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Martine Bagot - One of the best experts on this subject based on the ideXlab platform.
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Cutaneous T-cell Infiltrates: Analysis of T-cell Receptor y Gene Rearrangement by Polymerase Chain Reaction and Denaturing Gradient Gel Electrophoresis
2016Co-Authors: Loannis Theodorou, Marie-hélène Delfau-larue, Janine Wechsler, Martine Bagot, Claude Bigorgne, Chantal Lahet, Gilles Cochet, Jean-pierre FarcetAbstract:In Cutaneous T-cell infiltrates, the demonstration of a clonal T-cell receptor (TCR) gene rearrangement has been consid-ered helpful t o distinguish Cutaneous T-cell lymphomas from reactive lymphoproliferation. Hence, a polymerase chain reaction (PCR) method using GC-clamp primers and denaturing gradient gel electrophoresis has been developed in our laboratory t o analyze the TCRy locus configuration. Two hundred eleven Cutaneous samples from 155 patients were analyzed. A detectable clonal TCRy rearrangement was significantly associated with Cutaneous T-cell lymphomas as defined by morphologic and immunologic riteria. A clonal TCRy rearrangement was also detected frequently in lympho-matoid papulosis, never in reactive lymphocytic infiltrates and B-cell lymphomas, and rarely in parapsoriasis en plaque and Cutaneous Lymphoid Hyperplasia. Forty five patients ha
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Study of the reactive dendritic cells in small B-cell lymphoproliferations of the skin
Virchows Archiv, 2007Co-Authors: Amélie Carbonnelle, Martine Bagot, Nadine Martin-garcia, Nicolas Ortonne, Liliane Laroche, Valérie Molinier-frenkel, Janine WechslerAbstract:Distinguishing between low-grade primary Cutaneous B-cell lymphoma (LG-pCBCL) and Cutaneous Lymphoid Hyperplasia (CLH) based on histological features is often difficult. CLH lesions contain numerous reactive cells of the histiocyte lineage [Langerhans cells (LC), dermal dendritic cells (DDC), and macrophages], which are also often present in CBCL. The aim of this study was to determine whether immunohistochemical detection of those cells could help differentiate between CLH and LG-pCBCL. We determined the percentages of those histiocytic cells in the dermal infiltrates of 45 cases of Cutaneous lymphoproliferations comprising 16 CLH and 29 LG-pCBCL (19 follicle-center cell lymphomas and 10 marginal zone lymphomas) by immunohistochemical labeling with antibodies to CD1a, FXIIIa, and CD68 to respectively detect LC, DDC, and macrophages. To avoid observer-dependent bias, an automated morphometric analysis method was used to recognize immunoreactive cells and calculate their percentages within the infiltrate. FXIIIa^+ cells were significatively more frequent in CLH than in LG-pCBCL, whereas CD1a^+ and CD68^+ cell frequencies were comparable in the two groups. The results of our study suggest that DDC might play an important role in the genesis of Cutaneous lymphomas.
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Polymerase Chain Reaction Analysis of Immunoglobulin Gene Rearrangement in Cutaneous Lymphoid Hyperplasias
Archives of dermatology, 1999Co-Authors: Anne Bouloc, Marie-hélène Delfau-larue, Bernard Lenormand, Farnaz Meunier, Janine Wechsler, E. Thomine, Jean Revuz, Jean-pierre Farcet, Pascal Joly, Martine BagotAbstract:Background The differential diagnosis of Cutaneous Lymphoid Hyperplasia and B-cell lymphoma may be difficult. Whether the detection of clonal immunoglobulin gene rearrangement in the Cutaneous lesion is predictive of a malignant outcome remains controversial. We therefore studied cases of Cutaneous Lymphoid Hyperplasia by polymerase chain reaction analysis. Design Retrospective study of patients seen between 1988 and 1996. Setting Two dermatology university departments. Patients Twenty-four patients with Cutaneous Lymphoid Hyperplasias were included according to clinical, histopathological, and immunophenotypic criteria. Main Outcome Measures Clinical, histopathological, and laboratory findings. Results There were 13 men and 11 women (mean age, 49 years) who presented with erythematous or violaceous papules or nodules. The lesions were unique in 13 cases and multiple in 11 cases. All patients had immunochemical evidence of a mixed T- and B-cell infiltrate with polytypic B cells. Polyclonality was demonstrated in 23 patients, whereas a dominant B-cell clone was detected in 1 patient. No lymphoma developed during the follow-up (median, 4 years). In the same period, we studied 53 cases of B-cell lymphomas. Thirty-five (66%) of the 53 cases had a detectable clonal immunoglobulin gene rearrangement. Conclusions In the majority of our cases, polyclonality demonstrated by polymerase chain reaction analysis was in accordance with the diagnosis of Cutaneous Lymphoid Hyperplasia. In 1 of the 24 patients, the presence of a B-cell clone could be evidenced. This fact did not modify the treatment as there were no histological or immunophenotypic signs suggestive of a lymphoma.
