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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

Multiple scattered irregular nodules on the patient's legs. Bandage over excoriated lesion.
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fig3: Multiple scattered irregular nodules on the patient's legs. Bandage over excoriated lesion.

Mentions: These results prompted surgical excision with wide margins and referral to a hematology/oncology specialist. The patient was initially diagnosed with Mycosis Fungoides and was started on Methotrexate. Unfortunately, the Methotrexate proved to be ineffective, and over the next three months her disease continued to progress with multiple new nodules and plaques arising over several areas of her body (Figures 2 and 3). Several nodules became ulcerated and productive of purulent fluid (Figure 4). She additionally developed a lesion suspicious for metastasis in her spleen that was seen on CT scan. This lesion was not biopsied per the patient's request.


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)

Multiple scattered irregular nodules on the patient's legs. Bandage over excoriated lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Multiple scattered irregular nodules on the patient's legs. Bandage over excoriated lesion.
Mentions: These results prompted surgical excision with wide margins and referral to a hematology/oncology specialist. The patient was initially diagnosed with Mycosis Fungoides and was started on Methotrexate. Unfortunately, the Methotrexate proved to be ineffective, and over the next three months her disease continued to progress with multiple new nodules and plaques arising over several areas of her body (Figures 2 and 3). Several nodules became ulcerated and productive of purulent fluid (Figure 4). She additionally developed a lesion suspicious for metastasis in her spleen that was seen on CT scan. This lesion was not biopsied per the patient's request.

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