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Small Cell Variant Of Cd30+ Primary Cutaneous T‐cell Lymphoma With Epidermotropism That Completely Regressed After Incisional Skin Biopsy

Kamiya et al., 2006Lymphoma

Kamiya, T., Saga, K., Yanagisawa, K., Kaneko, R., Yamashita, T., Ishida, O., & Jimbow, K. (2006). Small cell variant of CD30+ primary cutaneous T-cell lymphoma with epidermotropism that completely regressed after incisional skin biopsy. The British journal of dermatology, 155(2), 484–487. https://doi.org/10.1111/j.1365-2133.2006.07337.x

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Abstract

Conflicts of interest: none declared. Sir, CD30+ primary cutaneous T‐cell lymphomas (CTCLs) without anaplastic large lymphoid cytology are extremely rare, especially with epidermotropism.1 In the literature we found few reports of primary CTCL predominantly composed of CD30+ small‐ to medium‐sized lymphoma cells.1, 2 We report on two patients with small cell CD30+ primary CTCL without anaplastic large cell phenotype. CD30+ atypical lymphoid cells showed epidermotropism, i.e. these cells were present not only in the dermis but also in the epidermis singly and in clusters. These tumours regressed completely after incisional skin biopsy. These two cases indicate that even primary CTCLs without anaplastic large cell cytology should be immunohistochemically examined for the expression of CD30 because CD30+ lymphomas have a significantly favourable prognosis when they are confined to the skin. Patient 1. In July 2003, a 32‐year‐old woman presented with an asymptomatic erythematous nodule on her right cheek (Fig. 1a). It had progressively enlarged over 1·5 months. The diameter of the nodule was 1·5 cm at presentation. No other similar lesions were noticed on other areas of the skin, and lymph nodes were not palpable.

Case Details

Disease Location

Flexor side of left forearm

Personal Characteristics

72 -year-old male march 2004

Clinical Characteristics

Presented with an asymptomatic erythematous nodule on the flexor side of left forearm, it had enlarged progressively for 2 months there were no superficial lymphadenopathy nor other similar skin lesions on examination histopathology of an incisional biopsy revealed almost the same features as in patient 1. There were also inflitation of small to medium sized atypical lymphoid cells not only in the dermis but also in the epidermis and follicular epithelia. 80% of the lymphoid cells were positive for CD30. These cells were also positive for CD3 but negative for CD4, 8, 20 and alk. Diagnosis of nonanaplastic type small cell CD30+ primary ctcl was made

Remission Characteristics

After the skin biopsy, the erythematous plaque started to regress two weeks later, only faint pigmentation remained at the site 1 year since the diagnosis, no recurrence, other lesions, lymphadenopathy or extranodal progression have been noticed

Treatment & Mechanisms

Proposed Remission Mechanisms

Only mentions the regression after biopsy

Clinical Treatment

None reported

Non-Clinical Treatment

None reported