Indolent CD8+ lymphoid proliferation of the face with eyelid involvement

In 2007, Petrella et al described a series of patients with clonally restricted, well-differentiated, nonepidermotropic, CD8-dominant lymphocytic infiltrates localized to the facial area. The clinical course described was indolent. A CD8 variant of primary cutaneous pleomorphic T-cell lymphoma has been proposed; however, there are many dissimilar features. The authors encountered 2 patients with CD8⁺ indolent lymphoid proliferation of the face, localized to the eyelid. Both patients were males in their 30s presenting with localized lesions of the eyelids. The biopsies showed an effacing lymphocytic infiltrate that spanned the sampled dermis. The lymphocytes were well differentiated, exhibiting mild nuclear contour irregularity. The infiltrate was predominated by CD8⁺ lymphocytes demonstrating TIA expression. There was a minimal B-cell component in 1 case, whereas another showed a significant degree of B-cell hyperplasia. They both underwent complete excision without recurrence. CD8⁺ indolent lymphoid proliferation has a reproducible clinical and morphologic presentation that warrants categorization as a distinct form of indolent lymphoproliferative disease, preferentially involving older adults with the most common site being the ear, recognizing that the nose, acral surfaces, and eyelids can also be involved.