S13C10P8Lymphoproliferative


S13C10P8-1: The basic patterns are vasculitic; perivascular infiltrates in the reticular dermis are a prominent feature. The papillary dermis is widened and edematous. Rete ridges are thin and elongated. To the right, the epidermis shows a focal area of necrosis with the formation of a scale. The perivascular infiltrates extend along vessels into the reticular dermis; they form wide cuffs.

S13C10P8-2: In the area of papillary dermal edema, the elongated rete ridges show inter-cellular edema with infiltrates of lymphoid cells. The lymphoid cells of the epidermal infiltrates show variations in nuclear size and outlines. The lesion has features of a progressive T-cell dysplasia, but the degree to which markers of inflammation are represented would be unusual for a T cell dysplasia as seen in the setting of so-called CTCL (lymphomatoid papulosis).

S13C10P8-3: The infiltrates are somewhat polymorphic with admixtures of histiocytes, small lymphoid cells, and transformed lymphoid cells; the transformed lymphocytes are intermediate in size. Many of the cells with pale cytoplasm are of lymphoid, rather than histiocytic, type; the density of the nuclear chromatin would offer support for this interpretation. The infiltrate in this field is perivascular.

S13C10P8-4: Most of the cells have pale cytoplasm. Nuclei are intermediate in size. The atypical cells are transformed lymphoid cells. Some of the nuclei are convoluted. Occasional small lymphocytes (lower right corner) provide a control for the evaluation of nuclear sizes. Also in the lower right corner, some of the nuclei have open chromatin patterns and a prominent central nucleolus (lymphomatoid papulosis with type A qualities in this field).

S13C10P8-5: There is variability in nuclear size and outline, but most of the nuclei are small to intermediate in size. There is a mitotic figure to the right near the lower margin of the field.

S13C10P8-6: The nuclei are mostly intermediate in size. Chromatin patterns are somewhat open and delicate. Most of the cells have pale cytoplasm. Patterns, in this lesion, are variable; in some fields, the patterns are type B, and in other fields, they are type A.

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