Abstract:

Introduction: CD30 expression has been infrequently described in cutaneous B-cell ‎lymphomas (CLBCL). We examined CD30 expression in reactive lymphoid hyperplasia (RLH) ‎and CBCL and correlate expression with clinicopathologic features.‎
Methods: CD30 was examined in 82 CBCL patients and 10 RLH patients that had been ‎evaluated in our cutaneous lymphoma clinics. The CBCL patients included: primary cutaneous ‎follicle center lymphoma (PCFCL), Grade 1/2 systemic/nodal follicular lymphoma ‎‎(SFL); Primary cutaneous marginal zone lymphoma/lymphoproliferative disorder ‎‎(PCMZL/LPD); systemic marginal zone lymphoma (SMZL); primary cutaneous diffuse large B-‎cell lymphoma, leg type (PCDLBCL-LT); and extracutaneous/systemic diffuse large B-cell ‎lymphoma (eDLBCL). We scored CD30 expression in each case for intensity and extent ‎and related CD30 expression to age at first diagnosis, sex, site of biopsy, clinical appearance, ‎extracutaneous involvement, multiple cutaneous lesions, B-symptoms, lymphadenopathy, ‎positive positron emission tomography/computed tomography (PET/CT), elevated lactate ‎dehydrogenase (LDH), and positive bone marrow biopsy. CD30 positivity was defined as ≥5% ‎of CD30+ cells.‎
Results: CD30 expression was identified in 35% of CBCL, ranging from few, weak, scattered ‎cells to strong and diffuse expression. It was most commonly present in PCFCL and never ‎expressed in PCDLBCL-LT. Rare PCFCL expressed strong, diffuse CD30, causing diagnostic ‎confusion with anaplastic large cell lymphoma. Some cases of PCMZL/LPD, SMZL, FL and ‎RLH showed scattered, strongly positive cells mimicking lymphomatoid papulosis, type ‎A. CD30 expression differed significantly by diagnosis (p<0.0001), site (p=0.242) and clinical ‎appearance (p=0.035). CD30 expression was associated with favorable clinical features, such as ‎younger age (p<0.0325), negative PET/CT (p=0.0340) and an LDH within normal limits ‎‎(p=0.0013).
Conclusions: CBCL may be expressed in CD30 causing diagnostic confusion. CD30 expression ‎is most likely in PCFCL and is associated with favorable clinical features.‎

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Olabisi Afolayan-Oloye, MD

Biography