PMC4802568_01
A, New-onset infiltrated arciform thin plaque over left suprabrow. B, Eruptive smooth papules (black arrows) admixed with chronic epidermally atrophic annular patches.
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fig1
The clinical presentation of both lymphomas was similar, consisting of eruptive asymptomatic papulonodular lesions invariably associated with preexisting patch MF without adenopathy or other constitutional symptoms (Fig 1).
Dilated ectatic blood vessels in the dermis and subcutis (A) with intravascular pleomorphic anaplastic cells (B) positive for CD30 (C). (A and B, hematoxylin-eosin stains; original magnifications: A, x4; B, x40; C, original magnification: x20).
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Biopsy of the first lesion, which developed over the left suprabrow, found dilated ectatic vascular structures in the dermis and subcutis with intraluminal large, pleomorphic, mononuclear cells positive for CD3, CD4, betaF1, and CD30 (Fig 2).
PMC4802568_02
Shave biopsy from a chronic patch shows a bandlike and focally nodular atypical mononuclear superficial dermal infiltrate. (Hematoxylin-eosin stain, original magnification: x10). The bandlike component had positivity for CD2, CD3 (inset, original magnification: x10), and CD4. The nodular aggregates were CD20 positive (inset, original magnification: x10). The identified B-cell and T-cell populations were clonal by gene rearrangement studies.
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MF until late 2013 when multiple smooth erythematous papules developed on the torso. Multiple skin biopsies found a mixed bandlike and focally nodular dermal mononuclear infiltrate comprised of immunophenotypically distinct B-cell and T-cell populations (Fig 3, Fig 4).
Punch biopsy from a new-onset papule shows nodular dermal aggregates (hematoxylin-eosin; original magnification: x10) of B cells positive for CD79a, CD20 (inset, original magnification: x10), and BCL-2 but negative for CD5, BCL-6, CD10, and CD23 consistent with cutaneous marginal zone lymphoma. These aggregates were surrounded by a T-cell infiltrate that on the lateral edges was bandlike in configuration and positive for CD3 and CD4 (inset, original magnification: x10) and negative for CD8 and CD30. Dual clonal B-cell and T-cell populations were identified by gene rearrangement studies.
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MF until late 2013 when multiple smooth erythematous papules developed on the torso. Multiple skin biopsies found a mixed bandlike and focally nodular dermal mononuclear infiltrate comprised of immunophenotypically distinct B-cell and T-cell populations (Fig 3, Fig 4).