Ann Dermatol.  2010 Nov;22(4):447-451. 10.5021/ad.2010.22.4.447.

Lymphomatoid Papulosis Followed by Anaplastic Large Cell Lymphoma in a Pediatric Patient

• Min JA
• Oh ST
• Kim JE
• Cho BK
• Chung NG
• Park HJ

• KMID: 2266185
• DOI: http://doi.org/10.5021/ad.2010.22.4.447

Abstract

Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP. However, this transformation rarely occurs in patients younger than 20 years of age. Here, we present the first known pediatric patient in Korea, a 12-year-old boy who developed a subcutaneous nodule on the scrotum 13 months after papulonecrotic lesions of LyP were identified on both lower extremities and face. Histological and immunohistochemical examination of the subcutaneous nodule revealed anaplastic large cell lymphoma (ALCL). A T-cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in the two specimens, indicating that a common T-cell clone had proliferated over time in both the LyP and ALCL lesions.

Keyword

Anaplastic large cell lymphoma; Lymphomatoid papulosis

MeSH Terms

Adult
Child
Clone Cells
Genes, T-Cell Receptor
Humans
Korea
Lower Extremity
Lymphoma, Large-Cell, Anaplastic
Lymphoma, T-Cell
Lymphomatoid Papulosis
Scrotum
T-Lymphocytes

Figure

• 

  Fig. 1 (A) Multiple, 1.3 cm sized, crusted, erythematous papules on both legs. (B) Tender, solitary, 1.5 cm sized, crusted, erythematous nodule on the scrotum.

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  Fig. 2 (A) Histological features of Lyp lesions show a folliculocentric distribution that an admixture of various cell types, including scattered atypical large lymphoid cells with large vesicular nuclei, eosinophils and small lymphocytes. (B) Section of an ALCL lesion showing extensive dermal infiltration of large atypical cells with prominent, bizarre nucleoli and abundant cytoplasm (top: H&E, ×40, bottom: H&E, ×400).

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  Fig. 3 Positive CD 30 immunostaining of sections of both LyP (A) and ALCL (B) (×40).

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  Fig. 4 PCR for TCR gene rearrangemnt. M, molecular ladder; lane 1, positive marker (Jurket cell 500 ng/ul); lane 2, negative control (D.W); lane 3, a papule of LyP (300 ng/ul); lane 4, a papule of LyP (100 ng/ul); lane 5, a nodule of ALCL (300 ng/ul); lane 6, a nodule of ALCL (100 ng/ul).

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