Differential Diagnosis

CD30+ anaplastic large T-cell lymphoma must be ruled out, as it has a far better prognosis than CD30- PTCL. When PTCL arises in the context of transformation of pre-existing MF or SS, only the history provides the answer. Since many cytotoxic lymphomas and related disorders are composed of medium to large cells, immuno-phenotyping is crucial to identify extranodal NK and T/NK-cell lymphomas, nasal and nasal type, as well as blastic NK-cell lymphoma with expression of CD56+ as a common hallmark. In ATLL, significant epidermotropism with formation of intrae-pidermal microabscesses is seen and leukemic spread of tumor cells found. Merkel cell carcinoma is characterized by expression of CK 20 (perinuclear dot-like pattern).

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