Cutaneus T-Cell Lymphoma in 53 Years Old Woman: Histopathological Features
Abstract
Cutaneous T-cell lymphomas (CTCLs) are clinically heterogeneous T-cell lymphomas that arise in the skin and are characterized by their clinical and pathological features. The pathogenesis of CTCL is not fully understood. The incidence of CTCL increases significantly with age, with a median age at diagnosis at about 55 years of age and a four-fold increase in incidence appreciated in patients over 70. A 53 year old woman presented with complaints of reddish spots and lumps on her left forearm and back which spread to her chest, stomach and legs. On examination, a lump the size of a golf ball was found on the left forearm and back as well as reddish spots that felt itchy and painful. Histopathological examination with HE staining showed proliferation of lymphoid follicles without a germinal center and monotonous cells of small to medium size partially surrounding the tubular glands in the dermis layer. Immunohistochemical examination revealed positive for CD 45 as well as CD 3 and negative for CD 20. A case of CTCL has been reported in a 53-year-old woman. Histopathological examination and immunohistochemistry are important to diagnose this disease.
References
Agar, N. S., Wedgeworth, E., Crichton, S., Mitchell, T. J., Cox, M., Ferreira, S., Robson, A., Calonje, E., Stefanato, C. M., & Wain, E. M. (2010). Survival outcomes and prognostic factors in mycosis fungoides/Sézary syndrome: validation of the revised International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer staging proposal. Journal of Clinical Oncology, 28(31), 4730–4739. https://doi.org/10.1200/JCO.2009.27.7665
Ahmed, S. K., Grams, M. P., Locher, S. E., McLemore, L. B., Sio, T. T., & Martenson, J. A. (2016). Adaptation of the Stanford technique for treatment of bulky cutaneous T-cell lymphoma of the head. Practical Radiation Oncology, 6(3), 183–186. https://doi.org/10.1016/j.prro.2015.10.021
Bradford, P. T., Devesa, S. S., Anderson, W. F., & Toro, J. R. (2009). Cutaneous lymphoma incidence patterns in the United States: a population-based study of 3884 cases. Blood, The Journal of the American Society of Hematology, 113(21), 5064–5073. https://doi.org/10.1182/blood-2008-10-184168
Choi, J., Goh, G., Walradt, T., Hong, B. S., Bunick, C. G., Chen, K., Bjornson, R. D., Maman, Y., Wang, T., & Tordoff, J. (2015). Genomic landscape of cutaneous T cell lymphoma. Nature Genetics, 47(9), 1011–1019. https://doi.org/10.1038/ng.3356
Criscione, V. D., & Weinstock, M. A. (2007). Incidence of cutaneous T-cell lymphoma in the United States, 1973-2002. Archives of Dermatology, 143(7), 854–859. https://doi.org/10.1001/archderm.143.7.854
Devata, S., & Wilcox, R. A. (2016). Cutaneous T-cell lymphoma: a review with a focus on targeted agents. American Journal of Clinical Dermatology, 17(3), 225–237. https://doi.org/10.1007/s40257-016-0177-5
Elenitoba-Johnson, K. S. J., & Wilcox, R. (2017). A new molecular paradigm in mycosis fungoides and Sezary syndrome. Seminars in Diagnostic Pathology, 34(1), 15–21.
Goddard, A. L., Vleugels, R. A., LeBoeuf, N. R., O’Farrell, D. A., Cormack, R. A., Hansen, J. L., Kupper, T. S., & Devlin, P. M. (2015). Palliative therapy for recalcitrant cutaneous T-cell lymphoma of the hands and feet with low-dose, high dose-rate brachytherapy. JAMA Dermatology, 151(12), 1354–1357. https://doi.org/10.1001/jamadermatol.2015.3028
Goyal, A., O’Leary, D., Goyal, K., Rubin, N., Bohjanen, K., Hordinsky, M., Chen, S. T., Pongas, G., Duncan, L. M., & Lazaryan, A. (2020). Increased risk of second primary hematologic and solid malignancies in patients with mycosis fungoides: a surveillance, epidemiology, and end results analysis. Journal of the American Academy of Dermatology, 83(2), 404–411. https://doi.org/10.1016/j.jaad.2019.07.075
Hristov, A. C., Tejasvi, T., & Wilcox, R. A. (2023). Cutaneous T‐cell lymphomas: 2023 update on diagnosis, risk‐stratification, and management. American Journal of Hematology, 98(1), 193–209.
Jahan‐Tigh, R. R., Huen, A. O., Lee, G. L., Pozadzides, J. V, Liu, P., & Duvic, M. (2013). Hydrochlorothiazide and cutaneous T cell lymphoma: prospective analysis and case series. Cancer, 119(4), 825–831.
Jawed, S. I., Myskowski, P. L., Horwitz, S., Moskowitz, A., & Querfeld, C. (2014). Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome): part I. Diagnosis: clinical and histopathologic features and new molecular and biologic markers. Journal of the American Academy of Dermatology, 70(2), 205-e1. https://doi.org/10.1016/j.jaad.2013.07.049
Jung, J. M., Lim, D. J., Won, C. H., Chang, S. E., Lee, M. W., & Lee, W. J. (2021). Mycosis fungoides in children and adolescents: a systematic review. JAMA Dermatology, 157(4), 431–438.
