We report an unusual case of atypical T‐cell proliferation involving the lymphatic vessels within a cutaneous hemangioma from an elderly woman. Despite the blastic morphology, the CD4 restricted phenotype and the very high proliferation index, the clinical presentation (single skin lesion in a healthy woman), the benign clinical course and the absence of T‐cell receptor (TCR) clonal rearrangement favored a reactive nature of the process. Since the atypical cells showed an effector/memory‐like regulatory T‐phenotype (CD45RO+, CD25+ and FOXp3+), expressed the migration‐associated molecule CCR7 and were exclusively located within podoplanin+ lymphatic vessels, we speculate that the process might reflect an unusual local immune response, with migration of T‐cells to draining lymph nodes.
Ardighieri L, Lonardi S, Vermi W, Medicina D, Cerroni L, Facchetti F. Intralymphatic atypical T‐cell proliferation arising in a cutaneous hemangioma.