22 (sic!) yrs male with clinical diagnosis "Fibroma" of the dorsum of the hand. The lession appears 2-3 weeks ago. MACRO: 5mm elevated solitary papule in the 1cm excised skin patch.  
HISTO: The lymhoid infiltrate consists of small lympho's (CD3+CD2+CD4+>>CD8+) and accumulations of CD30+CD4+CD2+CD5+CD15-ALK1-EMA- cells with admixture of S100+/CD1a+ reactive Langerhans' cells. the single CD56+ or GranzymB+ small T lympho's are present.  
PROPOSED DIAGNOSIS: ALCL vs LyP.  
Thank you for collaboration.

franco 2006-01-05 07:16	I think that it is a case of primary cutaneous anaplastic large-cell lymphoma
ugnius 2006-01-05 08:33	My dears, the last 2 cases of CD30+ lessions were similar, but the main question remains: can we propose any HISTOLOGICAL criteria for discrimination between LyP and ALCL? 1. Wedge shaped lession- LyP? 2. Solid sheets of cells- ALCL? 3. ???   Or we are fully dependant on clinical picture?   Thank you for assistance.
ugnius 2006-01-05 14:31	Additional CD2 and CD5 stains. CD3 very weak due to technical reasons (external block) on majority os the cells (photo is absent).
kunze 2006-01-05 18:06	I agree with Dr.Franco: Obviously, it's a solitary lesion and there are sheets of anaplastic lymphoid cells.
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