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Clinicopathologic manifestations of Epstein-Barr virus-associated cutaneous lymphoproliferative disorders
K Iwatsuki1, M Ohtsuka, H Harada
1Department of Dermatology, Fukushima Medical College, Japan.
Objective:
To elucidate clinicopathologic manifestations of cutaneous lymphoproliferative disorders associated with Epstein-Barr virus (EBV) infection.
Design:
Retrospective survey of case series.
Setting:
University hospital medical center.
Patients:
Sixty-five patients with cutaneous lymphomas and related disorders.
Main Outcome Measures:
Detection of EBV genes and EBV-encoded small nuclear RNAs.
Results:
Evidence of latent EBV infection was demonstrated in 15 patients: 3 had malignant lymphoma with clinical features mimicking cytophagic histiocytic panniculitis, 6 had facial vesiculopapular eruptions mimicking hydroa vacciniforme, 4 had angiocentric lymphoma, 1 had histiocytoid lymphoma associated with hemophagocytosis, and 1 had plasmacytoma. Hypersensitivity to mosquito bites was noted in a patient with hydroa vacciniforme-like eruptions and another with histiocytoid lymphoma. Angiocentric infiltration of atypical lymphoid cells was a common histological feature in the patients with hydroa vacciniforme-like eruptions and angiocentric lymphoma. No evidence of EBV infection was apparent in 19 patients with mycosis fungoides or Sézary syndrome, 7 with adult T-cell leukemia or lymphoma, 3 with lymphomatoid papulosis (type A), and 2 with lymphocytoma cutis.
Conclusion:
Patients with EBV-associated cutaneous lymphoproliferative disorders present with unique and diagnostic clinicopathologic features distinct from those of mycosis fungoides or Sézary syndrome.