Journal of Clinical Oncology, Vol 13, 1343-1354, Copyright © 1995 by American Society of Clinical Oncology
CD30/Ki-1-positive lymphoproliferative disorders of the skin-- clinicopathologic correlation and statistical analysis of 86 cases: a multicentric study from the European Organization for Research and Treatment of Cancer Cutaneous Lymphoma Project Group
M Paulli, E Berti, R Rosso, E Boveri, S Kindl, C Klersy, M Lazzarino, G Borroni, F Menestrina and M Santucci
Institute of Pathology, Biometry, Hematology and Dermatology, I.R.C.C.S. Policlinico S. Matteo.
PURPOSE: Recently, it has been shown that CD30 antigen expression is
associated with a relatively favorable prognosis in primary cutaneous
large-cell lymphomas (CLCLs). However, prognostic subsets within the CD30+
group have been difficult to identify due to lack of uniform
clinicopathologic and immunophenotypic criteria, limited clinical
information, and the inclusion of relatively few patients for statistical
analysis in prior studies. To address these problems, we formed a
multicentric study group of pathologists and dermatologists to classify and
evaluate 92 cases of CD30+ cutaneous lymphoproliferative disorders.
PATIENTS AND METHODS: An expert panel established consensus diagnoses for
86 CD30+ cutaneous lymphomas. Cases, clinically and histologically
classified as lymphomatoid papulosis (LyP), anaplastic large-cell lymphoma
(ALCL), nonanaplastic lymphoma, and borderline histology between LyP and
ALCL, were then analyzed statistically by univariate, multivariate, and Cox
regression model analysis of potential prognostic features. RESULTS:
Spontaneous regression and age less than 60 years were associated with a
favorable prognosis, while extracutaneous disease and age greater than 60
had a poor prognosis. Patients with LyP had the best prognosis, followed by
those with primary CD30+ lymphomas, regardless of cytologic type
(anaplastic or nonanaplastic). Borderline cases, morphologically
indistinguishable from LyP and CD30+ ALCL, had a favorable prognosis,
similar to LyP. CONCLUSION: Our findings indicate that CD30+ cutaneous
lymphoproliferative disorders comprise a spectrum of closely related skin
lesions, which can be assigned a relatively favorable or unfavorable
prognosis by a combined clinical and pathologic analysis.
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