The Cutaneous Lymphoid Proliferations

A Comprehensive Textbook of Lymphocytic Infiltrates of the Skin

Cynthia M. Magro, A. Neil Crowson, Martin C. Mihm

• Publisher: Wiley-Blackwell
• Year: 2015
• ISBN:
  9781118776445
• Edition: 2
• Topic: Medicine
• Subtopic: Pathology

A masterful and thorough revision of the only single-source, authoritative reference on cutaneous lymphoproliferative disease.

• Classic reference for unsurpassed coverage of lymphocytic infiltrates of the human skin
• Covers a broad spectrum of topics ranging from the role of the immune system in the pathogenesis of cutaneous lymphocytic infiltrates to one describing the immunohistochemica nd molecular aspects of lymphoid neoplasia.
• Each chapter contains an extensive array of 'clinical vignettes' clearly showing the application of principles and treatment techniques discussed in the chapter
• Presents a succinct and logical approach to the diagnosis of most cutaneous lymphocytic infiltrates and discusses the interplay between the immune system in the propagation of lymphocytic infiltrates focusing on the role of iatrogenic and endogenous immune dysregulation. The molecular and cytogenetic basis of lymphoid neoplasia is considered in great detail.
• Contains hundreds of full-color, high-quality clinical and histologic photographs, with over 200 new images in the new edition

CHAPTER 1
Introduction to the Classification of Lymphoma

Kiel Lukes–CollinsWorking Formulation classifications

Since the first edition of this book, further clinical, morphologic and genetic research has continued to shed light on the different aspects of lymphoma. A significant revision of the classification was published in 2008 (Swerdlow et al., 2008), which highlights the extensive advances that have been made over the decades in understanding these hematologic disorders. The prominent aspects of this approach will be considered, as well as the basis for the new recommendations. A review of some suggestions for further classifications of T cell lymphomas will also be detailed. The earliest classification schemes were based on architectural criteria; specifically, lymphomas were categorized in terms of those that assumed a diffuse versus a nodular growth pattern (Rappaport et al., 1956; Lennert et al., 1975; Lennert, 1978; Lennert and Feller, 1992). In the 1960s, the Rappaport classification scheme, prior to the advent of immunophenotyping, added a consideration of the cell type. In that classification scheme, the large lymphocytes were, not surprisingly, mistaken for histiocytes. Thus, for example, that scheme recognized a diffuse histiocytic lymphoma, which we now know to derive from lymphocytes and to be, most often, a diffuse large B cell lymphoma. With the use of immunophenotyping, and the recognition of the distinction between T and B lymphocytes and histiocytes, new approaches to lymphoma classification emerged. One such scheme, designated the Kiel classification (see Table 1.1), graded lymphoid neoplasms into low-grade versus high-grade lymphomas and attempted to relate the cell types identified in any particular lymphoma to their non-neoplastic counterparts in the benign lymph node (Gerard-Marchant et al., 1974; Lennert et al., 1975; Lennert, 1978, 1981; Stansfield et al., 1988; Lennert and Feller, 1992). Popular in the Western hemisphere from the mid-1970s to the mid-1980s, the Lukes–Collins classification emphasized immunophenotypic profiling (Lukes and Collins, 1974).

Table 1.1 Kiel classification of lymphomas

B cell	T cell
Low grade
Lymphocytic	Lymphocytic
Chronic lymphocytic and prolymphocytic leukemia	Chronic lymphocytic and prolymphocytic leukemia
Hairy cell leukemia	Small, cerebriform cell
	Mycosis fungoides, Sézary syndrome
Lymphoplasmacytic/cytoid (LP immunocytoma)	Lymphoepithelioid (Lennert’s lymphoma)
Plasmacytic	Angioimmunoblastic (AILD, LgX)
Centroblastic/centrocytic
Follicular ±diffuse	T zone
Diffuse
Centrocytic	Small cell (HTLV-1)
High grade
Centroblastic	Pleomorphic, medium and large cell (HTLV-1 ±)
Immunoblastic	Immunoblastic (HTLV-1 ±)
Large cell anaplastic (Ki-1+)	Large cell anaplastic (Ki-1+)
Burkitt’s lymphoma
Lymphoblastic	Lymphoblastic

Source: Lennert, 1981. Reproduced with permission of Springer.

