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Published on: January 9, 2019
A study of histologic and immunophenotypical staining patterns in cutaneous lymphoid hyperplasia
Reuven Bergman1, Khozayma Khamaysi, Ziad Khamaysi
1Department of Dermatology, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. r_bergman@rambam.health.gov.il
Insights
Histologic and immunohistochemical analysis of cutaneous lymphoid hyperplasia (CLH) identified distinct patterns. This may lead to a new classification system for improved diagnosis of CLH.
Area of Science:
- Dermatopathology
- Immunohistochemistry
- Molecular Pathology
Background:
- Cutaneous lymphoid hyperplasia (CLH) is typically classified by B-cell or T-cell predominance.
- Existing classifications lack detailed histologic and immunophenotypic correlation.
Purpose of the Study:
- To identify specific histologic features and immunohistochemical staining patterns in CLH.
- To establish a basis for a refined histologic classification system for CLH.
Main Methods:
- Clinical, histologic, immunophenotypic, and molecular analyses were performed on 24 CLH cases.
- Cases were categorized based on germinal center formation, histiocytic component, and nonspecific patterns.
Main Results:
- Ten cases showed well-defined lymphoid follicles with germinal centers.
- Six cases had germinal center clusters without defined follicles.
- Four cases exhibited a prominent histiocytic component; three were nonspecific.
- Most cases lacked clonal gene rearrangements, with exceptions in uneventful long-term follow-ups.
Conclusions:
- A limited number of cases were studied.
- A classification system integrating histologic, immunophenotypic, clinical, and molecular data may improve CLH diagnosis.
Background:
Cutaneous lymphoid hyperplasia (CLH) is generally classified according to clinicopathologic entities or put into broad spectrums of B-cell or T-cell predominance or co-dominance.
Objective:
We sought to discern histologic features and immunohistochemical staining patterns in CLH that may form a basis for a histologic classification system.
Methods:
We studied the clinical, histologic, immunophenotypical, and molecular characteristics of 24 consecutive patients with CLH.
Results:
The 24 cases were classified according to characteristic histologic features and immunophenotypical staining patterns as follows: presence of germinal center (GC) cell clusters forming well-defined lymphoid follicles (n = 10); presence of clusters of GC cell clusters not forming well-defined lymphoid follicles (n = 6); persistent arthropod assault type CLH (n = 1); CLH with a prominent histiocytic component (n = 4); and CLH without specific histologic and immunophenotypical features, that is, nonspecific mixed T-cell and B-cell CLH (n = 3). Most of the CLH cases did not demonstrate clonal T-cell receptor and/or immunoglobulin heavy chain gene rearrangements except for 3 cases in which the long-term follow-up was uneventful.
Limitations:
There were a limited number of cases in our study.
Conclusions:
A classification based on characteristic histologic features and immunophenotypical staining patterns, along with pertinent clinical and molecular data, may enhance the diagnosis of CLH.