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Treatment of Cutaneous Lymphoid Hyperplasia with thalidomide: report of two cases.
Journal of the American Academy of Dermatology, 1999Co-Authors: Hakima Benchikhi, Marie-hélène Delfau-larue, Janine Wechsler, Christine Bodemer, Sylvie Fraitag, Nicolas Gounod, Yves De Prost, J. Revuz, Martine BagotAbstract:Abstract Cutaneous benign Lymphoid Hyperplasia is a B-cell pseudolymphoma of unknown origin. The most favored sites of involvement include the face. We report two cases involving the nose that showed complete and stable regression after a 2-month treatment course with thalidomide. (J Am Acad Dermatol 1999;40:1005-7.)
Janine Wechsler - One of the best experts on this subject based on the ideXlab platform.
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Cutaneous T-cell Infiltrates: Analysis of T-cell Receptor y Gene Rearrangement by Polymerase Chain Reaction and Denaturing Gradient Gel Electrophoresis
2016Co-Authors: Loannis Theodorou, Marie-hélène Delfau-larue, Janine Wechsler, Martine Bagot, Claude Bigorgne, Chantal Lahet, Gilles Cochet, Jean-pierre FarcetAbstract:In Cutaneous T-cell infiltrates, the demonstration of a clonal T-cell receptor (TCR) gene rearrangement has been consid-ered helpful t o distinguish Cutaneous T-cell lymphomas from reactive lymphoproliferation. Hence, a polymerase chain reaction (PCR) method using GC-clamp primers and denaturing gradient gel electrophoresis has been developed in our laboratory t o analyze the TCRy locus configuration. Two hundred eleven Cutaneous samples from 155 patients were analyzed. A detectable clonal TCRy rearrangement was significantly associated with Cutaneous T-cell lymphomas as defined by morphologic and immunologic riteria. A clonal TCRy rearrangement was also detected frequently in lympho-matoid papulosis, never in reactive lymphocytic infiltrates and B-cell lymphomas, and rarely in parapsoriasis en plaque and Cutaneous Lymphoid Hyperplasia. Forty five patients ha
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Study of the reactive dendritic cells in small B-cell lymphoproliferations of the skin
Virchows Archiv, 2007Co-Authors: Amélie Carbonnelle, Martine Bagot, Nadine Martin-garcia, Nicolas Ortonne, Liliane Laroche, Valérie Molinier-frenkel, Janine WechslerAbstract:Distinguishing between low-grade primary Cutaneous B-cell lymphoma (LG-pCBCL) and Cutaneous Lymphoid Hyperplasia (CLH) based on histological features is often difficult. CLH lesions contain numerous reactive cells of the histiocyte lineage [Langerhans cells (LC), dermal dendritic cells (DDC), and macrophages], which are also often present in CBCL. The aim of this study was to determine whether immunohistochemical detection of those cells could help differentiate between CLH and LG-pCBCL. We determined the percentages of those histiocytic cells in the dermal infiltrates of 45 cases of Cutaneous lymphoproliferations comprising 16 CLH and 29 LG-pCBCL (19 follicle-center cell lymphomas and 10 marginal zone lymphomas) by immunohistochemical labeling with antibodies to CD1a, FXIIIa, and CD68 to respectively detect LC, DDC, and macrophages. To avoid observer-dependent bias, an automated morphometric analysis method was used to recognize immunoreactive cells and calculate their percentages within the infiltrate. FXIIIa^+ cells were significatively more frequent in CLH than in LG-pCBCL, whereas CD1a^+ and CD68^+ cell frequencies were comparable in the two groups. The results of our study suggest that DDC might play an important role in the genesis of Cutaneous lymphomas.
