Atypical Gamma-Delta-Positive T-Cell Lymphoproliferation With Clinical Features of Lymphomatoid Papulosis in Three Children

Primary cutaneous gamma-delta T-cell lymphoma has been described as an aggressive entity with a poor prognosis. However, gamma-delta T-cell receptor expression has been described in various types of skin lymphoproliferations. Paediatric cases of LyP are increasingly recognized, but paediatric LyP with a gamma-delta phenotype have been rarely described. We report three paediatric patients with indolent gamma-delta lymphoproliferation, with a relapsing-remitting course evoking LyP. These three cases emphasize that TCR gamma-delta expression in a lymphoproliferation is not a synonym of gamma-delta lymphoma. Indeed, these cases raise the question of a paediatric variant of CD30-negative lymphomatoid papulosis with histological features of atypical gamma-delta-positive T-cell lymphoproliferation and underline the necessity of cautious clinico-histological correlation when facing a gamma-delta lymphoproliferation to avoid overtreatment.