Kash, N., Massone, C., Fink-Puches, R., & Cerroni, L. (2016). Phenotypic variation in different lesions of mycosis fungoides biopsied within a short period of time from the same patient. The American Journal of Dermatopathology, 38(7), 541–545.
Katona, T. M., Smoller, B. R., Webb, A. L., Hattab, E. M., Khalil, A., & Hiatt, K. M. (2013). Expression of PTEN in mycosis fungoides and correlation with loss of heterozygosity. The American Journal of Dermatopathology, 35(5), 555–560.
Kaye, F. J., Bunn Jr, P. A., Steinberg, S. M., Stocker, J. L., Ihde, D. C., Fischmann, A. B., Glatstein, E. J., Schechter, G. P., Phelps, R. M., & Foss, F. M. (1989). A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides. New England Journal of Medicine, 321(26), 1784–1790. Https://doi.org/10.1056/NEJM1989122832126
Kirsch, I. R., Watanabe, R., O’Malley, J. T., Williamson, D. W., Scott, L.-L., Elco, C. P., Teague, J. E., Gehad, A., Lowry, E. L., & LeBoeuf, N. R. (2015). TCR sequencing facilitates diagnosis and identifies mature T cells as the cell of origin in CTCL. Science Translational Medicine, 7(308), 308ra158-308ra158. https://doi.org/10.1126/scitranslmed.aaa9122
Magro, C. M., Crowson, A. N., Kovatich, A. J., & Burns, F. (2003). Drug-induced reversible lymphoid dyscrasia: a clonal lymphomatoid dermatitis of memory and activated T cells. Human Pathology, 34(2), 119–129.
Maj, J., Jankowska-Konsur, A. M., Hałoń, A., Woźniak, Z., Plomer-Niezgoda, E., & Reich, A. (2015). Expression of CXCR4 and CXCL12 and their correlations to the cell proliferation and angiogenesis in mycosis fungoides. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 32(6), 437–442. https://doi.org/10.5114/pdia.2015.48034
Nahidi, Y., Meibodi, N. T., Ghazvini, K., Esmaily, H., & Hesamifard, M. (2015). Evaluation of the association between Epstein-Barr virus and mycosis fungoides. Indian journal of dermatology, 60(3), 321. https://doi.org/10.4103/0019-5154.156423
Nguyen, C. V, & Bohjanen, K. A. (2015). Skin-directed therapies in cutaneous T-cell lymphoma. Dermatologic Clinics, 33(4), 683–696.
Olsen, E. A., Hodak, E., Anderson, T., Carter, J. B., Henderson, M., Cooper, K., & Lim, H. W. (2016). Guidelines for phototherapy of mycosis fungoides and Sézary syndrome: a consensus statement of the United States Cutaneous Lymphoma Consortium. Journal of the American Academy of Dermatology, 74(1), 27–58. https://doi.org/10.1016/j.jaad.2015.09.033
Pankratov, O., Gradova, S., Tarasevich, S., & Pankratov, V. (2015). Poikilodermatous mycosis fungoides: clinical and histopathological analysis of a case and literature review. Acta Dermatovenerol Alp Pannonica Adriat, 24(2), 37–41. https://doi.org/10.15570/actaapa.2015.10
Park, J., Daniels, J., Wartewig, T., Ringbloom, K. G., Martinez-Escala, M. E., Choi, S., Thomas, J. J., Doukas, P. G., Yang, J., & Snowden, C. (2021). Integrated genomic analyses of cutaneous T-cell lymphomas reveal the molecular bases for disease heterogeneity. Blood, The Journal of the American Society of Hematology, 138(14), 1225–1236. https://doi.org/10.1182/blood.2020009655
Rook, A. H., Gelfand, J. M., Wysocka, M., Troxel, A. B., Benoit, B., Surber, C., Elenitsas, R., Buchanan, M. A., Leahy, D. S., & Watanabe, R. (2015). Topical resiquimod can induce disease regression and enhance T-cell effector functions in cutaneous T-cell lymphoma. Blood, The Journal of the American Society of Hematology, 126(12), 1452–1461. https://doi.org/10.1182/blood-2015-02-630335
Slater, D. (2001). Histopathological aspects of cutaneous lymphoma. Journal of the Royal Society of Medicine, 94(7), 337–340. https://doi.org/10.1177/014107680109400705
Whittemore, A. S., Holly, E. A., Lee, I.-M., Abel, E. A., Adams, R. M., Nickoloff, B. J., Bley, L., Peters, J. M., & Gibney, C. (1989). Mycosis fungoides in relation to environmental exposures and immune response: a case-control study. JNCI: Journal of the National Cancer Institute, 81(20), 1560–1567. https://doi.org/10.1093/jnci/81.20.1560
Willemze, R., Cerroni, L., Kempf, W., Berti, E., Facchetti, F., Swerdlow, S. H., & Jaffe, E. S. (2019). The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood, The Journal of the American Society of Hematology, 133(16), 1703–1714. https://doi.org/10.1182/blood-2018-11-881268
Copyright (c) 2024 Journal La Medihealtico
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.