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Polymerase Chain Reaction Analysis of Immunoglobulin Gene Rearrangement in Cutaneous Lymphoid Hyperplasias
Archives of dermatology, 1999Co-Authors: Anne Bouloc, Marie-hélène Delfau-larue, Bernard Lenormand, Farnaz Meunier, Janine Wechsler, E. Thomine, Jean Revuz, Jean-pierre Farcet, Pascal Joly, Martine BagotAbstract:Background The differential diagnosis of Cutaneous Lymphoid Hyperplasia and B-cell lymphoma may be difficult. Whether the detection of clonal immunoglobulin gene rearrangement in the Cutaneous lesion is predictive of a malignant outcome remains controversial. We therefore studied cases of Cutaneous Lymphoid Hyperplasia by polymerase chain reaction analysis. Design Retrospective study of patients seen between 1988 and 1996. Setting Two dermatology university departments. Patients Twenty-four patients with Cutaneous Lymphoid Hyperplasias were included according to clinical, histopathological, and immunophenotypic criteria. Main Outcome Measures Clinical, histopathological, and laboratory findings. Results There were 13 men and 11 women (mean age, 49 years) who presented with erythematous or violaceous papules or nodules. The lesions were unique in 13 cases and multiple in 11 cases. All patients had immunochemical evidence of a mixed T- and B-cell infiltrate with polytypic B cells. Polyclonality was demonstrated in 23 patients, whereas a dominant B-cell clone was detected in 1 patient. No lymphoma developed during the follow-up (median, 4 years). In the same period, we studied 53 cases of B-cell lymphomas. Thirty-five (66%) of the 53 cases had a detectable clonal immunoglobulin gene rearrangement. Conclusions In the majority of our cases, polyclonality demonstrated by polymerase chain reaction analysis was in accordance with the diagnosis of Cutaneous Lymphoid Hyperplasia. In 1 of the 24 patients, the presence of a B-cell clone could be evidenced. This fact did not modify the treatment as there were no histological or immunophenotypic signs suggestive of a lymphoma.
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Treatment of Cutaneous Lymphoid Hyperplasia with thalidomide: report of two cases.
Journal of the American Academy of Dermatology, 1999Co-Authors: Hakima Benchikhi, Marie-hélène Delfau-larue, Janine Wechsler, Christine Bodemer, Sylvie Fraitag, Nicolas Gounod, Yves De Prost, J. Revuz, Martine BagotAbstract:Abstract Cutaneous benign Lymphoid Hyperplasia is a B-cell pseudolymphoma of unknown origin. The most favored sites of involvement include the face. We report two cases involving the nose that showed complete and stable regression after a 2-month treatment course with thalidomide. (J Am Acad Dermatol 1999;40:1005-7.)
Hakima Benchikhi - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Cutaneous Lymphoid Hyperplasia with thalidomide: report of two cases.
Journal of the American Academy of Dermatology, 1999Co-Authors: Hakima Benchikhi, Marie-hélène Delfau-larue, Janine Wechsler, Christine Bodemer, Sylvie Fraitag, Nicolas Gounod, Yves De Prost, J. Revuz, Martine BagotAbstract:Abstract Cutaneous benign Lymphoid Hyperplasia is a B-cell pseudolymphoma of unknown origin. The most favored sites of involvement include the face. We report two cases involving the nose that showed complete and stable regression after a 2-month treatment course with thalidomide. (J Am Acad Dermatol 1999;40:1005-7.)
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Treatment of Cutaneous Lymphoid Hyperplasia with thalidomide: report of two cases.
Journal of the American Academy of Dermatology, 1999Co-Authors: Hakima Benchikhi, Christine Bodemer, Sylvie Fraitag, Nicolas Gounod, Yves De Prost, J. Revuz, J Wechsler, M H Delfau-larue, M BagotAbstract:Cutaneous benign Lymphoid Hyperplasia is a B-cell pseudolymphoma of unknown origin. The most favored sites of involvement include the face. We report two cases involving the nose that showed complete and stable regression after a 2-month treatment course with thalidomide.
Lyn M. Duncan - One of the best experts on this subject based on the ideXlab platform.
