S15C6P1-Lymphoid Lesions



S15C6P1-1: The epidermis is thin; rete ridges are effaced. The papillary dermis is widened, and edematous. There are perivenular infiltrates of lymphocytes in the reticular dermis. The patterns qualify as a “lymphocytic infiltrate of the dermis.” Spaces among collagen bundles of the reticular dermis are widened.

S15C6P1-2: The perivenular infiltrates are composed of lymphocytes and plasma cells. The component of plasma cells (yellow arrows) sets the patterns apart from those of the classic lymphocytic infiltrates of the dermis.

S15C6P1-3: Some of the lymphoid cells have a thin rim of pale cytoplasm; there is some variability in nuclear size, staining, and outlines.

S15C6P1-4: A second biopsy, at a later date, shows a nodular, non-encapsulated lesion of the dermis; it presses upon the epidermis. There are perivenular extensions into the neighboring dermis. There is some degree of pallor centrally in the infiltrate.

S15C6P1-5: To the left of the center of the field, the infiltrates are composed of atypical lymphocytes. Nuclei are not crowded; the cells have sufficient cytoplasm to influence the spacing of nuclei. To the right, there is a focus containing a high component of activated histiocytes.

S15C6P1-6: Small and large lymphoid cells are represented. Many of the lymphoid cells have pale cytoplasm with nuclei that are irregular in outline; the nuclei of these cells show delicate chromatin pattern. The character of the lymphoid infiltrates qualifies as “intermediate.” Histologically, the lesion is a lymphoma. In the sequence as represented on two biopsy specimens, a “lymphocytic infiltrate” has evolved into a lymphoma.

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