Case Number : Case 65 Posted By: Guest

Phillip McKee - Overseas consultations (Arizona, USA) Wrote:

The correct diagnosis is granulomatous slack skin. Granulomata may also be seen in: mycosis fungoides CD4+ small/medium T-cell lymphoma ATLL Subcutaneous panniculitis-like T-cell lymphoma Cutaneous marginal zone B-cell lymphoma The difference between GSS and granulomatous MF is one of degree. Emperipolesis and elastophagocytosis is much more pronounced in the former condition. In addition there are obvious clinical differences. Phillip

Submitted on 08/09/2010 20:59
________________________________________
Jonathan Shelton - (UK) Wrote:

One hugh osteoclast like giant cell with background mature lymphocytes - diagnosis - still could be lymphoid hyperplasia or reactive ??

Submitted on 08/09/2010 19:36
________________________________________
Phillip McKee - Overseas consultations (Arizona, USA) Wrote:

Good morning all. Richard, why didn't you ask me? Remember other lymphomas may have granulomata and giant cells! Phillip

Submitted on 08/09/2010 18:08
________________________________________
Hafeez Diwan - Baylor College of Medicine (Houston, TX) Wrote:

Probably granulomatous slack skin or granulomatous MF.

Submitted on 08/09/2010 17:46
________________________________________
Marcela Saeb Lima - MSLDermatopato (Mexico City) Wrote:

Granulomatous slack skin vs granulomatous MF

Submitted on 08/09/2010 13:18
________________________________________
Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Hi all, I think I was off the track! I was totally wrong. I re-examined the section, I agree with granulomatous slack skin. What I percieved as lymphocytes permeating an epithelial island is actually as u all said a multinucleated giant cell engulfing lymphocytes (emperiopolesis). Thank u all.

Submitted on 08/09/2010 12:30
________________________________________
Richard A. Carr - Warwick (UK) Wrote:

I want this to be granulomatous slack skin. Rather haloed lymphocytes with giant cells and emperipolesis. I think this is an exceedingly rare variant of MF as no one in the UK could provide me with a case when I needed it for a cutaneous lymphoma lecture!

Submitted on 08/09/2010 11:39
________________________________________
Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Diffuse lymphocytic infiltrate with small lymphocytes and giant cells (some showing emperipolesis). Thought of granulomatous slack skin.

Submitted on 08/09/2010 07:21
________________________________________
Juan Carlos Garcés - Hospital Oncológico / Hospital Luis Vernaza (Guayaquil Ecuador) Wrote:

Lymphoid infiltrate with giant cells with many nuclei. I would think in Granulomatous slack skin

Submitted on 08/09/2010 01:24
________________________________________
Mona Abdel-Halim - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

I think I am seeing a dense lymphocytic stromal infiltrate surrounding what looks like nests of poorly differentiated SCC. I think also that there is an epithelial giant cell. My first possibility is inflammatory SCC. Another DDx: is lymphoepithelioma like carcinoma.

Submitted on 08/09/2010 00:11
________________________________________