title: Fulminant head and neck congestion in advanced cutaneous T cell lymphoma: a poor prognostic indicator.
abstract: BACKGROUND
  Clinical factors associated with a poor prognosis in patients with cutaneous T cell lymphoma (CTCL) include the extent and type of skin involvement and the presence and extent of lymphadenopathy.
  
  
  METHODS
  We report retrospectively the clinical course and survival time of four patients with advanced CTCL after the development of fulminant head and neck congestion.
  
  
  METHODS
  All four patients presented with marked erythema and edema of the head and neck with marked cervical adenopathy. Treatment with multidrug chemotherapy and radiation induced only brief remissions. The clinical picture was felt to be due to extensive tumor infiltration of the skin as well as lymphatic compression due to cervical adenopathy rather than venous compression at the level of the mediastinum. Survival from onset of this fulminant head and neck congestion was 1-5 months.
  
  
  CONCLUSIONS
  Development of this fulminant head and neck congestion in patients with advanced CTCL heralds a progressively deteriorating clinical course with a poor prognosis.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Florida, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: McFalls
authors.forename: J
authors.initials: J
authors.lastname: Cohen
authors.forename: B
authors.initials: B
authors.lastname: Berman
authors.forename: F A
authors.initials: FA
authors.lastname: Kerdel
mesh_terms: D000328:Adult; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005260:Female; D006257:Head / Q000098:blood supply; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology*; D016399:Lymphoma, T-Cell / Q000150:complications / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*