title: CC chemokine receptor 4-positive diffuse large B-cell lymphoma involving the skin: a case report.
abstract: Leukocyte trafficking is critically regulated by chemokines and their receptors. The involvement of the skin in certain subsets of T-cell malignancies has been explained by the discovery of an interaction between the thymus and activation-regulated chemokine (TARC), which is abundant in the skin, and its receptor, CC chemokine receptor 4 (CCR4), which is expressed in the tumor cells. We describe a diffuse large B-cell lymphoma (DLBCL) that showed CCR4 expression with involvement of the skin. A 55-year-old man presented with a giant skin ulcer of the right axilla, and his disease was diagnosed as DLBCL. Further clinical examination revealed an ulcerated gastric lymphoma lesion. Immunohistochemical and real-time reverse transcriptase-polymerase chain reaction analyses showed that the tumor cells were positive for CCR4, and TARC was expressed at extremely high levels in the lymphoma-affected skin. These observations suggest that the interaction between CCR4 and TARC played a significant role in the involvement of the skin in this case, similar to what has been observed in certain subsets of T-cell malignancies. To the best of our knowledge, this report is the first of a CCR4-positive B-cell lymphoma. The present case provides new insights into the pathogenesis of skin involvement in B-cell lymphomas.
authors.affiliation: Department of Internal Medicine & Molecular Science, Nagoya City University Graduate School of Medical Sciences, Japan. itakashi@med.nagoya-cu.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inagaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kusumoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Inagaki
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Komatsu
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Iida
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Harada
authors.forename: Genji
authors.initials: G
authors.lastname: Takeuchi
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Uedaa
mesh_terms: D054414:Chemokine CCL17; D019742:Chemokines, CC / Q000096:biosynthesis; D005153:Facial Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D054398:Receptors, CCR4; D019707:Receptors, Chemokine / Q000096:biosynthesis*; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000556:secondary
chemical_list: C106230:CCL17 protein, human; C515354:CCR4 protein, human; D054414:Chemokine CCL17; D019742:Chemokines, CC; D054398:Receptors, CCR4; D019707:Receptors, Chemokine