Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates
Autor(a) principal: | |
---|---|
Data de Publicação: | 2004 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006 |
Resumo: | CONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. TYPE OF STUDY: Retrospective; histopathological and immunohistochemical analysis. SETTING: Referral center, university hospital. SAMPLE: 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. MAIN MEASUREMENTS: Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. RESULTS: The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. CONCLUSIONS: A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates. |
id |
APM-1_484997c1a5dcafc7a19a4332d4fd2118 |
---|---|
oai_identifier_str |
oai:scielo:S1516-31802004000400006 |
network_acronym_str |
APM-1 |
network_name_str |
São Paulo medical journal (Online) |
repository_id_str |
|
spelling |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltratesCutaneous T-cell lymphomaPseudolymphomaMycosis fungoidesImmunohistochemistryDifferential diagnosisCONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. TYPE OF STUDY: Retrospective; histopathological and immunohistochemical analysis. SETTING: Referral center, university hospital. SAMPLE: 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. MAIN MEASUREMENTS: Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. RESULTS: The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. CONCLUSIONS: A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates.Associação Paulista de Medicina - APM2004-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006Sao Paulo Medical Journal v.122 n.4 2004reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/S1516-31802004000400006info:eu-repo/semantics/openAccessCotta,Ana CristinaCintra,Maria LetíciaSouza,Elemir Macedo deMagna,Luis AlbertoVassallo,Joséeng2004-11-09T00:00:00Zoai:scielo:S1516-31802004000400006Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2004-11-09T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
spellingShingle |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates Cotta,Ana Cristina Cutaneous T-cell lymphoma Pseudolymphoma Mycosis fungoides Immunohistochemistry Differential diagnosis |
title_short |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_full |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_fullStr |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_full_unstemmed |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
title_sort |
Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates |
author |
Cotta,Ana Cristina |
author_facet |
Cotta,Ana Cristina Cintra,Maria Letícia Souza,Elemir Macedo de Magna,Luis Alberto Vassallo,José |
author_role |
author |
author2 |
Cintra,Maria Letícia Souza,Elemir Macedo de Magna,Luis Alberto Vassallo,José |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Cotta,Ana Cristina Cintra,Maria Letícia Souza,Elemir Macedo de Magna,Luis Alberto Vassallo,José |
dc.subject.por.fl_str_mv |
Cutaneous T-cell lymphoma Pseudolymphoma Mycosis fungoides Immunohistochemistry Differential diagnosis |
topic |
Cutaneous T-cell lymphoma Pseudolymphoma Mycosis fungoides Immunohistochemistry Differential diagnosis |
description |
CONTEXT: Non-specific lymphocytic infiltrates of the skin pose difficulties in daily practice in pathology. There is still a lack of pathognomonic signs for the differential diagnosis between benign and malignant lymphocytic infiltrates. OBJECTIVE: To evaluate the morphological and immunohistochemical profile of lymphocytic infiltrations of the skin according to clinical outcome. TYPE OF STUDY: Retrospective; histopathological and immunohistochemical analysis. SETTING: Referral center, university hospital. SAMPLE: 28 cases of lymphocytic infiltrates of difficult differential diagnosis selected from the records. MAIN MEASUREMENTS: Eighteen histological variables and the immunophenotypic profile were assessed using the CD4, CD8, CD3, CD20 and CD30 lymphoid markers and compared to subsequent follow-up. RESULTS: The most common diagnoses were: initial mycosis fungoides (eight cases) and drug reactions (five cases). Single morphological variables did not discriminate between benign and malignant infiltrates except for the presence of Pautrier-Darier's microabscesses, which were found only in mycosis fungoides (p = 0.015). Patterns of superficial and deep infiltration (p = 0.037) and also the presence of eosinophils (p = 0.0207) were more frequently found in benign lymphocytic infiltrates. Immunohistochemical profile of T-cell subsets showed overlap between benign and malignant infiltrates with a predominance of CD4-positive (helper) lymphocytes in the majority of cases. CONCLUSIONS: A combination of clinical and histological features remains the most reliable approach for establishing a definite diagnosis in cases of lymphoid skin infiltrates. |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802004000400006 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1516-31802004000400006 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.122 n.4 2004 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209260881838080 |