Retrospective Analysis of Six Primary Cutaneous T-cell Lymphoma Cases in the Light of Recent Advancements

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Retrospective Analysis of Six Primary Cutaneous T-cell Lymphoma Cases in the Light of Recent Advancements

Journal Title: Bagcilar Medical Bulletin - Year 2019, Vol 4, Issue 1

Abstract

Objective: Primary cutaneous lymphomas (PCLs) are lymphoproliferative malignancies of skin. Although they have been confine to mycosis fungoides (MF) and Sezary syndrome over the years, the concept of PCL quite changed with the describing of new types in recent years. In our study, re-evaluation of diagnostic properties of our previously diagnosed six PCL cases was aimed, in the light of these advancements. Method: The diagnostic features and progression of six PCL cases, which had been previously diagnosed and followed in the Dermatology clinic of İstanbul Şişli Etfal Training and Research Hospital, were retrospectively re-evaluated in the light of new advancements. For this purpose, besides their medical histories, clinical, laboratory and histopathologic findings were reviewed. In this manner, their diagnoses and clinical progressions were re-interpreted. Results: Case 1 had been diagnosed with “Sezary syndrome” and re-evaluation confirmed the diagnosis. Case 2 and 3 had been diagnosed with “lymphomatoid papulosis” and “high-grade medium/large-T-cell lymphoma”, respectively. After re-evaluation, 2nd case was thought to be more likely a high-grade CD30 (+) pleomorphic large-cell lymphoma, and 3. case a “CD30 (-) high-grade medium/large cell pleomorphic T-cell PCL”. Case 4 had been diagnosed with “diffuse high grade pleomorphic mixed T and B-cell PCL”. In the re-evaluation, lesions were thought to be an advanced “CD30 (+) high-grade pleomorphic large T-cell PCL that co-infiltrated with reactive B-cells”. Case 5 and case 6 had been diagnosed with “MF”, and “MF + follicular mucinosis (FM)”, respectively. When re-evaluated, 5th case was thought to be more likely an “MF emerged from an ulceronecrotic pityriasis lichenoides et varioliformis acuta”, whereas the previous diagnosis of 6th case was confirmed again. Conclusion: Diagnosis of a PCL with only clinical features or cellular morphology may lead a misdiagnosis. Patients should be evaluated with a multidisciplinary approach and methods, including immunophenotypic examination, DNA gene-rearrangement and, even electron microscope. It is very important to establish a close correlation between clinical findings and these examination findings to make correct diagnosis.

Authors and Affiliations

Betül Taş

Keywords

Skin lymphoma malignant non-Hodgkin diagnosis prognosis analysis

EP ID EP48061
DOI 10.4274/BMB.galenos.2019.32042
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