Atypical lymphoproliferative disorder-clinical and pathological features

Area of Science:

• Dermatopathology
• Oncology
• Hematopathology

Background:

• Cutaneous lymphoproliferative disorders present a diagnostic challenge due to diverse clinical and histopathological features.
• Accurate diagnosis is crucial for appropriate patient management and prognosis.

Observation:

• A 73-year-old woman presented with a single plaque, progressing to multiple lesions and a tumor.
• Initial biopsy suggested CD4/CD8 double-negative mycosis fungoides (MF).
• Rapid disease progression raised concern for peripheral T-cell lymphomas-not otherwise specified (PTCL-NOS).

Findings:

• Subsequent biopsies revealed epidermal spongiosis and subepidermal edema.
• Evidence of possible nodal involvement by cutaneous T-cell lymphoma was noted.
• The case demonstrated a rare combination of pathological features.

Implications:

• This case underscores the diagnostic complexities in differentiating atypical lymphoproliferative disorders.
• It highlights the importance of serial biopsies and comprehensive clinicopathological correlation.
• Such challenging cases necessitate a multidisciplinary approach for accurate diagnosis and treatment planning.