Procesos linfoides B cutáneos con patrón nodular / Cutaneous B cell processes with nodular pattern

Cutaneous lymphomas are low grade malignant neoplasms with favourable prognosis. Those related to the germinal centre with nodular pattern may be: follicular lymphomas (LFC) or extranodal marginal zone B-cell lymphomas (LMC). They are difficult to tell apart, and from reactive processes like cutaneous follicular hyperplasia and cutis immunocytomas. The objective of this study was to check the incidence and the value of both histology and immunohistochemistry in differential diagnosis. Fifty six patients with cutaneous lymphomas were selected within the period 1995-2004. The biopsies were studied with hematoxilin eosin and immunohistochemistry. Thirty two out of the fifty six cutaneous lymphoid infiltrates were of T origin (57.1%) and twenty four of B origin (42.8%), ten out of this last figure (17.7%) were lymphoid processes with nodular pattern Four LFC, three LMC and three HLC were diagnosed. Convergent follicles with scarce mantle and germinal centres with monomorph celullarity were observed in the LFC. Among the LMC, follicles with prominent mantle and nests of monocitoid cells in the mantle, interfollicular zone and in the germinal centers observed. In the HLC macrophages with detritus were found in the germinal centers. LFC showed: CD20 (+), CD 10 (+), bcl-2 (+) or (-), and bcl-6 (+) in the follicle and in the interfollicular area. LMC showed: CD 20 (+), bcl-2 (-), CD 10 (+/-), and bcl-6 (+) in the follicle, and bcl-2 (+), CD10 (-/+) and bcl-6 (-) in the interfollicular area. The HLC results were: bcl-2 (-), bcl-6 (+) and CD 10 (-) in the follicle and bcl-2 (+), bcl-6 (-) and CD 10 (-) in the interfollicular zone. We conclude that lymphoid B cell processes with nodular pattern are unusual. Histology and immunohistochemistry proved to be useful in the differential diagnosis of these lymphomas, and for differentiating these from lymphoid hyperplasias or non tumoral hyperplasias.

Linfoma de células en anillo de sello que simula carcinoma mucosecretante / Signet ring cell lymphoma mimicking mucin-producing carcinoma

Signet ring cell lymphoma is a rare neoplasm characterized by large, vacuolated and clear cells mimicking mucin-producing adenocarcinoma. It is localized in nodal and extranodal sites. A case of a 59 years old male, with a diffuse lymphoma signet ring cell type localized on oropharyngeal mucosa is reported. The histopathology study showed signet ring cells and the immunophenotype was: vimentine(+), CD45(+), CD20(+), Ig M(+), Kappa chain(+) and high index proliferative activity of neoplastic cells (Ki 67:70%). After a review of the literature and previous reports, we could not find a similar case in this anatomic site. The patient had a unfavourable clinical course and died two months after the diagnosis without receiving any treatment.

El linfoma de células en anillo de sello es una neoplasia poco frecuente, caracterizada por la presensenciade grandes células de citoplasma vacuolado, claro, similar a los encontrados en adenocarcinomasmucosecretantes. Se ha descripto en ganglios linfáticos y tejidos extralinfáticos. Se presenta el casode un paciente varón de 59 años con linfoma de células en anillo de sello localizado en pared lateral de orofaringe.Esta localización creemos que no ha sido descripta anteriormente. La histología mostró células en anillo de sello y el inmunofenotipo tumoral fue: vimentina, CD45, CD20, Ig M y cadenas kappa positivos, siendo la fracción de crecimiento tumoral alta (Ki 67:70%). El paciente evolucionó desfavorablemente y falleció a los dosmeses del diagnóstico sin recibir tratamiento.

Manifestaciones cutaneas de la amiloidosis sistemica. / Skin manifestaions of systemic amyloidosis

A proposito de una observacion de amiloidosis sistemica adquirida, se hace referencia a las caracteristicas que identifican a la sustancia amiloide, se passa revista a las manifestaciones clinicas de la amiloidosis sistemica, especialmente las manifestaciones cutaneomucosas, para referirse finalmente al tratamiento

Granulomatosis linfomatoidea con localizacion intestinal. / Lymphomatoid granulomatosis with intestinal localization

Desde un punto de vista clinico-quirurgico frente a un paciente que presenta uno o varios nodulos pulmonares que se acompanan de lesiones cutaneas o viscerales, con o sin alteraciones inmunologicas demostrables, se debe pensar en una granulomatosis linfamotoidea. Ante la sospecha clinica,la confirmacion del diagnostico se establece unicamente por el estudio histomorfologico La naturaleza y comportamiento de esta enfermedad se deben investigar con tecnicas inmunologicas e histoquimicas las que proveen una orientacion terapeutica. Se presenta un enfermo de 39 anos de edad, con una granulomatosis linfomatoidea de localizacion pulmonar, muscular, ganglios mesentericos e intestino delgado. Esta ultima no ha sido descripta en la literatura a nuestro alcance. Se efectuo estudio inmunohistoquimico, estableciendose como caracteristicas del infiltrado, ser linfoideo B policlonal