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Correspondence |

Secondary Cutaneous Vasculitislike MALT Lymphoma With an IGL-MYC Fusion

Kjell Matthias Kaune, MD; Mario Baumgart, MSc; Stefan Gesk, MD; Peter Middel, MD; B. Michael Ghadimi, MD; Reiner Siebert, MD; Hans Peter Bertsch, MD; Michael Peter Schön, MD; Christine Neumann, MD
Arch Dermatol. 2009;145(8):955-958. doi:10.1001/archdermatol.2009.166.
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Figure 1.

Clinical and histopathologic case photographs. The patient displayed purpuric papules on his hips resembling allergic vasculitis (A and B) and bluish reticular indurations on his upper arms resembling livedo reticularis (C and D). E, Perivascular and periadnexal nodular infiltrates of densely packed monomorphic lymphocytes with many erythrocytes admixed are seen in a skin section from the arm; the infiltrate extends to the subcutaneous fat tissue (hematoxylin-eosin, original magnification ×20 for primary photograph and ×400 for the insert). Giemsa stain reveals prominent nuclei and a pale cytoplasm of the tumor cells (F) (original magnification ×600), which express CD20 (G) and CXC receptor 4 (H) (original magnification ×200 for both G and H); besides cytoplasmic staining, the nuclei of many tumor cells are positive for CXC receptor 4.

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Figure 2.

Fluorescence in situ hybridization (FISH). We performed FISH on paraffin-embedded lesional tissue sections and evaluated at least 200 nuclei. A, Interphase nuclei hybridized with the Locus Specific Identifier MYC break-apart probe (Abbott Molecular, Des Plaines, Illinois). The 2 nuclei show 1 intact MYC allele with a colocalization of the red (MYC proximal) and green (MYC distal) signals, and a dissociation of the green and red signals (arrows) indicating that MYC is involved in a translocation. B, Interphase nuclei hybridized with an IGL break-apart probe (as described in Martíin-Subero et al2). The 2 nuclei display a significant dissociation of the red (IGL proximal) and green (IGL distal) signals (arrows) indicating the presence of a translocation affecting the IGL. C, Interphase nuclei hybridized with an IGL/MYC dual-color, dual-fusion probe: red signal, 8q24 (MYC locus); green signal, 22q11 (IGL locus). The presence of fused red and green signals (arrows) indicate that an IGL/MYC fusion due to a translocation t(8;22)(q24;q11) has taken place. The isolated red and green signals point to the unrearranged MYC and IGL alleles, respectively.

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