Question my report of tiny area is as follows:
There are a few neutrophil at the summits of parakeratotic scales associated with upper paillary dermal blood vessel ectasia subtle suprapapillary epidermal plate thinning, superficial dermal mostly perivascular lymphocytic predominant infiltrate without eosinophils and local areas of hypogranulosis. These histologic findings are consistent with psoriasis. An unusual presentation of an eczematous process with secondary surface irrational changes & focal impetginazation cannot be entirley excluded by they are not histologically favored. Alternating PAS stains were negative for microorganisms or thickening of basement membrane. CD3 immunostain with adequate controls was preformed to evaluate the consitutents of the lesion and failed to reveal significant t cell dyscrasia. Clinical correlation and resampling for histologic reevaluation upon short term and long term follow up if deemed necessary would be recommended. So do I have t cell lymphoma?
Answer Given the fact that cd3 immunostain was negative, you have no reason to believe you have t cell lymphoma. The other findings boil down to either psoriasis or chronic exzema. If it is a small patch of psoriasis, usually application of steroids periodically can keep it under control. By all means see your doctor about next steps, but even "wait and see" would be ok, since I don't see anything in this report that would indicate a life-threatening process.
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American Journal of Medicine
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Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO
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