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Cutaneous T-Cell Lymphoma: Clues to Diagnosis in Early Lesions

  • Marco Santucci
Part of the NATO ASI Series book series (NSSA, volume 265)

Abstract

The correct identification of cutaneous T-cell lymphomas and their differentiation from both inflammatory dermatoses and reactive lymphoid hyperplasias represent a vexing problem when dealing with the initial phases of a lymphomatous process. Even advanced diagnostic techniques, like immunophenotyping, quantitative DNA cytophotometry, and molecular genetic analysis, have proven to be unsuitable for solving the problem; thus, light microscopy remains the basic, gold standard diagnostic procedure. In order to make a definite diagnosis of lymphoma from early lesions, the most important and cardinal feature is the presence of lymphocytes with extremely convoluted (cerebriform), medium-large-sized (7–9 μm) nuclei (medium-large cerebriform celis), singly or in clusters in the epidermis and in discrete collections in the dermis. Additional histologic features are: (i) epidermotropism, manifested as single cells lining up along the basal keratinocytes near the dermal-epidermal junction; (ii) tendency of medium-large cerebriform cells within the epidermis to congregate and seemingly to touch one another; (iii) absence of spongiotic microvesiculation; (iv) little or no edema of the papillary dermis; slight to moderate fibrosis in some cases; and (v) a tendency of the dermal infiltrate, which as a rule is rather monomorphous in composition, to assume a lichenoid configuration.

Keywords

Mycosis Fungoides Early Lesion Papillary Dermis Cutaneous Lymphoma Inflammatory Dermatosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Marco Santucci
    • 1
  1. 1.Institute of Morbid Anatomy and HistopathologyUniversity of FlorenceFlorenceItaly

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