Limits...
Non Hodgkin T cell lymphoma: an atypical clinical presentation.

Maio P, Bento D, Vieira R, Afonso A, Sachse F, Kutzner H - An Bras Dermatol (2013 Mar-Apr)

Bottom Line: We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease.In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers.The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.

View Article: PubMed Central - PubMed

Affiliation: Curry Cabral Hospital, Central Lisbon Hospital Center EPE, Lisbon, Portugal. paulamaio@gmail.com

ABSTRACT
Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.

Show MeSH

Related in: MedlinePlus

Immunochemistry (CD4). Lymph cells infiltrate showing CD4 positivity
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3750894&req=5

f05: Immunochemistry (CD4). Lymph cells infiltrate showing CD4 positivity

Mentions: Body axial tomography showed severe ganglion involvement of the axillary and inguinallymph nodes and mild splenomegaly with multiple small parenchymal nodules. The skinbiopsy revealed diffuse lymphoid infiltration in the dermis composed of CD3, CD4positive T-cells, some of which had CD8 positivity (Figures 3,4 and 5). The axillary lymph node biopsy identified a lymphocyticproliferation composed of small cells with CD2, CD3 positive cells and CD7, CD8, CD20negative cells, and TIA expression allowing the diagnosis of T-cell lymphoma withcytotoxic expression (Figure 6). The study ofT-cell receptors rearrangement by PCR confirmed the monoclonality of the cell populationbased on the analysis of gamma genes.The absence of typical clinical lesions and thetypical histological markers of Hansen's disease, the successively negative nasal smearsand skin swabs, together with the PCR detection technique for M. leprae,allowed for the exclusion of a Hansen's disease diagnosis. The evaluation by aneurologist allowed a correlation between lymphoma and demyelinating neuropathy to becharacterized as a rare paraneoplastic syndrome.


Non Hodgkin T cell lymphoma: an atypical clinical presentation.

Maio P, Bento D, Vieira R, Afonso A, Sachse F, Kutzner H - An Bras Dermatol (2013 Mar-Apr)

Immunochemistry (CD4). Lymph cells infiltrate showing CD4 positivity
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750894&req=5

f05: Immunochemistry (CD4). Lymph cells infiltrate showing CD4 positivity
Mentions: Body axial tomography showed severe ganglion involvement of the axillary and inguinallymph nodes and mild splenomegaly with multiple small parenchymal nodules. The skinbiopsy revealed diffuse lymphoid infiltration in the dermis composed of CD3, CD4positive T-cells, some of which had CD8 positivity (Figures 3,4 and 5). The axillary lymph node biopsy identified a lymphocyticproliferation composed of small cells with CD2, CD3 positive cells and CD7, CD8, CD20negative cells, and TIA expression allowing the diagnosis of T-cell lymphoma withcytotoxic expression (Figure 6). The study ofT-cell receptors rearrangement by PCR confirmed the monoclonality of the cell populationbased on the analysis of gamma genes.The absence of typical clinical lesions and thetypical histological markers of Hansen's disease, the successively negative nasal smearsand skin swabs, together with the PCR detection technique for M. leprae,allowed for the exclusion of a Hansen's disease diagnosis. The evaluation by aneurologist allowed a correlation between lymphoma and demyelinating neuropathy to becharacterized as a rare paraneoplastic syndrome.

Bottom Line: We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease.In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers.The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.

View Article: PubMed Central - PubMed

Affiliation: Curry Cabral Hospital, Central Lisbon Hospital Center EPE, Lisbon, Portugal. paulamaio@gmail.com

ABSTRACT
Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.

Show MeSH
Related in: MedlinePlus