Critical review of lymphomatoid papulosis of the oral cavity with case report

A 60-year-old woman was referred to the Department of Dental Medicine at Lo ng Island Jewish Medical Center for evaluation of multiple lesions of the t ongue. She reported a long history of recurrent papular cutaneous eruptions that waxed and waned. A biopsy specimen of one of the cutaneous lesions wa s diagnosed as lymphomatoid papulosis. Sporadic, recurrent oral ulcers that resolved spontaneously were noted 10 to 14 days before the initial visit. These ulcers had recurred for the past 17 years. The most recent oral lesio n was an erythematous, irregular, solitary ulcerated area on the middle thi rd dorsum of tongue. The area quickly enlarged, ultimately developing exten sive surface necrosis. Shortly after, a similar lesion on the posterior dor sum of the tongue developed. Biopsy specimens of the former lesion showed n umerous, large, atypical, pleomorphic, and hyperchromatic cells with abunda nt mitoses. The large, atypical cells were immunohistochemically proven to be T lymphocytes. A diagnosis of lymphomatoid papulosis was made. Two weeks later, the tongue lesions had spontaneously and totally resolved. The clin ical, histomorphologic, and immunohistochemical features, as well as gene r earrangement studies of this rare entity, are presented.