[CD30 positive pilotropic lymphoma].
BACKGROUND
We report an unusual case of cutaneous CD30-positive lymphoma with pilar tropism and circulating Sezary cells which had a rapidly fatal course.


METHODS
A 78-year-old man presented erythematous infiltration of the face, a pruriginous eruption on the trunk and proximal portions of the limbs with small erythematopurpuric follicular papulae, and node enlargement in the inguinal and axillary areas. The rest of the clinical examination was normal. Circulating Sezary cells were found in significant numbers on two different blood smears. Histologic and immunohistochemistry examination of a skin biopsy evidenced medium to large sized lymphoid cell infiltration in a perifollicular localization. A few small cells penetrated the pilar apparatus. There was no follicular mucinosis. The tumoral cells expressed CD2, CD3, CD4 and 75 p. 100 were positive for CD30. Node aspiration showed lymphomatous cells and CD3+ and CD30+ lymphomatous infiltration was found on marrow smears. A T clone was evidenced both in blood and bone marrow leading to the diagnosis of pilotropic CD30-positive lymphoma. Chlorambucil and prednisone were given. The patient died 5 months later.


CONCLUSIONS
The cytology findings suggest medium to large cell pleomorphic lymphoma. The circulating Sezary cells, the pilotropic eruption, and the rapidly fatal outcome suggest transformation of a Sezary syndrome into CD30-positive large cell lymphoma which has been described in fungoid mycosis.
Trémeau-Martinage
C
C
Service de Dermatologie, Allergologie et Vénéréologie, CHU de Purpan, Toulouse.
Gorguet
B
B
Lamant
L
L
Brousset
P
P
Loche
F
F
Fillola
G
G
Corberand
J
J
Tkaczuck
J
J
Bazex
J
J
D000368:Aged; D001706:Biopsy; D017809:Fatal Outcome; D018859:Hair Follicle / Q000473:pathology*; D006801:Humans; D017730:Ki-1 Antigen / Q000032:analysis*; D008297:Male; D012751:Sezary Syndrome / Q000175:diagnosis* / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
D017730:Ki-1 Antigen
Lymphome pilotrope CD30 positif.