Self-regressing oral CD30-positive, EBV-negative, T-cell lymphoproliferative lesions. A poorly understood process highlighted by ominous clinicopathologic features and indolent behavior

Prokopios P. Argyris, Dan Ho, Mohammed N. Islam, Syed Ali Khurram, Elizabeth L. Courville, Susan Morgan, Bradley Sundick, Monica Soliman, Murali Janakiram, Rajaram Gopalakrishnan, Ioannis G. Koutlas

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Intraoral, primary, CD30-positive (CD30+) T-cell lymphoproliferative disorders (TLPDs) are uncommon, and their clinicopathologic presentation and management can vary and may be challenging. Herein, we present a retrospective study of 4 examples of self-regressing primary CD30+ TLPD affecting the gingiva. Study Design: Archived files were retrospectively reviewed for oral CD30+ TLPDs featuring (1) proper immunohistochemical documentation, (2) Epstein-Barr virus negativity, (3) adequate follow-up information corroborating regression, and (4) no history of hematopoietic malignancy or related-mucocutaneous disease. Results: Three women and 1 man (age range, 55-82 years; mean, 68.3 years) presented with rapidly growing gingival ulcers. Microscopic evaluation revealed diffuse infiltration by sheets of large, atypical cells admixed with lymphocytes and eosinophils, showing angiocentric distribution, focal neurotropism, and muscle infiltration. The lesional cells consistently stained for CD3 and CD30 and were variably immunoreactive against CD2, CD4, CD5, CD7, and CD8, but were negative for ALK1 and EBV-encoded small RNA. TCR-γ gene rearrangement studies revealed a monoclonal T-cell population in 1 case. All lesions showed complete regression 2 to 8 weeks postoperatively (mean follow-up, 4.5 weeks). Conclusions: Notwithstanding their alarming clinicopathologic appearance, there are CD30+ TLPDs confined to the oral cavity that have an indolent course. However, clinical staging is essential to exclude aggressive systemic malignancy.

Original languageEnglish (US)
Article number4638
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Early online dateJun 7 2021
DOIs
StateE-pub ahead of print - Jun 7 2021

Bibliographical note

Funding Information:
The authors are indebted to Brian Dunnette (University of Minnesota, Minneapolis, MN) for his assistance with the Aperio Scanning Platform.

Publisher Copyright:
© 2021 Elsevier Inc.

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