Peripheral T-cell lymphomas unspecified presenting in the skin: analysis of prognostic factors in a group of 82 patients

Abstract

In the present study the clinicopathologic and immunophenotypic features of 82 patients with a CD30 ؊ peripheral T-cell lymphoma, unspecified, presenting in the skin were evaluated. The purpose of this study was to find out whether subdivision of these lymphomas on the basis of cell size, phenotype, or presentation with only skin lesions is clinically relevant. The study group included 46 primary cutaneous CD30 ؊ large cell lymphomas and 17 small/medium-sized T-cell lymphomas as well as 17 peripheral T-cell lymphomas with both skin and extracutaneous disease at the time of diagnosis. Patients with primary cutaneous small-or mediumsized T-cell lymphomas had a significantly better prognosis (5-year-overall survival, 45%) than patients with primary cutaneous CD30 ؊ large T-cell lymphomas (12%) and patients presenting with concurrent extracutaneous disease (12%). The favorable prognosis in this group with primary cutaneous small-or mediumsized T-cell lymphomas was particularly found in patients presenting with localized skin lesions expressing a CD3 ؉ CD4 ؉ CD8 ؊ phenotype. In the primary cutaneous T-cell lymphoma (CTCL) group and in the concurrent group, neither extent of skin lesions nor phenotype had any effect on survival. Our results indicate that peripheral T-cell lymphomas, unspecified, presenting in the skin have an unfavorable prognosis, irrespective of the presence or absence of extracutaneous disease at the time of diagnosis, cell size, and expression of a CD4 ؉ or CD8 ؉ phenotype. The only exception was a group of primary cutaneous small-or medium-sized pleomorphic CTCLs with a CD3 ؉ CD4 ؉ CD8 ؊ phenotype and presenting with localized skin lesions. (Blood.

Flow Cytometric Characterization and Clinical Outcome of CD4+ T‐Cell Lymphoma in Dogs: 67 Cases

“…Large cell size determined by flow cytometry has been shown to be an independent predictor of worse outcome in dogs with circulating neoplastic B cells and in dogs with nodal B cell lymphomas 10, 16. Larger cell size has also been associated with worse outcome in human adult T‐cell lymphoma (ATL) and cutaneous PTCL 17, 18. Loss of the surface expression of the pan‐T cell marker CD5 was a relatively common finding within the CD4+/CD45+ lymphomas.…”

A Case of Primary Cutaneous CD4 Positive Small/medium T Cell Lymphoma

“…In previous studies, the overall median survival was significantly better for the patients with localized disease than for the patients with multifocal skin lesions 5,15 . Furthermore, indolent clinical behavior was associated with stable small lesions (＜3 cm), low proliferative activity and an intense CD8 positive lymphocyte infiltration, whereas an aggressive course was associated with rapidly evolving large skin lesions (＞5 cm), high levels of proliferation markers and rare CD8 lymphocytes 9 .…”

“…Immunohistochemically, CD3 and CD4 are positive, but CD8 and CD30 are negative in the majority of the case, and sometimes this is combined with the loss of the pan T cell markers 1,5,[11][12][13][14] . However, many studies have also reported tumors that are CD8 positive or CD4 negative 1,5,9,11,12 . In addition, many PCSM-TCL cases have shown a rich infiltrate of reactive B cells 14 .…”

“…The median age at the onset of the PCSM-TCL was reported to be 60 years 9,10 . In our case, the age at the onset of the skin lesion was 63 years and she presented with multiple, multifocal lesions.…”

“…Histologically, PCSM-TCL is characterized by a dense infiltration of small/medium sized pleomorphic T cells 9,[11][12][13][14] . Clonal T cell receptor gene rearrangement has been detected in most cases.…”