Dermatopathology

Type E Lymphomatoid Papulosis

Type E lymphomatoid papulosis is a primary cutaneous CD30 positive lymphoproliferative disorder with an angiotrophic infiltrate and a papulo-nodular presentation.

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Slide 1: This 48 year old male has a long standing history of benign appearing papules that follow a waxing and waning course. The biopsy shows a ulceration and a highly atypical lymphocytic infiltrate within the dermis.

Slide 2: The ulceration is likely ischemic in nature due to the angioinvasive properties of the infiltrate.

Slide 3: Smaller lymphocytes predominate the infiltrate around the eccrine coils.

Slide 4: The infiltrate is fairly heterogenous in composition. The dominant infiltrate is comprised of intermediate and larger lymphocytes with occasional mitotic figures. A lymphomatoid vasculitis is present.

Slide 5: There is extensive immunoreactivity for CD4.

Slide 6: There is extensive immunoreactivity for CD30.