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PD-1, S-100 and CD1a expression in pseudolymphomatous folliculitis, primary Cutaneous marginal zone B-cell lymphoma (MALT lymphoma) and Cutaneous Lymphoid Hyperplasia
Journal of cutaneous pathology, 2014Co-Authors: Amrita Goyal, Johanna B. Moore, Devon C. Gimbel, Joi B. Carter, Daniela Kroshinsky, Judith A. Ferry, Nancy L. Harris, Lyn M. DuncanAbstract:Background Pseudolymphomatous folliculitis is a Lymphoid proliferation that clinically and histopathologically mimics primary Cutaneous extranodal marginal zone lymphoma of mucosa-associated Lymphoid tissue (MALT lymphoma). In this study, we assessed the diagnostic value of three immunohistochemical markers, programmed death-1 (PD-1), CD1a and S100. Methods We evaluated 25 cases of Cutaneous Lymphoid proliferations with established diagnoses, including 9 patients with pseudolymphomatous folliculitis, 11 with MALT lymphoma, and 5 with Cutaneous Lymphoid Hyperplasia (CLH). The clinical, histopathologic and immunohistochemical characteristics were reviewed and three major characteristics assessed: (a) proportion of T cells expressing PD-1, (b) pattern of expression of CD1a by dendritic cells and (c) pattern of expression of S100 by dendritic cells. Results We found pseudolymphomatous folliculitis to have a significant increase in PD-1+ T cells compared with MALT lymphoma (p < 0.0001). The pattern of CD1a staining is also informative: MALT lymphoma is significantly more likely to demonstrate a peripheral concentration of CD1a+ dendritic cells around Lymphoid nodules than pseudolymphomatous folliculitis (p < 0.0003) or CLH (p < 0.05). Pseudolymphomatous folliculitis demonstrates an interstitial distribution of CD1a+ cells more often than MALT lymphoma (p < 0.04). S100 staining was not a helpful discriminator. Conclusions Histopathologic factors including PD-1 and CD1a staining patterns may allow for more certainty in distinguishing Lymphoid Hyperplasia, including pseudolymphomatous folliculitis, from MALT lymphoma.
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Cutaneous Lymphoid Hyperplasia and Cutaneous marginal zone lymphoma: comparison of morphologic and immunophenotypic features.
The American journal of surgical pathology, 1999Co-Authors: Marisa F. Baldassano, Judith A. Ferry, Nancy L. Harris, Elizabeth M. Bailey, Lyn M. DuncanAbstract:Cutaneous marginal zone lymphoma (MZL) is a recently described low-grade B-cell lymphoma that usually follows an indolent course. This tumor shares many histologic and clinical features with Cutaneous Lymphoid Hyperplasia (CLH), a benign reactive Lymphoid proliferation. Sixteen biopsy specimens from 14 patients with CLH were studied, and compared with 16 cases of Cutaneous MZL (9 primary Cutaneous, 7 with secondary involvement of the skin) to determine whether there were features that would permit their distinction on routinely fixed, paraffin-embedded tissue sections. Both disorders showed a female preponderance (CLH: 9 F, 5 M; MZL: I I F. 5 M). The median age was also similar (CLH: 54 years: Cutaneous MZL: 55 years). CLH was most common on the arm (8) and the head and neck (7) but also involved the trunk (1 primary Cutaneous MZL most often involved the limbs (3), trunk (3), and head and neck (3). Lymphoma did not develop in any of the 14 CLH patients (follow-up ranging from 9 to 246 months, mean 62 months). Six of 9 patients with primary Cutaneous MZL and all 7 patients with secondary Cutaneous MZL experienced relapses, most commonly isolated to skin or a subCutaneous site. On hematoxylin-eosin stained sections, a diffuse proliferation of marginal zone cells (p < 0.0001 ), zones of plasma cells (p = 0.01), the absence of epidermal change (p = 0.01), reactive germinal centers (p = 0.03), and a diffuse pattern of dermal or subCutaneous infiltration (p = 0.03) were more often seen in Cutaneous MZL. A dense lymphocytic infiltrate, bottom-heavy or top-heavy growth pattern, eosinophils, and a grenz zone were seen equally often in both disorders. Dutcher bodies were observed only in Cutaneous MZL. Immunoperoxidase stains on formalin-fixed paraffin-embedded tissue sections showed monotypic expression of immunoglobulin light chains by plasma cells in 11 of 16 MZL cases. By definition, no case with monotypic plasma cells was diagnosed as CLH. In CLH. T cells usually outnumbered B cells, and a B:T cell ratio ≥3:1 was not observed in any case. By contrast, 40% of the MZL cases showed a B:T cell ratio ≥3:1. No coexpression of CD20 and CD43 was seen in any case of either MZL or CLH. In summary, the clinical presentations of CLH and MZL are similar. In contrast to historical criteria for diagnosing Cutaneous Lymphoid infiltrates, the presence of reactive follicles favors a diagnosis of Cutaneous B-cell lymphoma (CBCL). In addition, a bottom-heavy or top-heavy growth pattern is not a distinctive finding. Marginal zone cells and zones or sheets of plasma cells are strong morphologic indicators of marginal zone lymphoma. The diagnosis of CBCL can be supported in 40% of the cases by demonstrating a B:T cell ratio of ≥3:1, and confirmed in 70% of the cases by demonstrating monotypic light chain expression of plasma cells on paraffin sections.
