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Derm1 > Ch. 24 - Cutaneous T/NK-cell lymphomas and myeloid leukemia > Flashcards

Ch. 24 - Cutaneous T/NK-cell lymphomas and myeloid leukemia Flashcards

1
Q

Mycosis fungoides, patch stage

A

Junctional (vacuolar interface) large dark lymphocytes with irregular nuclear contours and perinuclear halos. Pautrier’s microabscesses.

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2
Q

Mycosis fungoides, plaque stage

A

Like patch stage, but with a denser, band-like infiltrate in the upper dermis (including atypical lymphocytes)

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3
Q

Mycosis fungoides, tumor stage

A

Dense, nodular lymphocyte infiltrate in dermis. May acquire CD30 and lose epidermotropism.

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4
Q

What is the typical immunophenotype of MF?

A

CD3+, CD4+

CD7-, CD8-

CD30- (can be positive in advanced disease)

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5
Q

MF, pagetoid reticulosis variant

A

Entirely epidermotropic patches/plaques on distal extremities. Can be CD4-/CD8+. Great prognosis.

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6
Q

MF, folliculotropic variant

A

Follicular papules and boggy plaques. Atypical lymphocytes infiltrate follicular epithelium. Eosinophils and follicular mucinosis.

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7
Q

Granulomatous slack skin

A

Pendulus intertriginous skin with massive dermal/subQ infiltrate with huge multinucleate giant cells. Slowly progressive.

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8
Q

Sezary syndrome

A

Histopathologic findings similar to MF (eg Pautrier’s microabscesses) but with peripheral blood sezary (cerebriform) nuclei.

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9
Q

Adult T-cell leukemia/lymphoma

A

Dense dermal infiltrate with CD3/4+, CD25+ lymphocytes with peripheral blood flower cells with multilobed nuclei.

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10
Q

What is the difference between MF and Sezary syndrome?

A

MF arises from skin-resident memory T-cells. Sezary arises from central memory T-cells.

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11
Q

Describe the organism that causes ATLL

A

HTLV-1, a virus transmitted by sexual contact and blood transfusion. Found in southwestern japan and the west caribbeans.

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12
Q

Lymphomatous papulosis, type A

A

CD30+ Reed-sternberg-like cells with mixed background infiltrate. Most common type.

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13
Q

Lymphomatous papulosis, type B

A

Epidermotropic infiltrate of CD3+, CD30- small lymphocytes. Resembles MF.

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14
Q

Lymphomatous papulosis, type C

A

Diffuse sheets of CD30+ Reed-sternberg-like cells in dermis. May be indistinguishable from anaplastic large cell lymphoma.

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15
Q

Lymphomatoid papulosis, type D

A

Markedly epidermotropic CD8+, CD30+ lymphocytes. Mimics primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-ell lymphoma.

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16
Q

Lymphomatoid papulosis, type E

A

Angioinvasive CD30+ Beta F1+ lymphocytes. Mimics extranodal NK-T-cell lyphoma, nasal type.

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17
Q

Recall the lesions which lymphomatoid papulosis types B-E can mimic.

A

B: MF

C: ALCL

D: Primary cutaneous aggressive epidermotropic CD8+ T-cell lymphoma

E: Extranodal NK/T-cell lymphoma, nasal type

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18
Q

Primary cutaneous anaplastic large cell lymphoma

(genetics?)

A

Sheets of Reed-Sternberg-like cells in dermis, largely CD30+.

t(2;5) EML-ALK translocation

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19
Q

Subcutaneous panniculitis-like T-cell lymphoma

(key features?)

A

Lace-like fat infiltration with CD8+ TCR- lymphocytes. Beanbag cells (macrophages filled with karyorrhectic debris)

Associated with hemophagocytic syndrome.

20
Q

Extranodal NK/T-cell lymphoma, nasal type

(immunophenotype? cause?)

A

Dense dermal/SubQ lymphoid infiltrate with angiocentricity and necrosis.

CD2+, CD3e+, CD56+ (NK-cell markers)

EBV

21
Q

Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma

(immunophenotype?)

A

Band-like, lichenoid lymphoid infiltrate with epidermotropism.

CD3+, CD8+, perforin/granzyme & TIA-1+.

22
Q

Cutaneous gamma-delta T-cell lymphoma

A

Broad lyphoid infiltrate with TCR gamma-delta+ CD3+ CD56+ phenotype. Worse prognosis than subcutaneous panniculitis-like T-cell lymphoma.

23
Q

Primary cutaneous CD4+ small/medium T-cell lymphoma.

A

Dermal/SubQ infiltrate with CD3+, CD4+, CD8/30- phenotype. Hard to distinguish from MF.

24
Q

Hydroa vacciniforme-like lymphoma

(associations?)

A

Epidermal ulceration with angiocentric lymphocytes.

Associated with EBV, hypersensitivity to mosquito bites.

25
Q

Blastic plasmacytoid dendritic cell neoplasm

A

CD4+ CD56+ CD123+ (CD3-, MPO-) infiltrate in dermis and subcutis. Arises from plasmacytoid dendritic cells.

26
Q

Myeloid leukemia

A

Diffuse involvement without epidermotropism. Grenz zone. Usually monocytic/myelomonocytic. Lysozyme/MPO/chloroacetate esterase+.

27
Q
A

MF, patch stage

28
Q
A

MF, plaque stage

29
Q
A

MF, tumor stage

30
Q
A

MF, Pagetoid reticulosis variant

31
Q
A

MF, Folliculotropic variant

32
Q
A

MF, granulomatous slack skin

33
Q
A

Sezary syndrome (cannot distinguish from MF)

34
Q

CD3+ CD4+ CD8- CD25+

A

ATLL

35
Q

CD30+

A

Lymphomatoid papulosis, type A

36
Q

CD3+, CD30-

A

Lymphomatoid papulosis, Type B

37
Q

CD30+

A

Lymphomatoid papulosis, type C

38
Q

CD30+

A

ALCL

39
Q

CD8+, BF1+, gamma/delta TCR-, perf/granzyme+

A

Subcutaneous panniculitis-like T-cell lymphoma

40
Q

CD2+, CD3e+, CD56+, EBV+

A

Extranodal NK/T-cell lymphoma, nasal type

41
Q

F1+, CD3+, CD8+, perf/granzyme+

A

Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma

42
Q

Gamma/delta+, F1-, CD3+, CD56+, perf/granzyme+

A

Cutaneous gamma-delta T-cell lymphoma

43
Q

TIA-1+, CD2+, EBV+

A

Hydroa vaccinoforme-like lymphoma

44
Q

CD3+, CD4+, CD8-, CD30-

A

Primary cutaneous CD4+ small/medium T-cell lymphoma

45
Q

CD4+, CD56+, CD123+, MPO-

A

Blastic plasmacytoid dendritic cell neoplasm

46
Q

Lysozyme+, MPO+, chloroacetate esterase+

A

Myeloid leukemia

Derm1 (30 decks)

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