title: Agranular CD4+/CD56+ cutaneous neoplasm.
abstract: CD4+ CD56+ cutaneous neoplasm with hematological relapse is a rare malignant disease and has been described recently in the literature as blastic or agranular NK-cell leukemia/lymphoma. The origin of this neoplasm is uncertain. We describe a 75-year-old patient with a primary cutaneous neoplasm CD4+ CD56+ who evolved to leukemic phase despite standard lymphoma chemotherapy. Morphologically, the cells were undifferentiated without granules in the cytoplasm. The immunophenotype showed the expression of CD4, CD56, CD68, CD33, CD7, CD2, CD45RA, and CD38. Histological analysis revealed a cell infiltration mainly located in the dermis. T-cell receptor and immunoglobulin heavy chain genes were in germline configuration. Cytogenetic study showed complex structural abnormalities with a deletion of the chromosome 5 del(5q). The clinical course was aggressive with an early hematological relapse.
authors.affiliation: Service d'Hematologie Clinique, Centre hospitalier V. Dupouy, Argenteuil, France.
authors.forename: T
authors.initials: T
authors.lastname: Touahri
authors.forename: H
authors.initials: H
authors.lastname: Belaouni
authors.forename: H
authors.initials: H
authors.lastname: Mossafa
authors.forename: M
authors.initials: M
authors.lastname: Pulik
authors.forename: L
authors.initials: L
authors.lastname: Bourguigna
authors.forename: C
authors.initials: C
authors.lastname: Ibbora
authors.forename: D
authors.initials: D
authors.lastname: Dal Soglio
authors.forename: F
authors.initials: F
authors.lastname: Davi
authors.forename: C
authors.initials: C
authors.lastname: Fourcade
mesh_terms: D000368:Aged; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D015704:CD4 Antigens / Q000032:analysis*; D019002:CD56 Antigen / Q000032:analysis*; D020732:Cytogenetic Analysis; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D016130:Immunophenotyping; D007938:Leukemia / Q000209:etiology; D008297:Male; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
chemical_list: D000945:Antigens, Differentiation, T-Lymphocyte; D015704:CD4 Antigens; D019002:CD56 Antigen