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A Primary Cutaneous Non-T, Non-B CD4+, CD56+ Lymphoma

A Primary Cutaneous Non-T, Non-B CD4+, CD56+ Lymphoma Abstract Background: Cutaneous lymphomas are heterogeneous clonal lymphoproliferative disorders originating from B or T lymphocytes. Observation: We describe a patient with a unique primary cutaneous lymphoma characterized by a bruiselike aspect of the skin lesions, a CD4+, CD43+, CD56+, CD2-, CD3-, CD8-, T-cell receptor-negative phenotype of the medium-sized to large lymphoid tumor cells and an undetermined genotype (T-cell receptor β and immunoglobulin heavy chain in germline configuration, no clonal T-cell receptor γ population as detected after analysis with polymerase chain reaction combined with denaturing gradient gel electrophoresis) and fast relapse after radiotherapy. Conclusions: This non-B, non-T cutaneous lymphoma cannot be classified by any current lymphoma classification. It seems to represent a new disease entity with peculiar clinical, histologic, and molecular features.Arch Dermatol. 1996;132:550-553) References 1. Dummer R, Häffner A, Burg G. Cutaneous T-cell lymphomas (CTCL): new aspects in PCR-based diagnostic tools, immunology and treatment . Eur J Dermatol. 1994;4:281-286. 2. Burg G, Dummer R, Kerl H. Classification of cutaneous lymphomas . Dermatol Clin. 1994;12:213-217. 3. Agnarsson BA, Vonderheid EC, Kadin ME. Cutaneous T cell lymphoma with suppressor/cytotoxic (CD8) phenotype: identification of rapidly progressive and chronic subtypes . J Am Acad Dermatol. 1990;22:569-577.Crossref 4. Ralfkiaer E. Immunohistological markers for the diagnosis of cutaneous lymphomas . Semin Diagn Pathol. 1991;8:62-72. 5. Weiss LM, Hu E, Wood GS, et al. Clonal rearrangements of T-cell receptor genes in mycosis fungoides and dermatopathic lymphadenopathy . N Engl J Med. 1985;313:539-544.Crossref 6. Ralfkiaer E, O'Connor NT, Crick J, Wantzin GL, Mason DY. Genotypic analysis of cutaneous T-cell lymphomas . J Invest Dermatol. 1987;88:762-765.Crossref 7. Whittaker SJ, Smith NP, Jones RR, Luzzatto L. Analysis of beta, gamma, and delta T-cell receptor genes in mycosis fungoides and Sezary syndrome . Cancer. 1991;68:1572-1582.Crossref 8. Staib G, Mielke V, Griesser H, Menke M, Duller B, Sterry W. PCR-analysis of T-cell receptor (TCR)-gamma genes to differentiate between malignant and reactive T-cell infiltrates of the skin . J Invest Dermatol. 1993;100:458. 9. Volkenandt M, Wienecke R, Koch OM, et al. Conformational polymorphisms of cRNA of T-cell-receptor genes as a clone-specific molecular marker for cutaneous lymphoma . J Invest Dermatol. 1993;101:514-516.Crossref 10. Wood GS, Tung RM, Haeffner AC, et al. Detection of clonal T-cell receptor gamma gene rearrangements in early mycosis fungoides/Sezary syndrome by polymerase chain reaction and denaturing gradient gel electrophoresis (PCR/ DGGE) . J Invest Dermatol. 1994;103:34-41.Crossref 11. Burg G, Hess M, Küng E, Dommann S, Dummer R. Semimalignant ('pseudolymphomatous') cutaneous B-cell lymphomas . Dermatol Clin. 1994;12:399-407. 12. Santucci M, Pimpinelli N, Arganini L. Primary cutaneous B-cell lymphoma: a unique type of low-grade lymphoma: clinicopathologic and immunologic study of 83 cases . Cancer. 1991;67:2311-2326.Crossref 13. Wood GS, Ngan BY, Tung R, et al. Clonal rearrangements of immunoglobulin genes and progression to B cell lymphoma in cutaneous lymphoid hyperplasia . Am J Pathol. 1989;135:13-19. 14. Kerl H, Sterry W. Classification and staging . In: Burg G, Sterry W, eds. EORTC/ BMFT Cutaneous Lymphoma Project Group: Recommendations for Staging and Therapy of Cutaneous Lymphomas . Brussels, Belgium: European Organisation for Research and Treatment of Cancer; 1987:1-10. 15. Cerroni L, Kerl H. The use of monoclonal antibodies on paraffin sections in the diagnosis of cutaneous lymphoproliferative disorders . Dermatol Clin. 1994;12: 219-229. 16. Cordell JL, Falini B, Erber WN, et al. Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes) . J Histochem Cytochem. 1984; 32:219-229.Crossref 17. Arnold A, Cossman J, Bakhshi A, Jaffe ES, Waldmann TA, Korsmeyer SJ. Immunoglobulin-gene rearrangements as unique clonal markers in human lymphoid neoplasms . N Engl J Med. 1983;309:1593-1599.Crossref 18. Minden MD, Toyonaga B, Ha K, et al. Somatic rearrangement of T-cell antigen receptor gene in human T-cell malignancies . Proc Natl Acad Sci U S A. 1985; 82:1224-1227.Crossref 19. Bourguin A, Tung R, Galili N, Sklar J. Rapid, nonradioactive detection of clonal T-cell receptor gene rearrangements in lymphoid neoplasms . Proc Natl Acad Sci U S A. 1990;87:8536-8540.Crossref 20. Sterry W, Korte B, Schubert C. Pleomorphic T-cell lymphoma and large-cell lymphoma of the skin . Am J Dermatopathol. 1989;11:112-123.Crossref 21. Burg G, Braun-Falco O. Cutaneous Lymphomas, Pseudolymphomas and Related Disorders . New York, NY: Springer-Verlag NY Inc; 1983. 22. Boyd RL, Hugo P. Towards an integrated view of thymopoiesis . Immunol Today . 1991;12:71-79.Crossref 23. Griffin JD, Hercend T, Beveridge R, Schlossman SF. Characterization of an antigen expressed by human natural killer cells . J Immunol. 1983;130:2947-2951. 24. Mechtersheimer G, Staudter M, Moller P. Expression of the natural killer cell-associated antigens CD56 and CD57 in human neural and striated muscle cells and in their tumors . Cancer Res. 1991;51:1300-1307. 25. Wong KF, Chan JK, Ng CS, Lee KC, Tsang WY, Cheung MM. CD56 (NKH1)-positive hematolymphoid malignancies: an aggressive neoplasm featuring frequent cutaneous/mucosal involvement, cytoplasmic azurophilic granules, and angiocentricity . Hum Pathol. 1992;23:798-804.Crossref 26. Brody JP, Allen S, Schulman P, et al. Acute agranular CD4-positive natural killer cell leukemia . Cancer. 1995;75:2474-2483.Crossref 27. Adachi M, Maeda K, Takekawa M, et al. High expression of CD56 (N-CAM) in a patient with cutaneous CD4-positive lymphoma . Am J Hematol. 1994;47:278-282.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1996.03890290084011
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Abstract

Abstract Background: Cutaneous lymphomas are heterogeneous clonal lymphoproliferative disorders originating from B or T lymphocytes. Observation: We describe a patient with a unique primary cutaneous lymphoma characterized by a bruiselike aspect of the skin lesions, a CD4+, CD43+, CD56+, CD2-, CD3-, CD8-, T-cell receptor-negative phenotype of the medium-sized to large lymphoid tumor cells and an undetermined genotype (T-cell receptor β and immunoglobulin heavy chain in germline configuration, no clonal T-cell receptor γ population as detected after analysis with polymerase chain reaction combined with denaturing gradient gel electrophoresis) and fast relapse after radiotherapy. Conclusions: This non-B, non-T cutaneous lymphoma cannot be classified by any current lymphoma classification. It seems to represent a new disease entity with peculiar clinical, histologic, and molecular features.Arch Dermatol. 1996;132:550-553) References 1. Dummer R, Häffner A, Burg G. Cutaneous T-cell lymphomas (CTCL): new aspects in PCR-based diagnostic tools, immunology and treatment . Eur J Dermatol. 1994;4:281-286. 2. Burg G, Dummer R, Kerl H. Classification of cutaneous lymphomas . Dermatol Clin. 1994;12:213-217. 3. Agnarsson BA, Vonderheid EC, Kadin ME. Cutaneous T cell lymphoma with suppressor/cytotoxic (CD8) phenotype: identification of rapidly progressive and chronic subtypes . J Am Acad Dermatol. 1990;22:569-577.Crossref 4. Ralfkiaer E. Immunohistological markers for the diagnosis of cutaneous lymphomas . Semin Diagn Pathol. 1991;8:62-72. 5. Weiss LM, Hu E, Wood GS, et al. Clonal rearrangements of T-cell receptor genes in mycosis fungoides and dermatopathic lymphadenopathy . N Engl J Med. 1985;313:539-544.Crossref 6. Ralfkiaer E, O'Connor NT, Crick J, Wantzin GL, Mason DY. Genotypic analysis of cutaneous T-cell lymphomas . J Invest Dermatol. 