Document Detail


Reassessment of diagnostic criteria in cutaneous lymphocytic infiltrates.
MedLine Citation:
PMID:  15543371     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ana Cristina Cotta; Maria Letícia Cintra; Elemir Macedo de Souza; Luis Alberto Magna; José Vassallo
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-11-09
Journal Detail:
Title:  São Paulo medical journal = Revista paulista de medicina     Volume:  122     ISSN:  1516-3180     ISO Abbreviation:  Sao Paulo Med J     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-11-15     Completed Date:  2005-04-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100897261     Medline TA:  Sao Paulo Med J     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  161-5     Citation Subset:  IM    
Affiliation:
Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Antigens, CD / analysis
CD4-CD8 Ratio
Chi-Square Distribution
Diagnosis, Differential
Follow-Up Studies
Humans
Mycosis Fungoides / pathology*
Retrospective Studies
Skin Neoplasms / pathology*
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Antigens, CD

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