Angiocentric T-cell lymphoma associated with human T-cell lymphotropic virus type I infection.

We describe two patients who presented with vasculitic, ulcerative skin lesions that had the histologic features of lymphomatoid granulomatosis or angiocentric T-cell lymphoma. These patients were found to have antibodies to human T-cell lymphotropic virus type I.

Granulomatosis linfomatoide y linfomas extraganglionares de cabeza y cuello. Estudio clínico patológico de 44 casos / Limphomatoid granulomatosis and extraganglionary limphomas of the neak. Cinical patologyc study of 44 cases

Se revisaron 44 casos de lesiones linfoproliferativas de cabeza y cuello, 36 fueron linfomas extraganglionares y 8 corresponden a granulomatosis linfomatoide. Los linfomas presentaron 0.07% del material quirúrgico de este hospital. Los tipos histológicos más frecuentes fueron el difuso de células grandes hendidas (27.7%), el difuso mixto de células grandes y pequeñas (27.7%) y el difuso de células pequeñas hendidas (11%). Los sitios afectados más frecuentemente fueron fosa nasal (42.2%), amígdalas (22.2%), orofaringe (11.1%). Los signos más frecuenes fueron tumor, obstrucción nasal y rinorrea. La localización más frecuente en los 8 casos de granulomatosis linfomatoide fué la fosa nasal (87.5%) y clínicamente se manifestaron como tumor, odinofagia y disfagia. Unas de las diferencias estadísticamente significativas entre linfoma y granulomatosis linfomatoide fue el tiempo de evolución, a menor tiempo, mayor probabilidad de linfoma. Probablemente la granulomatosis linfomatoide y los linfomas T nasales corresponden a una misma enfermedad en diferentes fases de evolución.

[A variety of lymphomatoid granulomatosis, pseudosarcoid granulomatosis. An anatomo-clinical observation with an ultrastructural study]. / Une variété de granulomatose lymphomatoïde, la granulomatose pseudosarcoïdosique. Une observation anatomo-clinique avec étude ultrastructurale.

A case of sarcoid-like granulomatosis involving the lung, skin and a large cervical vessel is presented. The patient died 4 years after the beginning of the disease with a diffuse angioimmunoblastic lymphadenopathy and a sarcomatous change. Although peculiar histological lesions were seen, with a majority of epithelioid and giant Langhans cells, the extra-pulmonary involvement and the poor prognosis were similar to those of the typical lymphomatoid granulomatosis (Liebow's disease).

Lymphomatoid papulosis--electron microscopic observations on two cases.

The electron microscopic examination of two cases of lymphomatoid papulosis revealed a mixed cellular infiltrate consisting of lymphoid cells with T-cell features, histiocyte-like cells and some fibroblasts. Furthermore, uncharacteristic mesenchymal cells and some granulocytes could be identified. The activated vascular structures did not contribute cells to the infiltrates. Focal cellular protrusions of lymphocytic cells and close spatial relations between different cell types (especially between lymphocytic and histiocyte-like cells) speak for the action of regulative factors. Possibly nerval elements also influence the proliferative processes. Thus lymphomatoid papulosis can be interpreted as a pseudolymphomatous inflammation or lymphoreticular reaction.

Microvascular injury in lymphomatoid granulomatosis involving the skin. An ultrastructural study.

An electron microscopic study of a cutaneous lesion of lymphomatoid granulomatosis taken from a patient with pulmonary involvement was performed. Microvascular alterations ranged from mild, degenerative changes to vessel necrosis. Less severe changes included enlarged endothelial cells, with margination of small lymphoid cells in affected vessels. Luminal occlusion by necrotic endothelial cell fragments and fibrin was associated with thickening and reduplication of the basal lamina and an angiocentric, inflammatory infiltrate in severely affected vessels. The most frequently observed cells in the infiltrate were cleaved and noncleaved lymphocytes that exhibited notable cytolysis and degenerative changes in cytoplasmic organelles. We conclude that lymphomatoid granulomatosis involving the skin is a disorder in which substantial numbers of cleaved and noncleaved lymphoid cells participate, eventuating in small-vessel necrosis and occlusion and repeated endothelial cell regeneration.