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Kamijo H, Miyagaki T, Norimatsu Y, Awaji K, Oka T, Suga H, Sugaya M, Sato S. Primary cutaneous γδ T-cell lymphoma with unusual immunophenotype: A case report and review of published work. J Dermatol 2020; 47:300-305. [PMID: 31912565 DOI: 10.1111/1346-8138.15215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/05/2019] [Indexed: 11/26/2022]
Abstract
Primary cutaneous γδ T-cell lymphoma (CGD-TCL) is a rare form of primary cutaneous lymphoma. The histopathological features of CGD-TCL are still unclear because of its rarity. Here, we report a case of a 77-year-old Japanese man who presented with a 9-month history of erythematous plaques on his left forearm. Skin biopsy specimens revealed the infiltration of atypical medium/large-sized lymphocytes from the epidermis to the deep dermis. Atypical lymphocytes were positive for CD3, CD5, CD8 and Vδ1, and negative for CD4, CD7, CD56, EBER-ISH, intracellular antigen-1, granzyme B and perforin. CD30 was partially expressed. We also reviewed 246 cases of CGD-TCL from the published work. CD4- CD8- double-negative cases were 113 of 196 cases (57.6%), followed by CD4- CD8+ cases (52/196, 26.5%). CD5 was expressed in 25.8% of the cases (34/132). At least one cytotoxic molecule marker was expressed in 150 of 160 cases (93.8%). Some cases showed an indolent clinical course, especially in mycosis fungoides-like CGD-TCL cases. CD5 positivity and lack of cytotoxic molecule expression could be associated with a better prognosis. In addition, CD30 expression was found in approximately half of CGD-TCL cases (51/112 cases), suggesting that brentuximab vedotin could be a good treatment option for such patients. Further studies with more cases with detailed clinical and pathological information are necessary to elucidate the etiology and prognostic markers of this entity.
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Affiliation(s)
- Hiroaki Kamijo
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Yurie Norimatsu
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Awaji
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tomonori Oka
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hiraku Suga
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Makoto Sugaya
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology, International University of Health and Welfare, Chiba, Japan
| | - Shinichi Sato
- Department of Dermatology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Kempf W, Kazakov DV, Belousova IE, Mitteldorf C, Kerl K. Paediatric cutaneous lymphomas: a review and comparison with adult counterparts. J Eur Acad Dermatol Venereol 2015; 29:1696-709. [PMID: 25715748 DOI: 10.1111/jdv.13044] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 01/16/2015] [Indexed: 11/30/2022]
Abstract
Primary cutaneous lymphomas (CL) in children is rare. Only a few studies focused specifically on paediatric CL and therefore little is known whether primary CL in children are similar to or different from their adult counterparts with respect to the clinicopathological presentation, behaviour and prognosis. An extensive literature search using PubMed/MEDLINE from January 1995 through July 2014 was undertaken for articles reporting cases of paediatric CL. In addition, we identified 31 children with CL in our institutions. Mycosis fungoides and lymphomatoid papulosis are the two most prevalent lymphoma forms in children. A few entities of cutaneous lymphomas such as cutaneous diffuse large B-cell lymphoma leg type, and Sézary syndrome have not been reported so far in children. Other lymphoma entities such as hydroa vacciniforme-like lymphoma are mostly seen in certain geographic areas (Asia, Central and South America). In the paediatric population, low-malignant indolent forms such as primary cutaneous marginal zone lymphoma and primary cutaneous follicle centre lymphoma are very rare, whereas the more aggressive forms of B-cell lymphomas, precursor lymphoblastic lymphomas, and blastic plasmacytoid dendritic cell neoplasm are the most common forms in children, mostly involving the skin secondarily. Most paediatric lymphomas have similar clinicopathological features and course as their adults counterparts, particularly in the group of cutaneous T-cell lymphomas. The spectrum of cutaneous B-cell lymphomas in children significantly differs from the one in adults. Diagnostic work-up and treatment of paediatric patients with lymphomas are best achieved in close collaboration with paediatric haematopathologists and oncologists.
