The Cutaneous Lymphoid Proliferations A Comprehensive Textbook of Lymphocytic Infiltrates of the Skin

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  • Edition: 1st
  • Format: eBook
  • Copyright: 2006-04-10
  • Publisher: Wiley

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A complete reference to the latest understanding of lymphocytic infiltrates

The Cutaneous Lymphoid Proliferations provides a complete, authoritative treatment of the clinical features, phenotypes, pathogenesis, histopathology, diagnosis, and treatment of lymphocytic infiltrates of the skin. Incorporating the latest findings from the fields of light microscopy, immunohistochemistry, and flow cytometry, the book brings readers up to date on the most current thinking in the field. Those readers familiar with the authors' critically acclaimed The Melanocytic Proliferations will find a similar structure and the same attention to detail and quality in this latest reference.

The book starts off with a clinical atlas and introduction to the ontogeny and biology of the lymphoid system. Next, the authors explore novel molecular approaches to the diagnosis of cutaneous lymphoid proliferations and benign lymphocytic infiltrates. The remaining chapters concentrate on major inflammatory skin diseases and lymphoproliferative disorders, including chronic lymphocytic leukemia, lupus, adult T cell leukemia, and primary cutaneous Hodgkin's disease.

As a reference to lymphocytic infiltrates, this book is unsurpassed. Novice and experienced practitioners alike will gain important insights into the field, including:

  • The role of the immune system in the pathogenesis of cutaneous disease
  • Relationships between therapeutic drugs and cutaneous eruptions
  • Important drug reactions

Hundreds of full-color, high-quality clinical and histologic photographs help readers visualize the various infiltrates and their treatments. Having this reference on hand is essential for all dermatologists, dermatopathologists, oncologists, and general pathologists who need a synthesis of the current thinking in the field.

Author Biography

CYNTHIA M. MAGRO, M.D., is Professor of Pathology and Director of Dermatopathology at Weill Medical College of Cornell University in New York City. She has published extensively in the areas of inflammatory skin disease, including collagen vascular disease, vasculitis, cutaneous manifestations of systemic disease, and unique drug hypersensitivity reactions. A significant focus of her work has been lymphocytic infiltrates, including unique forms of drug reactions such as the interstitial granulomatous drug reaction and drug-associated reversible T cell dyscrasia; prelymphomatous cutaneous lymphoid dyscrasias including atypical lymphocytic lobular panniculitis pityriasis lichenoides chronica and pigmented purpuric dermatosis; and malignant T and B cell lymphomas. She has extended her work in immune mechanisms of skin disease and applied it to areas of lung transplantation and pulmonary fibrosis.

A. NEIL CROWSON, M.D., is Clinical Professor of Dermatology, Pathology, and Surgery, and Director of Dermatopathology at the University of Oklahoma and Regional Medical Laboratory in Tulsa, Oklahoma. His current research interests focus on mechanisms of neoplastic and inflammatory skin disease.

MARTIN C. MIHM, Jr., M.D., is Clinical Professor of Pathology and Dermatology at Harvard Medical School, Massachusetts General Hospital. He is internationally recognized for his expertise in the pathology, diagnosis, and management of pigmented lesions, lymphoid disorders, and vascular tumors. He has worked extensively to understand the host response to melanoma and other tumors. He has served as codirector of the WHO Melanoma Program in addition to his many obligations in translational and clinical research in cutaneous inflammation, tumor vaccination, and pathogenesis of vascular lesions in children.

Table of Contents

Chapter One: Introduction to the Classification of Lymphoma (Martin C. Mihm, Cynthia M. Magro, and A. Neil Crowson).

Kiel, Lukes–Collins, and Working Formulation Classifications.

WHO, Real, and EORTC Classifications.



Appendix: Definitions of Key Terms and Techniques.

Chapter Two: The Therapy of Cutaneous T Cell Lymphoma (Pierluigi Porcu and Mark A. Bechtel).


Diagnostic Work-up and Staging Procedures.

Goals of Therapy in Advanced Stage CTCL.

Extracorporeal Photopheresis (ECP).




Monoclonal Antibodies.

Cytotoxic Chemotherapy.

Investigational Therapies.

Monoclonal Antibodies.

TLR Agonists and Cytokines.

Histone Deacetylase Inhibitors (HDACi).

Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT).

CTCL Therapies.

Skin-Directed Therapies.


Chapter Three: Molecular Techniques (Carl Morrison).


Immunoglobulin Receptor Structure.



PCR Design for Determination of Clonality.

Detection of PCR Products for Clonality.

Evaluation of Results.

Limitations of Clonality Assessment by PCR.



Chapter Four: Benign Lymphocytic Infiltrates (Cynthia M. Magro and A. Neil Crowson).


Spongiotic and Eczematous Dermatitis.

Allergic Contact Dermatitis.

