Clinicopathologic and microenvironmental analysis of primary cutaneous CD30-positive lymphoproliferative disorders: a 26 year experience from an academic medical center in Brazil

Autor(es)

Ferreira, Cristiane Rubia ^{[1, 2, 3]} ; Zhao, Shuchun ^[2] ; Sanches, Jose Antonio ^[4] ; Miyashiro, Denis ^[4] ; Cury-Martins, Jade ^[4] ; Azevedo, Raymundo Soares ^[1] ; Zerbini, Maria C. N. ^[1] ; Natkunam, Yasodha ^[2] ; Gratzinger, Dita ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Pathol, BR-01246 Sao Paulo, SP - Brazil

^[2] Stanford Univ, Sch Med, Dept Pathol, Stanford, CA 94305 - USA

^[3] Univ Hosp Sao Paulo Univ HU USP, Anat Pathol Serv, Rua Prof Lineu Prestes 2565, BR-05508000 Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Dept Dermatol, BR-01246 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: DIAGNOSTIC PATHOLOGY; v. 14, n. 1 OCT 22 2019.
• Citações Web of Science: 0

Resumo

Background Primary cutaneous CD30+ lymphoproliferative disorders (pc-CD30-LPD) are a group of clonal T cell lymphoproliferative disorders that despite very similar tumor histology follow different and characteristic clinical courses, suggesting a homeostatic role of the tumor microenvironment. Little is known about tumor microenvironment and there is almost no literature about PD-L1 expression in pc-CD30-LPD. Methods This retrospective study presents a fully clinicopathologically characterized series of pc-CD30-LPDs from an academic medical center in Brazil, including 8 lymphomatoid papulomatosis (LyP), 9 primary cutaneous anaplastic large cell lymphoma (pcALCL) and 4 borderline lesions. All the cases were scored for FOXP3+ regulatory T-cells (Treg) and CD8+ cytotoxic tumor infiltrating lymphocytes (TIL) densities, as well as PD-L1 expression in tumor cells and tissue associated macrophages. The CD8+/FOXP3+ ratio was also evaluated. Results Among the 21 cases of pc-CD30-LPD, PD-L1 expression is frequent in both tumor cells and tissue associated macrophages in pc-CD30-LPD across categories, suggesting that the PD-L1 axis may be a common feature of pc-CD30-LPDs. While reactive T cell infiltrates vary widely from case to case, a common feature across pc-CD30-LPDs is higher density of CD8 than FOXP3 + T cells. The distribution of T cells within the lesions however differed between LyP and pcALCL: we found that LyP lesions tend to be permeated by CD8+ and FOXP3+ T cells, whereas pcALCL tend to be surrounded by a rim of CD8+ TIL and FOXP3+ Tregs with relatively lower density infiltrates in the center of the lesion. Conclusions LyP has a trend to have denser immune cells throughout the lesion, with higher FOXP3+ Treg and CD8+ TIL in the center than the edge comparing with pcALCL. PD-L1+ is frequent in tumor cells and tissue associated macrophages in pc-CD30-LPD. The differential distribution of CD8+ and FOXP3+ TILs in LyP as compared to pcALCL could provide a clue to the relapsing/remitting course of LyP as compared to the less frequent spontaneous regression of pcALCL. (AU)

• Processo FAPESP: 16/09180-0 - Caracterização de subgrupos genéticos em linfoma de grandes células anaplásicos, alk negativos Através da Técnica de FISH em casos brasileiros
• Beneficiário: Cristiane Rúbia Ferreira
• Modalidade de apoio: Bolsas no Exterior - Pesquisa