Güncel Patoloji Dergisi 2017, Cilt 1, Sayı 3
Is Lymphocytic Vasculitis Predictive Pattern for Lupus Erythematosus?
Sümeyye EKMEKCI 1, Özge ÇOKBANKIR 2, Banu LEBE 3
1 Sağlık Bilimleri Üniversitesi, Tepecik Eğitim ve Araştırma Hastanesi, Patoloji Bölümü, İZMİR
2 İzmir Ekonomi Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, İZMİR
3 Dokuz Eylül Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, İZMİR
DOI : 10.5146/jcpath.2017.11 Aim: Lymphocytic vasculitis is a histopathological pattern, not a name of a disease. There are lymphocytes settling along the vessel trace, infiltrating and surrounding the walls of the dermal vessels forming a cuff in the dermis. In case of lymphocytic vasculitis, thickening of vessel walls, swelling of endothelial cells and erythrocyte extravasations are also observed. Lymphocytic vasculitis is seen in many diseases including collagen vascular diseases.

Lupus erythematosus is a chronic disease of unknown etiology and histopathologically; its cutaneous lesions are mainly interphase vacuolar dermatitis. As well as dermal mucinosis, perivascular, periadnexial and interstitial lymphohistiocytic infiltrate, ?lymphocytic vasculitis? pattern can be remarkable. The purpose of our study is to determine the frequency of lymphocytic vasculitis pattern in lupus erythematosus patients and to investigate whether this is an additional finding useful in diagnosing lupus erythematosus.

Materials and Methods: We studied 36 cases that were diagnosed as lupus erythematosus with light microscopy and direct immunofluorescence findings. Clinical information of the cases were obtained from patient files. Parameters evaluated were lymphocytes that infiltrate the walls of the dermal vasculature, lymphatic infiltration of the perivascular area, thickening of the vessel walls, swelling of endothelial cells, and extravasation of erythrocytes. Based on these parameters, cases with lymphocytic vasculitis pattern were recorded and percentage ratios were calculated.

Results: Twenty-three (63.8%) of the cases were female and 13 (36.1%) were male. The age range was 28-82. 29 (80.5%) cases had superficial/ deep perivascular dermatitis pattern, 25 (69.4%) had interphase dermatitis pattern, 6 (16.6%) had dermal mucinosis and 6 (16.6%) had lymphocytic vasculitis pattern. Definitive diagnosis of the cases were made with the findings of light and direct immunofluorescence microscopy.

Conclusion: In our study, increased lymphocytic vasculitis pattern was observed in lupus erythematosus cases in accordance with the literature. Lymphocytic vasculitis pattern and some morphologic findings alert us towards lupus erythematosus and lead us to diagnosis even if not in clinical differential diagnosis. Anahtar Kelimeler : Lupus erythematosus, Lymphocytic vasculitis, Histopathology, Cutaneous lupus