CD8+ epidermotropic cytotoxic T-cell lymphoma with peripheral blood and central nervous system involvement.
BACKGROUND
Most cutaneous T-cell lymphomas demonstrate a malignant population with a CD4(+) phenotype. In rare cases, CD8(+) phenotypes have been described based on immunostaining of skin specimens. Although some CD8(+) lymphomas have an indolent course, others, such as CD8(+) epidermotropic cytotoxic T-cell lymphomas, are typically more aggressive. To our knowledge, involvement of peripheral blood or cerebrospinal fluid with a malignant population of CD8(+) cells demonstrated by flow cytometry and T-cell receptor gene rearrangement has not been previously described.


METHODS
We describe a patient with a CD8(+) cutaneous T-cell lymphoma with an initially indolent course and early stage diagnosed on the basis of a skin biopsy specimen. However, when flow cytometry was performed looking specifically at CD8(+)/CD4(-) cells in the peripheral blood and cerebrospinal fluid, a malignant population of CD8(+)/CD4(-)/CD26(-)/CD7(-) cells was discovered.


CONCLUSIONS
It is important for prognosis and treatment to be able to identify CD8(+) epidermotropic cytotoxic T-cell lymphoma and separate it from other relatively indolent CD8(+) lymphomas. Furthermore, detection of an abnormal CD8(+)/CD26(-)/CD7(-) T-cell population within the peripheral blood has important prognostic and therapeutic implications. The use of flow cytometry looking for abnormal CD8(+) populations in the peripheral blood or cerebrospinal fluid can assist with this critical information.
Introcaso
Camille E
CE
Department of Dermatology, Hospital of the University of Pennsylvania, 2 Maloney Bldg, 3400 Spruce St, Philadelphia, PA 19104, USA. camille.introcaso@uphs.upenn.edu
Kim
Ellen J
EJ
Gardner
Jennifer
J
Junkins-Hopkins
Jacqueline M
JM
Vittorio
Carmela C
CC
Rook
Alain H
AH
D000368:Aged; D015703:Antigens, CD / Q000378:metabolism; D016543:Central Nervous System Neoplasms / Q000276:immunology; D002555:Cerebrospinal Fluid / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D016130:Immunophenotyping; D007938:Leukemia / Q000276:immunology; D016410:Lymphoma, T-Cell, Cutaneous / Q000175:diagnosis / Q000276:immunology*; D011379:Prognosis; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000378:metabolism
D015703:Antigens, CD