Oral manifestations of Hydroa vacciniforme-like lymphoproliferative disorder: a clinicopathological study of a Peruvian population

Author(s)

Lopez de Caceres, Cinthia Veronica Bardalez ^[1] ; Rodrigues-Fernandes, Carla Isabelly ^[1] ; Rendon Henao, Javier ^[2] ; Morais, Thayna Melo de Lima ^[1] ; Soares, Ciro Dantas ^{[1, 3]} ; de Almeida, Oslei Paes ^[1] ; Fonseca, Felipe Paiva ^{[1, 4]} ; Delgado-Azanero, Wilson ^[5]

Affiliation

^[1] Univ Estadual Campinas, Piracicaba Dent Sch, Dept Oral Diag, Piracicaba - Brazil

^[2] Univ Antioquia, Med Sch, Dept Pathol, Medellin - Colombia

^[3] Private Pathol Serv, Natal, RN - Brazil

^[4] Univ Fed Minas Gerais, Sch Dent, Dept Oral Surg & Pathol, Av Antonio Carlos 6627, BR-31270901 Belo Horizonte, MG - Brazil

^[5] Univ Peruana Cayetano Heredia, Fac Estomatol, Dept Patol Med & Cirugia Oral, Lima - Peru

• Document type: Journal article
• Source: JOURNAL OF ORAL PATHOLOGY & MEDICINE; v. 50, n. 6, p. 530-539, JUL 2021.
• Web of Science Citations: 0

Abstract

Background Hydroa vacciniforme-like lymphoproliferative disorder (HVLPD) is a chronic Epstein-Barr virus (EBV)-positive lymphoproliferative disease which may either present as an indolent condition or progress to a systemic T-cell lymphoma. Methods All HVLPD diagnosed over a 10-year period were retrieved, and clinical data regarding sex, age, oral and systemic manifestations, and clinical follow-up were obtained. Immunohistochemistry was done in order to characterize the lymphoid cells, and in situ hybridization was used to demonstrate the presence of EBV. Results Eleven cases were included, with a male predominance and a mean age of 25.1 years. Buccal mucosa and the lips were the most affected oral sites, appearing as painful ulcers. All patients exhibited facial oedema, usually affecting the lips, nose and periorbital region. The clinical course was gradual but progressive, with four patients having fever and 3 showing lymphadenopathies. All cases showed a moderate to severe lymphocytic infiltrate with angiotropism, angiocentricity and epidermotropism. Two cases affecting the lip skin exhibited a periappendageal lymphocytic infiltrate. Few large pleomorphic cells were found, surrounded by smaller and medium-sized lymphoid cells, as well as reactive plasma cells, macrophages, neutrophils and eosinophils. All lesions exhibited a cytotoxic T-cell (CD8+) phenotype with a variable proliferative index. All cases were associated with EBV, and all patients died due to complications of the disease. Conclusions HVLPD is a rare disease that may show oral involvement with a cytotoxic T-cell phenotype, and is strongly associated with EBV. As shown in this series, HVLPD may show aggressive clinical behaviour. (AU)

• FAPESP's process: 17/14880-3 - Clinicopathological and immunohistochemical analysis of follicular lymphoid hyperplasias and lymphomas of the oral cavity
• Grantee: Oslei Paes de Almeida
• Support Opportunities: Regular Research Grants