CD30 positive Lymphoid Malignancies, second workshop Santander Spain July 2016

1. LYMPHOPROLIFERATIVE DISORDERS
CD30 POSITIVE
Daniela Dueñas Hancco. Resident
Carlos Barrionuevo Cornejo MD. Mg
Sandro Casavilca Zambrano MD. Mg

5. Large CD30 positive cells in bening
atypical lymphoid infiltrates of the
skin
• Lymphomatoid drug eruption
• Milker’s Nodule
• Herpes simplex virus infection
• Varicella zoster virus infection
• Molluscum contagiosum
• Nodular scabies
• Leshmaniasis
• Syphilis
• Pernio

8. Case 1
Age: 8 y/o.
Sex: M
From: Huarochiri
Time of disease: 4 ms Antecedents: Sun exposure: Yes (Without
protection)
CASO 16-7108
TIMELINE
Papular
lesion(Like
“granito”) and
blister with
crust in lower
limbs
4 mb
Came
INEN
Crusting lesions
in face. F°40°C.
Pruritic leasions
Facial Edema,
cervical
adenopaty.
3 mb 2 mb
Generalized
lesions:
Abdomen,
trunk, lower
limbs.

9.  Facial edema, with
increased volume in lower
lip right.
 Some deep crusted lesions
0.5-1 cm diameter,
painless, nonpruritic
uninfected in upper and
lower extremities.
Cervical
lymphadenopaties < 2 cm.
Physical Exam

10. Hb 11.8
Leucocitos 4110
Linfocitos 66
Monocitos 6
Eosinofilos 1
Basofilos 0
Segmentados 26
Abastonados 0
Metamielocitos 0
Promielocitos 0
Blastos 0
Celulas neoplásicas 0
Hematologic
LABORATORY TESTS
LDH: 709 ( )
BIOCHEMICAL
LDH, Lactate
Dehydrogenase, Lactic
Dehydrogenase

26. Summary
• Morphology:
– Compromise of the dermis, epidermis, annexes, vessels and
nerves.
– Small to medium sizes cells, with hyperchromatic nuclei and
irregular contours.
• Immunohistochemistry:
– CD3+, CD56+, TIA1+, GR/B+, CD30+/-, CD4-, CD8-, LMP1-,
Ki67 70%
• CISH:
– EBER positive

27. LYMPHOPROLIFERATIVE DISORDER OF
T/NK CELLS HYDROA-VACCINIFORME LIKE

28. CASO 16-5387
Time of disease: 1 year.
Consumptive Syndrome, fever, vomiting, abdominal pain,
weight loss and lymphadenopathy (cervical and abdominal)
CASE 2
Age: 35 y/o.
Sex: M
Antecedents: HTLV-1(+)
Physical exam.
Slimmed, esophageal candidiasis, cervical
lymphadenopathy, hepatomegaly, inguinal
lymphadenopathy

43. SUMMARY
• Morphology:
– Diffuse pattern.
– Small to medium sizes cells, hyperchromatic nuclei, irregular
contours, interspersed with large Sternbergoids cells
• Inmunohistoquímica:
– Small to médium sizes cells: CD3+, CD4+, CD7-/+, CD30-, CD8-
, LMP1-, Ki67 30%
– Sternbergoids Cells: CD30+, LMP1(EBV)+, CD15-, CD20-, CD3-
, CD4-, CD8-, CD7-.

44. Adult T-cell
leukemia/lymphoma
(ATLL)HODGKIN-LIKE

45. • Age: 71 y/o
• Sex: M
• Time of disease: 5ms
• Cervical lymphadenopathy, weight loss, fatigue.
• Ph.E: Cervical Lymphadenopaties (around. 5cm).
CASO 16-3294
Case 3

70. Summary
• Morphology:
– Diffuse pattern.
– Small mature cells with round nuclei, clumped chromatin.
– Vessels with neoplastic emboli consisting of medium-sized cells,
hyperchromatic nuclei and clumped chromatin .
• Immunohistochemistry:
– Small to medium sizes cells: CD20+, CD23+, BCL2+, CCND1-,
BCL6-, Ki67 15%
– Neoplastic emboli: CD3+, CD56+, CD8+, CD7+, CD30+, BCL2+,
CD4-, CD2-, Ki67 90%.
• CISH:
– EBER positive

71. Summary
• TCR gene rearrangements:
– A clonal product is evident in the analysis in the TCR beta locus
– Additionally clonal product is observed in the analysis of TCR
gamma locus
– The monoclonal peak appears in the middle of a strong
polyclonal component
– Conclusion: positive for detecting a TCR gene rearrangement

72. COMPOUND non-Hodgkin lymphoma:
- Small cell lymphocytic lymphoma
- T / NK Cell neoplasia

73. Age: 93 y/o
Sex: F
Hometown and Origin: La Libertad
Ant. Oncolog: None
Ant. Pathologic: DM (tto. Irregular)
CASO 16- 1757
Time of disease : 4 ms.
Course: Progresive
Purplish erythematous skin lesions
scattered on the trunk, neck and lower
limbs
Progressive growth associated with
pruritus. No B symptoms
Physical exam:
Skin: Generalized purplish nodular lesions,
predominantly of the trunk, some with
signs of flogosis.
Ulcerated lesion with serous secretion in
lumbar region
lymphadenopathies cervical, axillary and
inguinal
Case 4

91. Summary
• Morphology:
– Diffuse pattern with compromiso of the dermis.
– Large centroblastic-like cells with some immunoblast and
reactive lymphocytes.
• Immunohistochemistry:
– CD20+, MUM1+, CD30-/+, CD15-, BCL6-, BCL2-, CD56-, CD3-,
Ki67 70%
• CISH:
– EBER positive

92. Diffuse Large B cell lymphoma EBV positive,
Related To Age

93. Hydroa vacciniforme-like T / NK Lymphoproliferative
Disorder

104. Adult T-cell leukemia/lymphoma (ATLL)HODGKIN-LIKE

106. COMPOUND non-Hodgkin lymphoma:
- Small cell lymphocytic lymphoma
- T / NK Cell neoplasia

109. Diffuse Large B cell lymphoma EBV positive,
Related To Age

112. Thank you