Cutaneous T-cell lymphoma (mycosis fungoides)
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2009, Vol 26, Issue 2
Abstract
A 62-year-old man presented with easy fatigue, extended erythroderma in both palms which has not responded to local vitamin and steroid administration for two months (fig. 1). The medical history of the patient included hypertension treated with daily atenolol and hypercholesterolemia treated with daily rosuvastatin. His family medical history was unremarkable. The physical examination revealed the erythroderma in both palms along with small oval and digitate patches on the inner sides of both arms, patches of different size and shape (“non-digitate”) on the trunk, a small plaque on the upper part of the left arm, and limited erythematous, scaly patches on the abdomen and right thigh. There were no enlarged peripheral lymph nodes. The patient otherwise was in good health; the results of routine laboratory studies including the peripheral blood analysis were all normal. However, the study of the peripheral blood smears revealed the presence of abnormal lymphocytes (2% in the differential counts. Skin biopsy specimens were taken from the elongated patch on the right arm and from the plaques on the abdomen. Histological examination of the patch revealed mild acanthosis, discrete scale-crusts atop a basket-woven cornified layer. There was a single focus of epidermotropism of lymphocytes into the epidermis, with few lymphocytes aligned as solitary units in the basal layer. The dermis contained a sparse perivascular infiltrate of small non-atypical lymphocytes. Immunohistochemically, the majority of lymphocytes expressed CD3, CD5, CD7, and CD45RO antigens. CD4 antigen was expressed by 80% of lymphoid cells, whereas CD8 labelled 20% of the lymphocytes; all CD8-positive cells were located in the dermis.
Authors and Affiliations
J. MELETIS, A. SARANTOPOULOS, E. PAPAKOSTAS, P. KOUZIS, T. CHATZILEONIDA, N. VINIOU
Keywords
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