Related Experiment Videos
Atypical fibroxanthoma with lymphomatoid reaction
Rui Zheng1, Linglei Ma, Christopher K Bichakjian
1Department of Dermatology, The First Hospital of Shanxi Medical University, Taiyuan, China.
Journal of Cutaneous Pathology
|November 3, 2010
Summary
Atypical fibroxanthoma (AFX) can present with an unusual lymphoid infiltrate that mimics lymphomatoid papulosis. Recognizing this reactive infiltrate is crucial to prevent misdiagnosis of lymphoma in skin tumors.
Area of Science:
- Dermatopathology
- Oncology
- Immunohistochemistry
Background:
- Atypical fibroxanthoma (AFX) is a rare skin neoplasm predominantly affecting elderly individuals on sun-damaged skin.
- Histopathologic variants of AFX are diverse, but an associated atypical lymphoid infiltrate has not been previously documented.
Observation:
- Two cases of AFX with atypical lymphoid infiltrates were analyzed.
- Both cases presented as solitary nodules in elderly patients.
- Microscopic examination revealed pleomorphic spindle cells characteristic of AFX, accompanied by a significant intralesional atypical lymphoid infiltrate.
Findings:
- Spindle cells were positive for CD10 and negative for S-100, cytokeratins, and muscle markers, confirming AFX.
- One case showed CD30-positive large mononuclear cells within the lymphoid infiltrate, resembling lymphomatoid papulosis.
- T-cell receptor gamma (TCRγ) gene rearrangement analyses were negative in both cases, suggesting a reactive lymphoid process.
Implications:
- This study describes a previously unreported association between AFX and atypical lymphoid infiltrates.
- Awareness of this finding is essential for dermatopathologists to avoid misdiagnosing AFX as cutaneous lymphoma.
- Proper identification of the reactive nature of the infiltrate is critical for accurate diagnosis and patient management.