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Robson A, Assaf C, Bagot M, Burg G, Calonje E, Castillo C, Cerroni L, Chimenti N, Dechelotte P, Franck F, Geerts M, Gellrich S, Goodlad J, Kempf W, Knobler R, Massone C, Meijer C, Ortiz P, Petrella T, Pimpinelli N, Roewert J, Russell-Jones R, Santucci M, Steinhoff M, Sterry W, Wechsler J, Whittaker S, Willemze R, Berti E. Aggressive epidermotropic cutaneous CD8+ lymphoma: a cutaneous lymphoma with distinct clinical and pathological features. Report of an EORTC Cutaneous Lymphoma Task Force Workshop. Histopathology 2015; 67:425-41. [PMID: 24438036 DOI: 10.1111/his.12371] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 01/12/2014] [Indexed: 12/11/2022]
Abstract
AIMS Aggressive epidermotropic cutaneous CD8(+) lymphoma is currently afforded provisional status in the WHO classification of lymphomas. An EORTC Workshop was convened to describe in detail the features of this putative neoplasm and evaluate its nosological status with respect to other cutaneous CD8(+) lymphomas. METHODS AND RESULTS Sixty-one CD8(+) cases were analysed at the workshop; clinical details, often with photographs, histological sections, immunohistochemical results, treatment and patient outcome were discussed and recorded. Eighteen cases had distinct features and conformed to the diagnosis of aggressive epidermotropic cutaneous CD8(+) lymphoma. The patients typically present with widespread plaques and tumours, often ulcerated and haemorrhagic, and histologically have striking pagetoid epidermotrophism. A CD8(+) /CD45RA(+) /CD45RO(-) /CD2(-) /CD5(-) /CD56(-) phenotype, with one or more cytotoxic markers, was found in seven of 18 patients, with a very similar phenotype in the remainder. The tumours seldom involve lymph nodes, but mucosal and central nervous system involvement are not uncommon. The prognosis is poor, with a median survival of 12 months. Examples of CD8(+) mycosis fungoides, lymphomatoid papulosis and Woringer-Kolopp disease presented the typical features well documented in the CD4(+) forms of those diseases. CONCLUSIONS Aggressive epidermotropic cutaneous CD8(+) lymphoma is a distinct lymphoma that warrants inclusion as a distinct entity in future revisions of lymphoma classifications.
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Affiliation(s)
| | - Chalid Assaf
- Department of Dermatology, Charité-University Medicine, Berlin, Germany
| | - Martine Bagot
- Department of Pathology, Universite Paris, Paris, France
| | - Gunter Burg
- Department of Dermatology and Venereology, University of Zurich, Zurich, Switzerland
| | | | | | - Lorenzo Cerroni
- Department of Dermatology Medical, University of Graz, Graz, Austria
| | - Nicola Chimenti
- Department of Dermatology, University of L'Aquila, Rome, Italy
| | - Pierre Dechelotte
- Department of Pathology, University of Clermont-Ferrand, Clermont-Ferrand, France
| | - Frederic Franck
- Department of Pathology, University of Clermont-Ferrand, Clermont-Ferrand, France
| | - Maria Geerts
- Department of Dermatology, Ghent University Hospital, Gent, Belgium
| | - Sylke Gellrich
- Department of Dermatology, Charité-University Medicine, Berlin, Germany
| | - John Goodlad
- Department of Pathology, Western General Hospital, Edinburgh, UK
| | - Werner Kempf
- Department of Dermatology and Venereology, University of Zurich, Zurich, Switzerland
| | - Robert Knobler
- Department of Dermatology, University of Vienna, Vienna, Austria
| | - Cesare Massone
- Department of Dermatology Medical, University of Graz, Graz, Austria
| | - Chris Meijer
- Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands
| | - Pablo Ortiz
- Hospital Universitario, Universidad Complutense, Madrid, Spain
| | - Tony Petrella
- Departmentof Pathology, Dijon's University Hospital, Dijon, France
| | - Nicola Pimpinelli
- Division of Dermatology, University of Florence Medical School, Florence, Italy
| | - Joclim Roewert
- Department of Dermatology, Charité-University Medicine, Berlin, Germany
| | | | - Marco Santucci
- Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - Mattias Steinhoff
- Department of Dermatology, Charité-University Medicine, Berlin, Germany
| | - Wolfram Sterry
- Department of Dermatology, Charité-University Medicine, Berlin, Germany
| | - Janine Wechsler
- Department of Pathology Henri-Mondor Hospital, University Paris-Val-de-Marne, Paris, France
| | | | - Rein Willemze
- Department of Dermatology, Leiden University, Leiden, the Netherlands
| | - Emilio Berti
- Department of Dermatology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico and Università degli Studi di Milano-Bicocca, Milan, Italy
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