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December 1981

Microvascular Injury in Lymphomatoid Granulomatosis Involving the SkinAn Ultrastructural Study

Author Affiliations

From the Departments of Pathology (Drs Murphy, Harrist, and Mihm) and Dermatology (Dr Sato), Harvard Medical School, Massachusetts General Hospital, Boston.

Arch Dermatol. 1981;117(12):804-808. doi:10.1001/archderm.1981.01650120050022

• An electron microscopic study of a cutaneous lesion of lymphomatoid granulomatosis taken from a patient with pulmonary involvement was performed. Microvascular alterations ranged from mild, degenerative changes to vessel necrosis. Less severe changes included enlarged endothelial cells, with margination of small lymphoid cells in affected vessels. Luminal occlusion by necrotic endothelial cell fragments and fibrin was associated with thickening and reduplication of the basal lamina and an angiocentric, inflammatory infiltrate in severely affected vessels. The most frequently observed cells in the infiltrate were cleaved and noncleaved lymphocytes that exhibited notable cytolysis and degenerative changes in cytoplasmic organelles. We conclude that lymphomatoid granulomatosis involving the skin is a disorder in which substantial numbers of cleaved and noncleaved lymphoid cells participate, eventuating in small-vessel necrosis and occlusion and repeated endothelial cell regeneration.

(Arch Dermatol 1981;117:804-808)