In the early 1980s, the International Working Formulation categorized lymphoid neoplasms into low, intermediate, and high grade malignancies based on clinical aggressiveness in concert with light microscopic findings. The goal was to produce a categorization of hematologic malignancies regardless of site of origin that was clinically useful, yet had scientific merit and diagnostic reproducibility (the non-Hodgkin pathological classification project 1982). Although the Kiel classification presaged the Working Formulation, this newer classification scheme did not emphasize B and/or T cell ontogeny per se; this was in contradistinction to the updated Kiel classification (Table 1.2). Among the low-grade malignancies were small lymphocytic lymphoma, chronic lymphocytic leukemia, small cleaved follicular lymphoma, and follicular lymphoma of mixed cell type. The intermediate-grade tumors included malignant lymphoma of follicle center cell origin with a predominance of large cells, diffuse lymphoma of small cleaved cells, and diffuse lymphoma of mixed and/or cleaved or noncleaved large cell type. The high-grade tumors were the diffuse immunoblastic, lymphoblastic, and Burkitt’s lymphoma. The cytomor...

Table of contents

• Cover
• Titlepage
• Copyright
• Acknowledgments
• CHAPTER 1 Introduction to the Classification of Lymphoma
• CHAPTER 2 The Therapy of Cutaneous T Cell Lymphoma
• CHAPTER 3 Molecular Analysis in Cutaneous Lymphoid Proliferation
• CHAPTER 4 Benign Lymphocytic Infiltrates
• CHAPTER 5 Reactive Lymphomatoid Tissue Reactions Mimicking Cutaneous T and B Cell Lymphoma
• CHAPTER 6 Precursor Lesions of Cutaneous T Cell Lymphoma
• CHAPTER 7 Marginal Zone Lymphoma and Other Related Post Germinal Center B Cell Lymphoproliferative Disorders of The Skin
• CHAPTER 8 Primary Cutaneous Follicle Center Cell Lymphoma
• CHAPTER 9 Primary Cutaneous Diffuse Large B Cell Lymphoma Including the Leg Type and Precursor B Cell Lymphoblastic Lymphoma
• CHAPTER 10 Intravascular Lymphoma
• CHAPTER 11 Cutaneous Mantle Cell Lymphoma
• CHAPTER 12 Mycosis Fungoides and Sézary Syndrome
• CHAPTER 13 Cd30-Positive Lymphoproliferative Disorders Including Lymphomatoid Papulosis, Borderline Cd30-Positive Lymphoproliferative Disease, Anaplastic Large Cell Lymphoma, and T-Cell-Rich Cd30-Positive Large B Cell Lymphoma
• CHAPTER 14 CD4+ peripheral T cell lymphoma, not otherwise specified, including primary cutaneous CD4+ small/medium-sized pleomorphic T cell lymphoma
• CHAPTER 15 Subcutaneous Panniculitis-Like T Cell Lymphoma
• CHAPTER 16 CD8 T Cell Lymphoproliferative Disease of the Skin
• CHAPTER 17 Nasal and Related Extranodal Natural Killer Cell/T Cell Lymphomas and Blastic Plasmacytoid Dendritic Cell Neoplasm
• CHAPTER 18 Primary Cutaneous γ δ T Cell Lymphoma
• CHAPTER 19 Epstein–Barr Virus-Associated Lymphoproliferative Disease
• CHAPTER 20 Hodgkin Lymphoma of the Skin
• CHAPTER 21 Chronic Lymphocytic Leukemia of B Cell and T Cell Prolymphocytic Leukemia
• CHAPTER 22 Adult T Cell Leukemia/Lymphoma
• CHAPTER 23 Angioimmunoblastic Lymphadenopathy/Angioimmunoblastic T Cell Lymphoma
• CHAPTER 24 Lymphomatoid Granulomatosis
• CHAPTER 25 Cutaneous Infiltrates of Myeloid Derivation
• Index
• EULA