Primary cutaneous T-cell lymphoma localized to the lower leg: a distinct, locally aggressive cutaneous T-cell lymphoma.
BACKGROUND
Distinct categories of skin lymphoma with preferential site localization and unique clinical behavior, including leg-type primary cutaneous diffuse large B-cell lymphoma, have recently been described. Although these entities are rare, they exhibit reproducible clinicopathologic features, and their recognition may allow more appropriate treatment protocols.


METHODS
We describe the distinctive clinicopathologic features that were observed in 3 patients with an unusual variant of primary cutaneous T-cell lymphoma. All cases originated on the legs of elderly patients and exhibited a locally aggressive clinical behavior with relatively rapid relapses after radiotherapy and resistance to other therapies. Histologically, dense dermal-centered infiltrates of atypical, variably sized mature helper T cells were identified. One patient died of progressive disease.


CONCLUSIONS
Rare cases of primary cutaneous lymphomas do not necessarily fit current criteria for a standard diagnostic category but may represent unique clinicopathologic entities, such as primary cutaneous T-cell lymphoma localized to the lower leg. It is important to be able to identify these unusual lymphoma variants for prognosis and adequate treatment. The aggressive nature of lymphomas preferentially localized on the lower extremities may not be restricted to B-cell or cytotoxic neoplasms.
Poligone
Brian
B
Department of Dermatology, University of Rochester, 575 Elmwood Ave, Box 697, Rochester, NY 14642, USA. brian_poligone@urmc.rochester.edu
Wilson
Lynn D
LD
Subtil
Antonio
A
Heald
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D035002:Lower Extremity; D016410:Lymphoma, T-Cell, Cutaneous / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D015996:Survival Rate; D017211:Treatment Failure
D000970:Antineoplastic Agents