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Affiliation(s)
- W Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland.,Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D V Kazakov
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland.,Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Prague, Czech Republic
| | - I E Belousova
- Department of Dermatology, Medical Military Academy, Saint-Petersburg, Russia
| | - C Mitteldorf
- Department of Dermatology, HELIOS-Klinikum, Hildesheim, Germany
| | - K Kerl
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
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Martinez-Escala ME, Sidiropoulos M, Deonizio J, Gerami P, Kadin M, Guitart J. γδ T-cell-rich variants of pityriasis lichenoides and lymphomatoid papulosis: benign cutaneous disorders to be distinguished from aggressive cutaneous γδ T-cell lymphomas. Br J Dermatol 2014; 172:372-9. [DOI: 10.1111/bjd.13364] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. E. Martinez-Escala
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - M. Sidiropoulos
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - J. Deonizio
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - P. Gerami
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
| | - M.E. Kadin
- Department of Dermatology Boston University; Roger Williams Medical Center; Providence RI U.S.A
| | - J. Guitart
- Department of Dermatology; Northwestern University Feinberg School of Medicine; 676 North St. Clair Street Suite 1600 Chicago IL 60611 U.S.A
- Department of Dermatology; Robert H. Lurie Cancer Center; Chicago IL U.S.A
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Two Cases of Primary Cutaneous Lymphoma With a γ/δ+ Phenotype and an Indolent Course. Am J Dermatopathol 2014; 36:570-7. [DOI: 10.1097/dad.0000000000000029] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Suga H, Sugaya M, Miyagaki T, Ohmatsu H, Fujita H, Sato S. Primary cutaneous γδ T-cell lymphoma following mycosis fungoides. Int J Dermatol 2014; 53:e82-4. [PMID: 24444029 DOI: 10.1111/j.1365-4632.2012.05494.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hiraku Suga
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Bautista-Quach MA, Tong T, Nademanee A, Huang Q. Primary Cutaneous Gamma-Delta T-Cell Lymphoma With Marked Pagetoid Epidermotropism Shortly After Allogeneic Stem Cell Transplantation. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 13:e6-9. [DOI: 10.1016/j.clml.2013.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/08/2013] [Accepted: 05/23/2013] [Indexed: 12/01/2022]
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Cutaneous γδ T-cell lymphomas: a spectrum of presentations with overlap with other cytotoxic lymphomas. Am J Surg Pathol 2013; 36:1656-65. [PMID: 23073324 DOI: 10.1097/pas.0b013e31826a5038] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We reviewed our multicenter experience with gamma-delta (γδ) T-cell lymphomas first presenting in the skin. Fifty-three subjects with a median age of 61 years (range, 25 to 91 y) were diagnosed with this disorder. The median duration of the skin lesions at presentation was 1.25 years (range, 1 mo to 20 y). The most common presentation was deep plaques (38 cases) often resembling a panniculitis, followed by patches resembling psoriasis or mycosis fungoides (10 cases). These lesions tended to ulcerate overtime (27 cases). Single lesions or localized areas of involvement resembling cellulitis or pyoderma were reported in 8 cases. The most common anatomic site of involvement was the legs (40 cases), followed by the torso (30 cases) and arms (28 cases). Constitutional symptoms were reported in 54% (25/46) of the patients, including some with limited skin involvement. Significant comorbidities included autoimmunity (12 cases), other lymphoproliferative disorders (5 cases), internal carcinomas (4 cases), and viral hepatitis (2 cases). Lymphadenopathy (3/42 cases) and bone marrow involvement (5/28 cases) were uncommon, but serum lactose dehydrogenase (LDH) was elevated in 55% (22/39) of the patients. Abnormal positron emission tomography and/or computed tomography scans in 20/37 subjects mostly highlighted soft tissue or lymph nodes. Disease progression was associated with extensive ulcerated lesions resulting in 27 deaths including complications of hemophagocytic syndrome (4) and cerebral nervous system involvement (3). Median survival time from diagnosis was 31 months. Skin biopsies varied from a pagetoid pattern to purely dermal or panniculitic infiltrates composed of intermediate-sized lymphocytes with tissue evidence of cytotoxicity. The most common immunophenotype was CD3+/CD4⁻/CD5⁻/CD8⁻/BF1⁻/γ-M1+/TIA-1+/granzyme-B+/CD45RA-/CD7-, and 4 cases were Epstein-Barr virus positive. This is the largest study to date of cutaneous γδ T-cell lymphomas and demonstrates a variety of clinical and pathologic presentations with a predictable poor outcome.
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Youn SH, Lee YW, Min SK, Park HR, Kim KH, Kim KJ. Fatal Cutaneous γ/δ T-Cell Lymphoma with Central Nerve System Metastasis. Ann Dermatol 2011; 23 Suppl 1:S100-4. [PMID: 22028551 PMCID: PMC3199401 DOI: 10.5021/ad.2011.23.s1.s100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 10/16/2010] [Accepted: 10/16/2010] [Indexed: 12/05/2022] Open
Abstract
Cutaneous γ/δ T-cell lymphoma is an extremely rare and highly aggressive tumor that is often resistant to treatment, such as polychemotherapy and radiotherapy. Due to the complexity of clinical, pathologic, and immunohistochemical features of this disease entity, the physician should perform a careful evaluation; however, treatment should be rapid and aggressive. We present a case of fatal cutaneous γ/δ T-cell lymphoma of a 55-year old woman who died after recurrence with central nerve system metastasis.
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Affiliation(s)
- Sung Hwan Youn
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Caudron A, Bouaziz J, Battistella M, Sibon D, Lok C, Leclech C, Ortonne N, Molinier-Frenkel V, Bagot M. Two Atypical Cases of Cutaneous Gamma/Delta T-Cell Lymphomas. Dermatology 2011; 222:297-303. [DOI: 10.1159/000327932] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 03/29/2011] [Indexed: 11/19/2022] Open
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FUJII M, UEHARA J, HONMA M, ITO Y, TAKAHASHI H, ISHIDA-YAMAMOTO A, IIZUKA H. Primary cutaneous γδ-T-cell lymphoma treated with low-dose methotrexate and narrowband ultraviolet B irradiation: Report of a case with testicular involvement. J Dermatol 2010; 38:368-72. [DOI: 10.1111/j.1346-8138.2010.00998.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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