desordenes linfoproliferativos cd30 positivos
TRANSCRIPT
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