HVLL morphology and immunophenotype. (A-B) Case 1: Skin biopsy showing an infiltrate mainly in the dermis that extends into the subcutaneous fat. Note that the infiltrate surrounds adnexae (hematoxylin and eosin [H&E] stain, original magnification ×25). (B) Higher magnification shows a small lymphoid infiltrate without atypia surrounding a blood vessel (H&E stain, original magnification ×400). (C) Case 15: Skin biopsy showing a dense infiltrate with atypical medium to large lymphoid cells with rather abundant cytoplasm (H&E stain, original magnification ×400). Insert: The atypical cells have irregular nuclei with large eosinophilic nucleoli (H&E stain, original magnification ×630). (D) Case 11: Skin biopsy with intraepidermal bullae and a dense infiltrate in the upper dermis surrounding adnexae and blood vessels (H&E stain, original magnification ×100). Immunohistochemical analysis in a case with a αβ T-cell phenotype (case 9). (E) CD3 stain shows that the cells surrounding the adnexa are strongly CD3 positive. Additionally, the infiltrating cells are TIA-1 positive (F), CD8 positive (G), and negative for CD4 (H; E-H, immunoperoxidase, original magnification ×200). (I) CD30 staining reveals many positive cells (immunoperoxidase, original magnification ×400). (J) EBER ISH is positive in the infiltrating lymphocytes. Note that the number of EBER-positive cells is less than those positive for CD3 (original magnification ×200).