1987;88:762-765.Crossref 7. Whittaker SJ, Smith NP, Jones RR, Luzzatto L. Analysis of beta, gamma, and delta T-cell receptor genes in mycosis fungoides and Sezary syndrome . Cancer. 1991;68:1572-1582.Crossref 8. Staib G, Mielke V, Griesser H, Menke M, Duller B, Sterry W. PCR-analysis of T-cell receptor (TCR)-gamma genes to differentiate between malignant and reactive T-cell infiltrates of the skin . J Invest Dermatol. 1993;100:458. 9. Volkenandt M, Wienecke R, Koch OM, et al. Conformational polymorphisms of cRNA of T-cell-receptor genes as a clone-specific molecular marker for cutaneous lymphoma . J Invest Dermatol. 1993;101:514-516.Crossref 10. Wood GS, Tung RM, Haeffner AC, et al. Detection of clonal T-cell receptor gamma gene rearrangements in early mycosis fungoides/Sezary syndrome by polymerase chain reaction and denaturing gradient gel electrophoresis (PCR/ DGGE) . J Invest Dermatol. 1994;103:34-41.Crossref 11. Burg G, Hess M, Küng E, Dommann S, Dummer R. Semimalignant ('pseudolymphomatous') cutaneous B-cell lymphomas . Dermatol Clin. 1994;12:399-407. 12. Santucci M, Pimpinelli N, Arganini L. Primary cutaneous B-cell lymphoma: a unique type of low-grade lymphoma: clinicopathologic and immunologic study of 83 cases . Cancer. 1991;67:2311-2326.Crossref 13. Wood GS, Ngan BY, Tung R, et al. Clonal rearrangements of immunoglobulin genes and progression to B cell lymphoma in cutaneous lymphoid hyperplasia . Am J Pathol. 1989;135:13-19. 14. Kerl H, Sterry W. Classification and staging . In: Burg G, Sterry W, eds. EORTC/ BMFT Cutaneous Lymphoma Project Group: Recommendations for Staging and Therapy of Cutaneous Lymphomas . Brussels, Belgium: European Organisation for Research and Treatment of Cancer; 1987:1-10. 15. Cerroni L, Kerl H. The use of monoclonal antibodies on paraffin sections in the diagnosis of cutaneous lymphoproliferative disorders . Dermatol Clin. 1994;12: 219-229. 16. Cordell JL, Falini B, Erber WN, et al. Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes) . J Histochem Cytochem. 1984; 32:219-229.Crossref 17. Arnold A, Cossman J, Bakhshi A, Jaffe ES, Waldmann TA, Korsmeyer SJ. Immunoglobulin-gene rearrangements as unique clonal markers in human lymphoid neoplasms . N Engl J Med. 1983;309:1593-1599.Crossref 18. Minden MD, Toyonaga B, Ha K, et al. Somatic rearrangement of T-cell antigen receptor gene in human T-cell malignancies . Proc Natl Acad Sci U S A. 1985; 82:1224-1227.Crossref 19. Bourguin A, Tung R, Galili N, Sklar J. Rapid, nonradioactive detection of clonal T-cell receptor gene rearrangements in lymphoid neoplasms . Proc Natl Acad Sci U S A. 1990;87:8536-8540.Crossref 20. Sterry W, Korte B, Schubert C. Pleomorphic T-cell lymphoma and large-cell lymphoma of the skin . Am J Dermatopathol. 1989;11:112-123.Crossref 21. Burg G, Braun-Falco O. Cutaneous Lymphomas, Pseudolymphomas and Related Disorders . New York, NY: Springer-Verlag NY Inc; 1983. 22. Boyd RL, Hugo P. Towards an integrated view of thymopoiesis . Immunol Today . 1991;12:71-79.Crossref 23. Griffin JD, Hercend T, Beveridge R, Schlossman SF. Characterization of an antigen expressed by human natural killer cells . J Immunol. 1983;130:2947-2951. 24. Mechtersheimer G, Staudter M, Moller P. Expression of the natural killer cell-associated antigens CD56 and CD57 in human neural and striated muscle cells and in their tumors . Cancer Res. 1991;51:1300-1307. 25. Wong KF, Chan JK, Ng CS, Lee KC, Tsang WY, Cheung MM. CD56 (NKH1)-positive hematolymphoid malignancies: an aggressive neoplasm featuring frequent cutaneous/mucosal involvement, cytoplasmic azurophilic granules, and angiocentricity . Hum Pathol. 1992;23:798-804.Crossref 26. Brody JP, Allen S, Schulman P, et al. Acute agranular CD4-positive natural killer cell leukemia . Cancer. 1995;75:2474-2483.Crossref 27. Adachi M, Maeda K, Takekawa M, et al. High expression of CD56 (N-CAM) in a patient with cutaneous CD4-positive lymphoma . Am J Hematol. 1994;47:278-282.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: May 1, 1996

References