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October 2010

Asymptomatic Tumors in a 64-Year-Old Man—Diagnosis

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Arch Dermatol. 2010;146(10):1167-1172. doi:10.1001/archdermatol.2010.282-b

Biopsy specimens of the skin lesions demonstrated diffuse infiltration of the dermis by medium-sized cells, with a grenz zone and sparing the epidermis. Tumor cells expressed CD4 and CD56 and were negative for EBER (Epstein-Barr virus–encoded RNA), CD3, CD5, CD20, CD23, CD30, CD79a, granzyme, TIA, myeloperoxidase, cyclin D1, and keratin by immunohistochemical analysis. The Ki-67 proliferation index was high, and polymerase chain reaction assays to detect rearrangements of T-cell receptor and immunoglobulin genes were negative. The bone marrow biopsy revealed normal cells with trilineage hematopoiesis and no involvement by a malignant neoplasm. No immunophenotypic evidence of an abnormal cell population was identified by flow cytometric analysis. Multiple computed tomography (CT) scans revealed stable, nonenlarged lymph nodes in the axilla and mediastinum. No signs of systemic involvement were evident on further testing.

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