Pityriasis Rosea.

Pityriasis Rosea-like Drug Reaction.

Other Spongiotic/Eczematous Tissue Reactions.

Photoallergic Reactions.

Other Causes of Subacute Eczematous Dermatitis.

Nummular Eczema.

Small Plaque Parapsoriasis.

Pruritic Urticarial Plaques and Papules of Pregnancy.

Superficial Erythema Annulare Centrifugum.

Interface Dermatitis: Cell-Poor Vacuolar Interface Dermatitis.

Erythema Multiforme.

Gianotti–Crosti Syndrome (Popular Acrodermatitis of Childhood).

Acute Graft-Versus-Host Disease.

Morbiliform Viral Exanthem and Morbiliform Drug Eruption.

Collagen Vascular Disease Compatible with Antibody-Dependent Cellular Immunity and/or Anti endothelial Cell Antibodies.

Interface Dermatitis: Lichenoid Pattern.

Lichen Planus.

Lichen Planus-like Eruptions of Hepatobiliary Disease.

Lichen Planus-like Eruptions of Secondary Syphilis.

Lichenoid Drug Reactions.

Lichenoid Connective Tissue Disease Syndromes.

Lichenoid (‘‘Chronic’’) Graft-Versus-Host Disease.

Diffuse and Nodular Lymphocytic Dermal Infiltrates Without Atypia.

Polymorphous Light Eruption as the Prototypic Type IV Immune Reaction.

Other Dermal Perivascular Lymphocytic Infiltrates.

Gyrate Erythemas.

Diffuse and Nodular Lymphocytic Infiltrates Associated with Autoimmune Disease.

Nonscarring Discoid Lupus Erythematosus/Tumid Lupus Erythematosus.


Jessner’s Lymphocytic Infiltrate of the Skin.


Chapter Five: Reactive Lymphomatoid Tissue Reactions Mimicking Cutaneous T and B Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Lymphomatoid Drug Eruptions.

Molecular Profile of Lymphomatoid Drug Eruptions.

Pathogenetic Basis of Lymphomatoid Drug Reactions.

Reactive Lymphomatoid Lesions Encountered in Lesions of Collagen Vascular Disease.

Lymphomatoid Lupus Erythematosus.

Pathogenesis of Lymphomatoid Tissue Response in Collagen Vascular Disease.

Lupus Erythematosus Profundus.

Viral-Associated Lymphomatoid Dermatitis.

Lymphocytoma Cutis.

Primary Cutaneous Plasmacytosis.


Case Vignettes.


Chapter Six: Precursor Lesions of Cutaneous T Cell Lymphoma (Cynthia M. Magro, Joan Guitart and A. Neil Crowson).

Cutaneous T Cell Lymphoid Dyscrasia.

Large Plaque Parapsoriasis.

Hypopigmented Epitheliotropic T Cell Dyscrasia/Hypopigmented Large Plaque Parapsoriasis as a Precursor Lesion to Hypopigmented Mycosis Fungoides.

Pigmented Purpuric Dermatosis (PPD).

Pityriasis Lichenoides Chronica.

Syringolymphoid Hyperplasia with Alopecia.

Idiopathic Follicular Mucinosis/Alopecia Mucinosa.

Atypical Lymphocytic Lobular Panniculitis.

Case Vignettes.

Additional Molecular and Cytogenetic Studies.


Chapter Seven: Marginal Zone Lymphoma and Other Low-Grade B Cell Lymphoproliferative Disorders of the Skin (Cynthia M. Magro and A. Neil Crowson).

Marginal Zone Lymphoma.

Castleman’s Disease.

Primary Cutaneous Plasmacytoma.

Case Vignettes.


Chapter Eight: Primary Cutaneous Follicle Center Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Case Vignettes.

Additional Molecular and Cytogenetic Study.


Chapter Nine: Primary Cutaneous Diffuse Large B-Cell Lymphoma and Precursor Lymphoblastic Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Primary Cutaneous Diffuse Large B-Cell Lymphoma.

Cutaneous Precursor B Cell Lymphoblastic Lymphoma/Lymphoblastic Leukemia (Precursor B Cell Acute Lymphoblastic Leukemia.

Case Vignettes.

Additional Molecular and Cytogenetic Studies.


Chapter Ten: Intravascular Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Case Vignette.


Chapter Eleven: Chronic Lymphocytic Leukemia of B Cell and T Cell Phenotype (T Cell Prolymphocytic Leukemia) (Cynthia M. Magro and A. Neil Crowson).

B Cell Chronic Lymphocytic Leukemia.

T Cell Prolymphocytic Leukemia.

Case Vignettes.

Additional Molecular and Cytogenetic Studies.


Chapter Twelve: Cutaneous Mantle Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Case Vignettes.

Additional Molecular and Cytogenetic Studies.


Chapter Thirteen: Primary Cutaneous γ δ T Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).


