Pseudocarcinomatous change in lymphomatoid papulosis and primary cutaneous CD30+ lymphoma: a clinicopathologic and immunohistochemical study of 6 patients.

We report 6 cases of pseudoepitheliomatous hyperplasia (PEH) mimicking squamous cell carcinoma in association with an atypical CD30+ dermal infiltrate. Three patients had lymphomatoid papulosis type A, and 3 patients had cutaneous CD30+ lymphoma. All 6 cases showed histologic evidence of PEH with keratinocyte atypia. In 4 cases there was significant atypia to prompt a diagnosis of squamous cell carcinoma. Three of these received treatment with wide local excision and 2 had been engrafted. Immunohistochemical staining for epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha) showed similar expression in lesional and perilesional skin. Epidermal growth factor receptor (EGFR) expression by the proliferating epithelium was similar to that of the suprabasal adjacent normal epidermis. There was no aberrant expression of EGF, TGF-alpha, and EGFR by atypical lymphocytes. These cases demonstrate that PEH associated with CD30+ lymphoproliferative disease may closely resemble squamous cell carcinoma, thereby leading to inappropriate diagnosis and treatment.

[1]  W. Scovell,et al.  The EGF/TGFα response element within the TGFα promoter consists of a multi-complex regulatory element , 1999, Oncogene.

[2]  Joly,et al.  Pseudoepitheliomatous hyperplasia in cutaneous T‐cell lymphoma. A clinical, histopathological and immunohistochemical study with particular interest in epithelial growth factor expression , 1999, The British journal of dermatology.

[3]  V. Diehl,et al.  Detection of clonal Hodgkin and Reed-Sternberg cells with identical somatically mutated and rearranged VH genes in different biopsies in relapsed Hodgkin's disease. , 1998, Blood.

[4]  S. Whittaker,et al.  Lymphomatoid papulosis in association with mycosis fungoides: a study of 15 cases , 1998, The British journal of dermatology.

[5]  G. Collina,et al.  [Malignant melanoma with pseudoepitheliomatous reaction marker. A case report]. , 1998, Pathologica.

[6]  Y. Takeda,et al.  Pleomorphic adenoma of the minor salivary gland with pseudoepitheliomatous hyperplasia of the overlying oral mucosa: Report of two cases , 1998, Pathology international.

[7]  R. Gacek,et al.  Pseudoepitheliomatous Hyperplasia Versus Squamous Cell Carcinoma of the External Auditory Canal , 1998, The Laryngoscope.

[8]  C. Quirk,et al.  Hypertrophic lichen planus mimicking squamous cell carcinoma , 1998, The Australasian journal of dermatology.

[9]  H. Kerl,et al.  EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer. , 1997, Blood.

[10]  M. A. Everett,et al.  Epithelial induction in dermatofibroma: a role for the epidermal growth factor (EGF) receptor. , 1997, The American Journal of dermatopathology.

[11]  Keen Ce.  Combined skin lesions. , 1996 .

[12]  P. Brousset,et al.  Hodgkin's disease following mycosis fungoides: phenotypic and molecular evidence for different tumour cell clones. , 1996, Journal of clinical pathology.

[13]  A. Chott,et al.  The dominant T cell clone is present in multiple regressing skin lesions and associated T cell lymphomas of patients with lymphomatoid papulosis. , 1996, The Journal of investigative dermatology.

[14]  M. Tomaszewski,et al.  A comparison of clinical, morphological and immunohistochemical features of lymphomatoid papulosis and primary cutaneous CD30(Ki‐1)‐positive anaplastic large cell lymphoma , 1995, Journal of cutaneous pathology.

[15]  A. Zauber,et al.  Incidence of second cancers in patients treated for Hodgkin's disease. , 1995, Journal of the National Cancer Institute.

[16]  D. Kumar,et al.  Pseudoepitheliomatous Hyperplasia Mistaken for Cancer After Delayed Reconstruction* , 1995, Southern medical journal (Birmingham, Ala. Print).

[17]  R Fischer,et al.  Hodgkin disease: Hodgkin and Reed-Sternberg cells picked from histological sections show clonal immunoglobulin gene rearrangements and appear to be derived from B cells at various stages of development. , 1994, Proceedings of the National Academy of Sciences of the United States of America.

[18]  R. Willemze,et al.  Spectrum of primary cutaneous CD30 (Ki-1)-positive lymphoproliferative disorders. A proposal for classification and guidelines for management and treatment. , 1993, Journal of the American Academy of Dermatology.

[19]  G. Kao,et al.  Primary cutaneous CD30‐positive anaplastic large cell lymphoma. Report of 27 cases , 1993, Journal of cutaneous pathology.

[20]  H. Shimizu,et al.  Immunohistochemical evaluation of epidermis overlying basal cell carcinomas , 1993, The British journal of dermatology.

[21]  L. Nanney,et al.  Increased epidermal growth factor receptors in melanocytic lesions. , 1992, Journal of the American Academy of Dermatology.

[22]  D. Macdonald,et al.  Abnormal expression of epidermal growth factor receptor in cutaneous epithelial tumours , 1992, Journal of cutaneous pathology.

[23]  P. Dykes,et al.  Epidermal growth factor receptors in human epidermal tumours , 1990, The British journal of dermatology.

[24]  L. Baldini,et al.  Association between mycosis fungoides and Hodgkin's disease: Three case reports , 1990 .

[25]  J. Rosai,et al.  Pseudoepitheliomatous hyperplasia in Spitz nevi. A possible source of confusion with squamous cell carcinoma. , 1989, Archives of pathology & laboratory medicine.

[26]  R. Warnke,et al.  Malignant lymphoma presenting as pseudoepitheliomatous hyperplasia. A report of two cases. , 1988, The American journal of surgical pathology.

[27]  L. Nanney,et al.  Melanoma, growth factors, acanthosis nigricans, the sign of Leser-Trélat, and multiple acrochordons. A possible role for alpha-transforming growth factor in cutaneous paraneoplastic syndromes. , 1987, The New England journal of medicine.

[28]  M. Berger,et al.  Epidermal growth factor receptors in lung tumours , 1987, The Journal of pathology.

[29]  L. Nanney,et al.  Altered [125I]epidermal growth factor binding and receptor distribution in psoriasis. , 1986, The Journal of investigative dermatology.

[30]  R. Willemze,et al.  The clinical and histological spectrum of lymphomatoid papulosis , 1982, The British journal of dermatology.

[31]  R. Spiro,et al.  Radiation‐induced skin cancer of the head and neck , 1970, Cancer.