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Patterns of Lymphohistiocytic Reaction in Skin: An Approach to Cutaneous Lymphohematopoietic Infiltrate Using Histologic Patterns and Immunostains

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Abstract

We propose an approach to the diagnosis of atypical lymphoid infiltrates and malignant lymphomas based on histomorphologic and immunologic patterns. Our approach rests on the evidence that lymphoma patterns often are superimposed on physiologic patterns of lymphoid proliferations/hyperplasias in response to injury, infection, and antigenic stimulation. Hence, we discuss dermotropic considerations based on epidermotropic, dermatotropic, and panniculitic infiltrative lymphohistiocytic patterns. For each histologic pattern, we present histologic and immunophenotypic examples to facilitate the development of a differential diagnosis and arrival at a final diagnosis. The epidemiology and definitions of cutaneous lymphoid hyperplasia, atypical lymphoid hyperplasia, and lymphoma are also presented. Finally, we recommend a specific approach for obtaining and processing of skin specimens, particularly when lymphoma is suspected.

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Authors and Affiliations

  1. Department of Hematopathology and Cutaneous Lymphoma, IHCFLOW Diagnostic Laboratory, 18804 Chaville Rd, Lutz, FL, 33558, USA

    Hernani D. Cualing MD

  2. Department of Dermatology, Roger Williams Medical Center, Boston University School of Medicine, Providence, RI, USA

    Marshall E. Kadin MD

Authors
  1. Hernani D. Cualing MD
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  2. Marshall E. Kadin MD
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Correspondence to Hernani D. Cualing MD .

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Editors and Affiliations

  1. Department of Hematopathology, IHCFLOW Diagnostic Laboratory, Lutz, Florida, USA

    Hernani D. Cualing

  2. Department of Dermatology, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island, USA

    Marshall E. Kadin

  3. Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    Mai P. Hoang

  4. Pensacola and Atlanta Dermpath Diagnostics, University of South Florida College of Medicine, Tampa, Florida, USA

    Michael B. Morgan

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Cualing, H.D., Kadin, M.E. (2014). Patterns of Lymphohistiocytic Reaction in Skin: An Approach to Cutaneous Lymphohematopoietic Infiltrate Using Histologic Patterns and Immunostains. In: Cualing, H., Kadin, M., Hoang, M., Morgan, M. (eds) Cutaneous Hematopathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0950-6_1

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  • DOI: https://doi.org/10.1007/978-1-4939-0950-6_1

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