Cutaneous pheomorphic T cell lymphoma. Immunologic, virologic, and T-cell receptor gene rearrangement studies in one European case with initial pseudolymphoma presentation.
An unusual case of cutaneous nodular T cell lymphoma evolving for 4 years with massive eosinophilia and greatly increased IgE levels is discussed. Repeated histologic and immunohistologic examinations could not ascertain malignancy because tumors were composed of a granuloma-like, highly polymorphic cellular infiltrate with mature immunotype and no significant nuclear abnormalities nor epidermotropism. T cell lymphoma was evidenced by the T cell receptor beta-chain gene study, which showed a clonal rearrangement. Final histologic classification was "pleomorphic T cell lymphoma" because further biopsy samples displayed numerous lymphoid cells with pleomorphic convoluted nuclei. The T-cell receptor gene probe is a major tool for the early diagnosis of some T cell lymphomas. The case we report shares many features with the smoldering type of human T cell lymphotropic virus type I-associated Japanese endemic pleomorphic T cell lymphoma. Our virologic study confirms that in nonendemic Western countries, pleomorphic T cell lymphomas do not show evidence of a retrovirus association.
D000911:Antibodies, Monoclonal / Q000276:immunology; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008223:Lymphoma / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D011971:Receptors, Immunologic / Q000235:genetics; D012867:Skin / Q000276:immunology / Q000473:pathology; D012878:Skin Neoplasms / Q000276:immunology* / Q000473:pathology; D013601:T-Lymphocytes
D000911:Antibodies, Monoclonal; D011971:Receptors, Immunologic