PMC6293026_01
Two distinct lymphoproliferative processes in case 1. A, Biopsy-proven peripheral T-cell lymphoma involving the left buttock. B, Biopsy-proven EBV-associated CD30+ B-cell LPD involving the right lower extremity.
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fig1
On examination, an indurated, scaly, erythematous plaque was present on the left upper buttock (Fig 1, A).
PMC6293026_02
MTX-induced EBV-associated CD30+ LPD in case 2. A, Confluent ulceration of medial right calf. B, CD30 stain.
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Lesions worsened over the next several months despite continued methotrexate and prednisone at the same doses, ultimately with development of a large confluent area of crusted ulcers on the right medial calf (Fig 2, A). This clinical behavior prompted biopsy that found a mixed inflammatory infiltrate, with large atypical lymphoid cells with high nuclear/cytoplasmic ratio present in an angiocentric distribution, positive for CD20, CD30, EBV latent membrane protein (LMP), and EBER (Fig 2, B).