominal pain, weight loss and lymphadenopathy (cervical and abdominal)

CASE 2

Age: 35 y/o.Sex: MAntecedents: HTLV-1(+)

Physical exam.Slimmed, esophageal candidiasis, cervical lymphadenopathy, hepatomegaly, inguinal lymphadenopathy

SUMMARY

• Morphology:– Diffuse pattern. – Small to medium sizes cells, hyperchromatic nuclei, irregular

contours, interspersed with large Sternbergoids cells• Inmunohistoquímica:

– Small to médium sizes cells: CD3+, CD4+, CD7-/+, CD30-, CD8-, LMP1-, Ki67 30%

– Sternbergoids Cells: CD30+, LMP1(EBV)+, CD15-, CD20-, CD3-, CD4-, CD8-, CD7-.

Adult T-cell leukemia/lymphoma

(ATLL)HODGKIN-LIKE

• Age: 71 y/o• Sex: M• Time of disease: 5ms• Cervical lymphadenopathy, weight loss, fatigue.• Ph.E: Cervical Lymphadenopaties (around. 5cm).

CASO 16-3294

Case 3

Summary• Morphology:

– Diffuse pattern. – Small mature cells with round nuclei, clumped chromatin.– Vessels with neoplastic emboli consisting of medium-sized cells,

hyperchromatic nuclei and clumped chromatin .

• Immunohistochemistry:– Small to medium sizes cells: CD20+, CD23+, BCL2+, CCND1-,

BCL6-, Ki67 15%– Neoplastic emboli: CD3+, CD56+, CD8+, CD7+, CD30+, BCL2+,

CD4-, CD2-, Ki67 90%.• CISH:

– EBER positive

Summary

• TCR gene rearrangements:– A clonal product is evident in the analysis in the TCR beta locus– Additionally clonal product is observed in the analysis of TCR

gamma locus– The monoclonal peak appears in the middle of a strong

polyclonal component– Conclusion: positive for detecting a TCR gene rearrangement

COMPOUND non-Hodgkin lymphoma:- Small cell lymphocytic lymphoma- T / NK Cell neoplasia

Age: 93 y/oSex: FHometown and Origin: La LibertadAnt. Oncolog: NoneAnt. Pathologic: DM (tto. Irregular)

CASO 16- 1757

Time of disease : 4 ms.Course: ProgresivePurplish erythematous skin lesions scattered on the trunk, neck and lower limbsProgressive growth associated with pruritus. No B symptoms

Physical exam: Skin: Generalized purplish nodular lesions,predominantly of the trunk, some with signs of flogosis.Ulcerated lesion with serous secretion in lumbar regionlymphadenopathies cervical, axillary and inguinal

Case 4

Summary

• Morphology:– Diffuse pattern with compromiso of the dermis. – Large centroblastic-like cells with some immunoblast and

reactive lymphocytes. • Immunohistochemistry:

– CD20+, MUM1+, CD30-/+, CD15-, BCL6-, BCL2-, CD56-, CD3-, Ki67 70%

• CISH:– EBER positive

Diffuse Large B cell lymphoma EBV positive, Related To Age

Hydroa vacciniforme-like T / NK Lymphoproliferative Disorder

Adult T-cell leukemia/lymphoma (ATLL)HODGKIN-LIKE

COMPOUND non-Hodgkin lymphoma:- Small cell lymphocytic lymphoma- T / NK Cell neoplasia

Diffuse Large B cell lymphoma EBV positive, Related To Age

Thank you