[Cutaneous T-cell lymphoma following renal transplantation].
BACKGROUND
Post-transplant cutaneous lymphomas are the second skin cancer after cutaneous carcinoma and are usually of the B-cell type. Post-transplant cutaneous T-cell lymphomas are extremely rare. We described a case of a cutaneous T-cell lymphoma in a renal transplant recipient.


METHODS
A 52-year-old woman was hospitalized for an erythematous infiltrated eruption. Seven years earlier, she had undergone kidney transplantation. No palpable lymphadenopathy or hepatosplenomegaly was present. The patient's skin biopsy specimen was histologically suggestive of CD30- fungoid mycosis. The same clonal TCR-rearrangement was identified in the blood and in the skin. No EBV was detected within the cutaneous lesion on immunohistochemical analysis or by PCR in the blood. Chlorambucil (Chloraminophène) was associated with a topical treatment with chlormethine (Caryolysine) and corticosteroids while tacrolimus (Prograf) was reduced and stopped. There was no evidence of recurrence of the lymphoma after 12 months of follow-up.


CONCLUSIONS
The particularity of our observation is the apparition, 7 years after transplantation, of a CD30-, EBV-fungoid mycosis with a blood and cutaneous clonal TCR-rearrangement. Despite this poor prognosis factor, the cutaneous lymphoma regressed after reduction of the immunosuppressive treatment reduction and institution of topical corticosteroids, chlormethine and chlorambucil.
Defossez-Tribout
C
C
Service de Dermatologie et Vénéréologie, CHU, 80054 Amiens Cedex 1.
Carmi
E
E
Lok
C
C
Westeel
P-F
PF
Chatelain
D
D
Denoeux
J-P
JP
D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D016410:Lymphoma, T-Cell, Cutaneous / Q000209:etiology*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000209:etiology*