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Eosinophil-Rich CD30+ Lymphoproliferative Disorder of the Oral Mucosa
A Form of “Traumatic Eosinophilic Granuloma”

Bachir Alobeid MD, Lang-Xing Pan MD, PhD, Laura Milligan MSc, Leo Budel MD, Glauco Frizzera MD
DOI: http://dx.doi.org/10.1309/JQFXPND6DBLF6B9U 43-50 First published online: 1 January 2004

Abstract

We describe 3 patients who had oral mucosal lesions with features of traumatic eosinophilic granuloma (TEG) and containing CD30+ atypical cells. In 1 patient, the oral lesion was followed by skin nodules. All lesions were evaluated histologically, by immunohistochemical analysis, and by polymerase chain reaction (PCR) analysis of the T-cell receptor (TCR)γ chain gene. All oral lesions were characterized by a dense and deeply infiltrative lymphoproliferation, showing epitheliotropism and massive eosinophilia. They contained atypical large lymphoid cells, which expressed T-cell markers and CD30. PCR analysis showed a monoclonal rearrangement of the TCRγchain gene in all lesions and, in 1 patient, the same rearrangement in the oral and cutaneous specimens.

The lesions in these patients seem to be the oral counterpart of the spectrum of primary cutaneous CD30+ lymphoproliferative disorders and should be recognized as such to avoid a diagnosis of large T-cell lymphoma and possible consequent overtreatment. However, they represent only a subset among several others within the complex and heterogeneous category of disorders referred to as TEG.

Key Words:
  • Traumatic eosinophilic granuloma
  • Eosinophilic ulcer of oral mucosa
  • CD30+ lymphoproliferative disorder
  • Atypical histiocytic granuloma
  • Angiolymphoid hyperplasia with eosinophilia
  • Kimura disease