Cutaneous CD4+ CD56+ hematologic malignancies.
BACKGROUND
Hematologic malignancies expressing CD4 and CD56 are most commonly associated with the recently described CD4(+) CD56(+) hematodermic neoplasm.


METHODS
Thirteen cases of CD4(+) CD56(+) hematologic malignancies were prospectively encountered in the routine and referral practices of the authors.


RESULTS
Patients 1 and 2 were elderly men exhibiting an acute onset of skin, bone-marrow, and peripheral blood involvement, both dying of their disease within less than 12 months. CD3(+) phenotype and a clonal T-cell receptor beta rearrangement indicated categorization as a CD4(+) natural killer T-cell lymphoma. Patient 3 developed a CD56(+) anaplastic large cell lymphoma and is without disease after excision and radiation. Indolent CD4(+) CD56(+) poikilodermatous mycosis fungoides defined case 4. There were 7 patients with CD123(+) CD4(+) CD56(+) hematodermic neoplasm, 4 dying within 18 months of presentation with peripheral blood/marrow involvement in 6 of the 7 cases. Two patients with granulocytic sarcoma dying within 100 days of presentation defined the last two cases.


CONCLUSIONS
There were relatively small numbers in each of the categories and the follow-up was limited in those cases where death was not reported.


CONCLUSIONS
Cutaneous malignancies composed of CD4(+) CD56(+) hematopoietic cells define a varied group and oftentimes have an aggressive clinical course although not in every case.
Magro
Cynthia M
CM
Department of Pathology, Weill Medical College of Cornell University, New York, New York, USA. cym2003@med.cornell.edu
Porcu
Pierluigi
P
Schaefer
Jochen
J
Erter
Jack W
JW
Furman
Richard R
RR
Shitabata
Paul K
PK
Crowson
A Neil
AN
D000328:Adult; D000368:Aged; D001706:Biopsy; D015704:CD4 Antigens / Q000378:metabolism*; D019002:CD56 Antigen / Q000378:metabolism*; D003713:Dendritic Cells / Q000378:metabolism / Q000473:pathology; D017809:Fatal Outcome; D019337:Hematologic Neoplasms / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000378:metabolism / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000378:metabolism / Q000473:pathology; D015458:Leukemia, T-Cell / Q000378:metabolism / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000378:metabolism / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000378:metabolism / Q000473:pathology; D023981:Sarcoma, Myeloid / Q000378:metabolism / Q000473:pathology; D012878:Skin Neoplasms / Q000378:metabolism* / Q000473:pathology*
D015704:CD4 Antigens; D019002:CD56 Antigen