Long-term follow-up and management of small and medium-sized CD4+ T cell lymphoma and CD8+ lymphoid proliferations of acral sites: A multicenter experience Journal Article


Authors: Virmani, P.; Jawed, S.; Myskowski, P. L.; Horwitz, S.; Skripnik Lucas, A.; Moskowitz, A.; Pulitzer, M.; Zain, J.; Rosen, S. T.; Querfeld, C.
Article Title: Long-term follow-up and management of small and medium-sized CD4+ T cell lymphoma and CD8+ lymphoid proliferations of acral sites: A multicenter experience
Abstract: Background: Primary cutaneous CD4+ small–medium pleomorphic T cell lymphoma (SMPTCL) is a low-grade cutaneous T cell lymphoma. Its clinical and histopathologic features are comparable with those of CD8+ lymphoid proliferations (LPs) of the ear and acral sites. Objectives: We performed a retrospective analysis of patients with CD4+ SMPTCL or CD8+ LP to elucidate the clinical course, prognosis, and outcomes. Methods: Demographic, clinical, and treatment data were reviewed. Histopathologic data based on architectural, cytomorphologic, and immunohistochemical features were assessed. Immunohistochemical staining for T and B cell markers was evaluated. Results: A total of 25 patients including 22 with CD4+ SMPTCL and three with CD8+ LP were identified. All patients presented with a single lesion, predominantly on the head, neck, or upper trunk (84%). No patients showed extracutaneous disease at any evaluation. The most common histopathologic changes showed a dense nodular infiltrate of small cells with hyperchromatic nuclei without significant follicular or adnexal involvement. Patients were treated with excision (48%), local radiation (28%), or topical or intralesional steroids (24%). All patients achieved complete resolution of disease. Five patients demonstrated cutaneous relapse at new sites. Conclusions: The CD4+ SMPTCL/CD8+ LP subgroup usually presents with solitary lesions and demonstrates an indolent clinical course. Typical presentation, classic histopathology, widespread expression of follicular T helper cell markers, and loss of a T cell antigen are diagnostic features of CD4+ SMPTCL, whereas monomorphous CD8+ infiltrate without follicular T helper cell markers is consistent with CD8+ LP. Local skin-directed therapy is appropriate in these patients. © 2016 The International Society of Dermatology
Keywords: cutaneous t cell lymphoma; cutaneous lymphoma
Journal Title: International Journal of Dermatology
Volume: 55
Issue: 11
ISSN: 0011-9059
Publisher: Wiley Blackwell  
Date Published: 2016-11-01
Start Page: 1248
End Page: 1254
Language: English
DOI: 10.1111/ijd.13340
PUBMED: 27369070
PROVIDER: scopus
PMCID: PMC5053827
DOI/URL:
Notes: Article -- Export Date: 2 November 2016 -- Source: Scopus
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MSK Authors
  1. Melissa P Pulitzer
    130 Pulitzer
  2. Steven M Horwitz
    364 Horwitz
  3. Alison Moskowitz
    148 Moskowitz
  4. Patricia Myskowski
    137 Myskowski
  5. Sarah Inam Jawed
    8 Jawed
  6. Pooja   Virmani
    10 Virmani