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Primary Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified: A Rapidly Progressive Variant of Cutaneous T-Cell Lymphoma.

Aderhold K, Carpenter L, Brown K, Donato A - Case Rep Oncol Med (2015)

Bottom Line: Within three months her cancer had progressed into diffuse lesions spanning her entire body.As rapid progression is usually uncharacteristic of Mycosis Fungoides, her diagnosis was amended to PTL-NOS.Cutaneous T-Cell Lymphoma (CTCL) should be suspected in patients with patches, plaques, erythroderma, or papules that persist or multiply despite conservative treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA 19608, USA.

ABSTRACT
Primary Cutaneous Peripheral T-Cell Lymphoma NOS (PTL-NOS) is a rare, progressive, fatal dermatologic disease that presents with features similar to many common benign plaque-like skin conditions, making recognition of its distinguishing features critical for early diagnosis and treatment (Bolognia et al., 2008). A 78-year-old woman presented to ambulatory care with a single 5 cm nodule on her shoulder that had developed rapidly over 1-2 weeks. Examination was suspicious for malignancy and a biopsy was performed. Biopsy results demonstrated CD4 positivity, consistent with Mycosis Fungoides with coexpression of CD5, CD47, and CD7. Within three months her cancer had progressed into diffuse lesions spanning her entire body. As rapid progression is usually uncharacteristic of Mycosis Fungoides, her diagnosis was amended to PTL-NOS. Cutaneous T-Cell Lymphoma (CTCL) should be suspected in patients with patches, plaques, erythroderma, or papules that persist or multiply despite conservative treatment. Singular biopsies are often nondiagnostic, requiring a high degree of suspicion if there is deviation from the anticipated clinical course. Multiple biopsies are often necessary to make the diagnosis. Physicians caring for patients with rapidly progressive, nonspecific dermatoses with features described above should keep more uncommon forms of CTCL in mind and refer for early biopsy.

No MeSH data available.


Related in: MedlinePlus

Initial presentation of the 5 cm nodule found on the right posterior shoulder.
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Related In: Results  -  Collection


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fig1: Initial presentation of the 5 cm nodule found on the right posterior shoulder.

Mentions: On examination, the patient had a solitary 5 cm ill-defined, red-violaceous, immobile, irregular nodule on her right posterior shoulder (Figure 1). The lesion was not indurated or fluctuant and was nontender to palpation. There was a small area of excoriation with crusting. Due to the malignant features of the lesion, a 3 mm punch biopsy was performed. Laboratory or imaging tests were not performed at the time of biopsy.


Primary Cutaneous Peripheral T-Cell Lymphoma Not Otherwise Specified: A Rapidly Progressive Variant of Cutaneous T-Cell Lymphoma.

Aderhold K, Carpenter L, Brown K, Donato A - Case Rep Oncol Med (2015)

Initial presentation of the 5 cm nodule found on the right posterior shoulder.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4563086&req=5

fig1: Initial presentation of the 5 cm nodule found on the right posterior shoulder.
Mentions: On examination, the patient had a solitary 5 cm ill-defined, red-violaceous, immobile, irregular nodule on her right posterior shoulder (Figure 1). The lesion was not indurated or fluctuant and was nontender to palpation. There was a small area of excoriation with crusting. Due to the malignant features of the lesion, a 3 mm punch biopsy was performed. Laboratory or imaging tests were not performed at the time of biopsy.

Bottom Line: Within three months her cancer had progressed into diffuse lesions spanning her entire body.As rapid progression is usually uncharacteristic of Mycosis Fungoides, her diagnosis was amended to PTL-NOS.Cutaneous T-Cell Lymphoma (CTCL) should be suspected in patients with patches, plaques, erythroderma, or papules that persist or multiply despite conservative treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA 19608, USA.

ABSTRACT
Primary Cutaneous Peripheral T-Cell Lymphoma NOS (PTL-NOS) is a rare, progressive, fatal dermatologic disease that presents with features similar to many common benign plaque-like skin conditions, making recognition of its distinguishing features critical for early diagnosis and treatment (Bolognia et al., 2008). A 78-year-old woman presented to ambulatory care with a single 5 cm nodule on her shoulder that had developed rapidly over 1-2 weeks. Examination was suspicious for malignancy and a biopsy was performed. Biopsy results demonstrated CD4 positivity, consistent with Mycosis Fungoides with coexpression of CD5, CD47, and CD7. Within three months her cancer had progressed into diffuse lesions spanning her entire body. As rapid progression is usually uncharacteristic of Mycosis Fungoides, her diagnosis was amended to PTL-NOS. Cutaneous T-Cell Lymphoma (CTCL) should be suspected in patients with patches, plaques, erythroderma, or papules that persist or multiply despite conservative treatment. Singular biopsies are often nondiagnostic, requiring a high degree of suspicion if there is deviation from the anticipated clinical course. Multiple biopsies are often necessary to make the diagnosis. Physicians caring for patients with rapidly progressive, nonspecific dermatoses with features described above should keep more uncommon forms of CTCL in mind and refer for early biopsy.

No MeSH data available.


Related in: MedlinePlus