Takanori Hirose - One of the best experts on this subject based on the ideXlab platform.
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Lymphomatoid keratosis : An epidermotropic type of Cutaneous Lymphoid Hyperplasia: Clinicopathological, immunohistochemical, and molecular biological study of 6 cases
Archives of dermatology, 2007Co-Authors: Eiichi Arai, Michio Shimizu, Tetsuya Tsuchida, Seiichi Izaki, Fumihiro Ogawa, Takanori HiroseAbstract:Objective To provide evidence that lymphomatoid keratosis should be categorized as an epidermotropic subtype of Cutaneous Lymphoid Hyperplasia. Design Clinicopathological, immunohistochemical, and molecular biological studies of epidermotropic and dermal bandlike infiltrates of lymphocytes without necrotic keratinocytes, Civatte bodies, or Max-Joseph spaces and solar lentigo or seborrheic keratosis adjacent to the lesion, but with epidermal hyperplastic change (clinically scaly plaque) in cases of lymphomatoid keratosis. Conventional histopathologic study as well as immunohistochemical examinations for CD1a, CD3, CD4, CD8, CD20, and CD79a and S100 protein and genotypic examinations were performed. Setting University departments comprising 2 sections of dermatology and 1 section of pathology. Main Outcome Measures Ratio of T to B cells and of CD4 + to CD8 + cells, and the phenotype of epidermotropic cells were evaluated. Gene rearrangement of the immunoglobulin heavy chain gene and T-cell receptor (TCR)-β and TCRγ genes was also investigated by the polymerase chain reaction method. Results Immunohistochemically, epidermotropic CD20 + and/or CD79a + cells were present. In the upper dermal lymphocytic infiltrates, the CD3 + /CD79a + cell ratio ranged from 5:5 to 8:2. The CD4 + /CD8 + cell ratio was within normal limits. Rearrangements of the TCRγ gene were demonstrated in 2 cases and of the TCRβ gene in 1 case. Conclusions Our results indicate that lymphomatoid keratosis is a clinically benign keratotic lesion but histologically malignant, simulating mycosis fungoides. Immunohistochemical findings showed a reaction pattern in all cases, but genotypical examination showed some clonal dermatoses. Therefore, “lymphomatoid” keratosis should be classed as a pseudolymphoma, namely, a subtype of Cutaneous Lymphoid Hyperplasia with epidermotropism.
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A review of 55 cases of Cutaneous Lymphoid Hyperplasia: reassessment of the histopathologic findings leading to reclassification of 4 lesions as Cutaneous marginal zone lymphoma and 19 as pseudolymphomatous folliculitis.
Human pathology, 2005Co-Authors: Eiichi Arai, Michio Shimizu, Takanori HiroseAbstract:To clarify the confusion surrounding the diagnosis of Cutaneous Lymphoid Hyperplasia (CLH) that was formerly described as lymphadenosis benigna cutis, lymphocytoma cutis, or lymphocytic infiltration of Jessner and to assess whether newly recognized diagnoses, such as Cutaneous marginal zone lymphoma and pseudolymphomatous folliculitis (PLF), may have been overlooked, we reexamined 55 Japanese cases of nonepidermotropic lymphoproliferative disorder that had previously been diagnosed as "Cutaneous pseudolymphoma." In all these cases, the immunohistochemical expressions of CD1a, CD3, CD4, CD8, CD20, CD21, CD30, CD43, CD56, CD68, CD79a, kappa and lambda chains, S-100 protein, and latent membrane protein were assessed. In addition, in 13 cases the gene rearrangement of the immunoglobulin heavy chain was investigated using a polymerase chain reaction method. As a result of these investigations, we have identified 4 cases of Cutaneous marginal zone lymphoma, 19 cases of PLF, 1 case of diffuse large B-cell lymphoma, and 2 cases of solitary nonepidermotropic pseudo-T-cell lymphoma, with the remaining 29 cases being CLH. Cutaneous marginal zone lymphoma, which represented 7.3% of the total, was distinguished from CLH by the presence of patchy or diffuse proliferation of centrocyte-like cells, plasma cells at the periphery of the lymphocytic infiltration, monotypic restriction of the light chains, and gene rearrangement of the immunoglobulin heavy chain. Pseudolymphomatous folliculitis was identified by the presence of activated pilosebaceous units with abundant CD1a-and S-100 protein-positive T-cell-activated dendritic cells. Of the cases that were reassessed, 34.5% were PLF.
