Eosinophilic ulcer of the oral mucosa (EUOM) is a very rare, benign, self-limiting ulcerative lesion of the oral cavity of unknown pathogenesis, and belongs to the same spectrum of CD30+ T-cell lymphoproliferative disease (LPD) of the oral mucosa. The etiology and pathogenesis of the disease are unknown. We report two cases in children who were initially diagnosed with EUOM and CD30+ T-cell LPD, respectively. However, retrospective analysis revealed that a majority of infiltrated atypical T cells were positive for Epstein-Barr virus (EBV). The present cases suggest that the pathogenesis and etiology of EUOM or CD30+ T-cell LPD occurring in children are different from those in adults. EUOM or CD30+ T-cell LPD in children is a manifestation of EBV-positive T-cell LPD, and should therefore be distinguished from the disease in adults.
Citations
Citations to this article as recorded by
Pediatric oral Epstein-Barr virus associated self-remitting CD30+ lymphoproliferative disorder: A distinct entity Ziv Schwartz, Robert B. Bowe, Morton Coleman, Cynthia M. Magro Annals of Diagnostic Pathology.2018; 37: 57. CrossRef
Lymphomatoid papulosis is an enigmatic disease entity which is clinically benign and histologically malignant. Although sporadic cases have been reported, we could not find any comprehensive report on the combined clinical and histologic features of lymphomatoid papulosis in the literature.
Perhaps the most controversial aspect of lymphomatoid papulosis is its pathogenesis and categorization as a benign versus a malignant entity. To date, there are no reports on p53 and bcl-2 protein expression in lymphomatoid papulosis.
We analysed the clinico-pathological findings of 18 cases with lymphomatoid papulosis during the 10 year period from 1984 to 1995 and examined the prevalence of immunoreactivity for CD30(DAKO, Ber-H2), p53(DAKO, DO-7), and bcl-2(DAKO, 124) using an immunohistochemical(ABC) method. The results obtained are summarized as follows. 1) Age distribution ranged from 20 to 65, with a mean age of 45 years and a sex distribution which showed a male predominence(8:1). The lesions were located on the trunk and extremities(8cases), extremities (7cases), and trunk(3 cases). The morphology of the lesions were papules or plaques(12 cases), and nodules(6 cases). 2) Histopathologic types were classified into 3 types: type A(4 cases), type B(8 cases) and mixed type (6 cases). 3) Positive immunoreactivity for CD30 was seen in 17%(3 of 18cases): type A(2 of 3) and mixed type(1 of 3). 4) The positive immunoreactivity for p53 and bcl-2 was observed in 29%(5 of 18) and 11%(2 of 18), respectively. 5) Cases showing positive immunoreactivity for P53 were type A(1 of 5), type B(1 of 5), and mixed type(3 of 5). 6) Cases showing positive immunoreactivity for bcl-2 were mixed type(2 of 2).
One case developed into Ki-1 lymphoma. These results support the idea that lymphomatoid papulosis and Ki-1 lymphoma represent a continuum. The role of p53 gene mutation and bcl-2 activation in the development of lymphomatoid papulosis is currently unknown. But, our results suggest that p53 gene mutation and bcl-2 activation are not a critical step in the development of lymphomatoid papulosis.
Further studies are needed to elucidate the role of p53 gene mutation and bcl-2 activation in the development and progression of lymphomatoid papulosis.
Forty one cases of Hodgkin's disease and non-Hodgkin's lymphomas were immunohisto-chemi-cally studied for the presence of CD30 antigen on the paraffin embedded formaldehyde fixed tissue by using Ber H2(CD30) monoclonal antibody (Dakopatts, diluted l : 20) and avidin biotin peroxidase complex technique seventy five %(6/8) of Hodgkin's lymphoma and 27% (9/33) of non-Hodgkin's lymphomas were CD30 positive. Five of l7 diffuse large cell and immunoblastic lymphoma and one large cell anaplastic lymphoma showed large numbers of CD30 positive cells.
Occasional CD30 positive cells were found in one of 2 angiommunoblastic lymphadenopathy-like T cell lymphoma, one of 4 small lymphocytic lymphoma and one unclassified lymphoma. Immunophenotypically l6% of B cell lymphoma and 42% of T cell lymphoma showed CD30 positivity. six cases of Hodgkin's disease except lymphocyte predominance showed positive tumor cells. Our results show that CD30 is more widespread in histologic subtypes of lymphomas and is not specific for the diagnosis of Hodgkin's disease.