Primary Cutaneous Lymphoma-Associated Pseudoepitheliomatous Hyperplasia Masquerading as Squamous Cell Carcinoma in a Young Adult

  • Mahsa Ansari Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Farid Azmoodeh Ardalan Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Masoumeh Najafi Department of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Azadeh Goodarzi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Alireza Ghanadan Mail Department of Pathology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Anaplastic large cell lymphoma, Squamous cell carcinoma, Immunocytochemistry

Abstract

Primary cutaneous anaplastic large cell lymphoma is a T-cell malignancy with atypical CD30 positive lymphocytes. Pseudoepitheliomatous hyperplasia is an uncommon finding in primary cutaneous anaplastic large cell lymphoma, and may mimic squamous cell carcinoma as pseudomalignancy. Careful attention of a pathologist to correct diagnosis of pseudoepitheliomatous hyperplasia and its underlying causes will help physicians to avoid inappropriate management. Here, we present a 22-year-old man referred to our hospital with a solitary nodule persistent on his forearm which was diagnosed as squamous cell carcinoma in the first biopsy. The lesion recurred after two months and histopathologic and immunohistochemistry examination revealed anaplastic large cell lymphoma with florid pseudoepitheliomatous hyperplasia which masquerading as well-differentiated squamous cell carcinoma. Diagnosis of pseudoepitheliomatous hyperplasia must guide the pathologist to search for underlying causes, such as primary cutaneous lymphoma. Pseudoepitheliomatous hyperplasia may mimic squamous cell carcinoma and this can result in inappropriate diagnosis and management.

References

Hsu MY, Murphy GF. Cutaneous lymphomas and leukemias. In: Elder DE, editor. Lever′s Histopathology of the Skin. 10 th ed. New Delhi: Wolters Kluwer; 2008. p. 921-48.

Bolognia JL, Jorrizo JL, Schaffer JV. Dermatology. In: Willemze, editor. Cutaneous T-Cell Lymphoma. 3nd ed. Madrid: Mosby (Elsevier); 2012: p. 2017-27.

Zayour M, Gilmore E, Heald P, et al. A distinct entity in the spectrum of the CD30+ cutaneous lymphoproliferative diseases: oligolesional nodules with pseudoepitheliomatous hyperplasia followed by spontaneous resolution. Am J Dermatopathol 2009;31(1):37-43.

Scarisbrick JJ, Calonje E, Orchard G, et al. Pseudoepitheliomatous change in lymphomatoid papulosis and primary cutaneous CD30+ lymphoma: a clinicopathologic and immunohistochemical study of 6 patients. J Am Acad Dermatol 2001;44(2):239-47.

Courville P, Wechsler J, Thomine E, et al. Pseudoepitheliomatous hyperplasia in cutaneous T-cell lymphoma. A clinical, histopathological and immunohistochemical study with particular interest in epithelial growth factor expression. The French Study Group on Cutaneous Lymphoma. Br J Dermatol. 1999;140(3):421-6.

Zayour M, Lazova R. Pseudoepitheliomatous Hyperplasia: A Review. Am J Dermatopathol 2011;33(2):112-6.

Weedon D, editor. Tumors of the epidermis. In: Weedon's Skin Pathology. London: Churchill Livingstone Elsevier; 2010: p. 670-71.

Lynch JM. Understanding Pseudoepitheliomatous Hyperplasia. Pathol Case Rev 2004;9(2):36-45.

Biswas A, Gey van Pittius D, Stephens M, et al. Recurrent primary cutaneous lymphoma with florid pseudoepitheliomatous hyperplasia masquerading as squamous cell carcinoma. Histopathology 2008;52(6):755-58.

Massone C, EL-Shabrawi-Caelen L, Kerl H, et al. The morphologic spectrum of primary cutaneous anaplastic large T-cell lymphoma: a histopathologic study on 66 biopsy specimens from 47 patients with report of rare varients. J Cuan Pathol 2008;35(1):46-53.

Published
2015-12-22
How to Cite
1.
Ansari M, Azmoodeh Ardalan F, Najafi M, Goodarzi A, Ghanadan A. Primary Cutaneous Lymphoma-Associated Pseudoepitheliomatous Hyperplasia Masquerading as Squamous Cell Carcinoma in a Young Adult. Acta Med Iran. 53(12):785-788.
Section
Case Report(s)