Case Vignette.


Chapter Fourteen: Mycosis Fungoides (Cynthia M. Magro, Martin C. Mihm, and A. Neil Crowson).


Historical Perspective.


Clinical Presentation.

Patch Stage.

Plaque Stage.

Tumor Stage.

Extracutaneous Dissemination.

Clinical Variants.


Mycosis Fungoides in Childhood.

Adnexotropic Mycosis Fungoides.

Woringer–Kolopp Disease (Pagetoid Reticulosis).

Granulomatous Slack Skin/Granulomatous Mycosis Fungoides.

Sezary Syndrome.

Extracutaneous Involvement in Mycosis Fungoides.

Phenotypic Profile.

Molecular Profile.



Case Vignettes.

Additional Molecular and Cytogenetic Studies.

References, 297

Chapter Fifteen: Primary Cutaneous Pleomorphic Small/Medium Sized T-Cell Lymphoma And Peripheral T-Cell Lymphoma, Unspecified, Presenting in the SKIN (CD30-Negative Large Cell T Cell Lymphoma) (Cynthia M. Magro and A. Neil Crowson).

Case Vignettes.

Additional Molecular and Cytogenetic Study.


Chapter Sixteen: Adult T Cell Leukemia/Lymphoma (Cynthia M. Magro).

Case Vignettes.


Chapter Seventeen: Angioimmunoblastic Lymphadenopathy (AILD)/Angioimmunoblastic T Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Case Vignettes.


Chapter Eighteen: CD8 T Cell Lymphoproliferative Disease of the Skin (Cynthia M. Magro and A. Neil Crowson).


Primary Cutaneous CD8 Lymphoma.

CD8 Variant of Lymphomatoid Papulosis and Other Related CD30-Positive T Cell Lymphoproliferative Disorders of CD8 Subtype.

CD8 Prolymphocytic Leukemia.

CD8 Pseudolymphoma Related to Underlying HIV Disease.

CD8 Cytotoxic Pseudolymphoma Related to Drug Therapy.

Case Vignettes.


Chapter Nineteen: Subcutaneous Panniculitis-Like T Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).

Case Vignettes.


Chapter Twenty: Epstein–Barr Virus-Associated Lymphoproliferative Disease (Cynthia M. Magro and A. Neil Crowson).


Hydroa Vacciniforme-Like EBV-Associated T Cell Lymphoproliferative Disease/Mosquito Bite Hypersensitivity.

Epstein–Barr Virus-Associated B Cell Lymphoproliferative Disease in the Setting of Iatrogenic Immune Dysregulation.

Case Vignettes.


Chapter Twenty-One: Nasal and Related Extranodal Natural Killer Cell/T Cell Lymphomas (Cynthia M. Magro and A. Neil Crowson).


Biology of NK and NK-like T Cells.

NK/T-Cell Lymphoma.

Nasal NK/T-Cell Lymphoma.

Nasal Type NK/T Cell Lymphoma.

Aggressive NK Cell Lymphoma.

Role of Epstein–Barr Virus in the Evolution of NK/T Cell Lymphomas.

Blastic/Blastoid NK Cell Lymphoma/Agranular CD4-positive CD56-positive Hematodermic Neoplasm.

Panniculitis-like T Cell Lymphoma Showing CD56 Positivity.

Chronic Granular Lymphocytosis/Large Granular Cell Leukemia.

Natural Killer-like T Cell Lymphoma of the CD4 Subset: A Rare Variant of Natural Killer Cell Lymphoma to Be Distinguished from the Hematodermic Neoplasm.

Case Vignettes.


Chapter Twenty-Two: Lymphomatoid Granulomatosis (LYG) (Cynthia M. Magro and A. Neil Crowson).


Case Vignette.


Chapter Twenty-Three: CD30-Positive Lymphoproliferative Disorders Including Lymphomatoid Papulosis, Borderline CD30-Positive Lymphoproliferative Disease, Anaplastic Large Cell Lymphoma, and T-Cell-Rich CD30-Positive Large B Cell Lymphoma (Cynthia M. Magro and A. Neil Crowson).


Lymphomatoid Papulosis.

CD8 Lymphomatoid Papulosis.

Borderline CD30-Positive Lymphoproliferative Disorders (Type C LYP) (Case Vignette 9).

Cutaneous Anaplastic Large Cell Lymphoma.

CD30-Positive Large B Cell Lymphoma.

Case Vignettes.

Additional Molecular and Cytogenetic Studies.


Chapter Twenty-Four: Primary Cutaneous Hodgkin Lymphoma (Cynthia M. Magro).

Subtypes of Hodgkin Lymphoma.

Classic Hodgkin Lymphoma.

Lymphocyte-Predominant Hodgkin lymphoma.

Case Vignette.

Additional Molecular and Cytogenetic Studies.



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