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Primary Cutaneous Cd4+ Small/medium-sized Pleomorphic T-cell Lymphoma With Expression Of Follicular T-helper Cell Markers And Spontaneous Remission

Ayala et al., 2016Lymphoma

Ayala, D., Ramón, M. D., Cabezas, M., & Jordá, E. (2016). Primary Cutaneous CD4+ Small/Medium-Sized Pleomorphic T-Cell Lymphoma With Expression of Follicular T-Helper Cell Markers and spontaneous Remission. Linfoma cutáneo primario de células T pleomórficas de pequeño y mediano tamaño CD4+ con expresión de marcadores de linfocito T helper folicular y resolución espotaneousánea. Actas dermo-sifiliograficas, 107(4), 357–359. https://doi.org/10.1016/j.ad.2015.10.012

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Case Details

Disease Location

Erythematous nodular lesion on right cheek

Personal Characteristics

62 -year-old male no past history of interest

Clinical Characteristics

Primary cutaneous CD4+ small/medium sized t-cell lymphoma presented an asymptomatic tumor that had appeared on his right cheek a month earlier and had shown rapid growth physical exam found a well-defined erythematous nodule measuring 2x1.5cm, the nodule had a rubbery consistency and presented a central erosion histology of a biopsy revealed a diffuse, dense infiltrate seen to occupy the full thickness of the dermis, with extension into the subcutaneous cellular tissue; the was no evidence of epidermotropism this was a polymorphous infiltrate formed mainly of lymphocytes, histiocytes, and plasma cells. The predominant cells in the neoplastic infiltrate were small-and medium-sized lymphocytes with marked pleomorphism ihc was intensely positive for CD3, 4, and 5. There were also poorly defined infiltrates rich in CD20+ cells with light chain restriction. The sample was also positive for pd1 and bcl-6. There was a monoclonal rearrangement of the t-cell receptor beta gene. Ki-67 cell proliferation index was below 20%

Remission Characteristics

After a 4 week follow-up, the tumor lesion underwent sr until its complete disappearance, leaving only a scar at the biopsy site. There were no pigmentation changes, and the area was no infiltrated or indurated to palpation after a year of follow-up the patient remains asymptomatic with no evidence of recurrence

Treatment & Mechanisms

Proposed Remission Mechanisms

No major mechanism reported

Clinical Treatment

Unclear whether the biopsy was ex or in

Non-Clinical Treatment

None reported