title: CD8(+) granulomatous cutaneous T-cell lymphoma: a potential association with immunodeficiency.
abstract: BACKGROUND
  Granulomatous cutaneous T-cell lymphoma (G-CTCL) is a rarely encountered entity. Most G-CTCL is CD4(+), with granulomatous mycosis fungoides representing the vast majority of cases. Because of the rarity of CD8(+) G-CTCL, there is a paucity of data regarding the clinicopathologic features and expected course.
  
  
  OBJECTIVE
  To describe the clinical and histopathologic features of G-CTCL.
  
  
  METHODS
  This is a retrospective review of collected cases.
  
  
  RESULTS
  We present 4 cases of CD8(+) G-CTCL. Patients presented with papules and nodules on the trunk and extremities without antecedent patch or plaque disease. In all cases, biopsy specimens were obtained, and these revealed a dense granulomatous infiltrate accompanied by an atypical lymphoid infiltrate of CD8(+) T cells. T-cell clonality studies were positive in 3 of 4 cases. Staging was negative for nodal involvement, but lung granulomas were seen in all cases. In all 4 cases, the patient's medical history was significant for immunodeficiency, either primary or iatrogenic. All 4 patients had slowly progressive disease.
  
  
  CONCLUSIONS
  This is a small retrospective case series.
  
  
  CONCLUSIONS
  CD8(+) G-CTCL appears to be associated with immunodeficiency. The finding of a CD8(+) G-CTCL should prompt an evaluation for underlying immunodeficiency. Additional studies are required to validate these conclusions.
authors.affiliation: Department of Dermatology, Northwestern University, Chicago, Illinois; Luminous Dermatology, Santa Barbara, California. Electronic address: bryan.gammon@gmail.com.
authors.forename: Bryan
authors.initials: B
authors.lastname: Gammon
authors.affiliation: Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, United Kingdom.
authors.forename: Alistair
authors.initials: A
authors.lastname: Robson
authors.affiliation: Department of Dermatology, Northwestern University, Chicago, Illinois.
authors.forename: Janyana
authors.initials: J
authors.lastname: Deonizio
authors.affiliation: Department of Dermatology, Northwestern University, Chicago, Illinois.
authors.forename: Lisa
authors.initials: L
authors.lastname: Arkin
authors.affiliation: Department of Dermatology, Northwestern University, Chicago, Illinois.
authors.forename: Joan
authors.initials: J
authors.lastname: Guitart
mesh_terms: D000328:Adult; D000361:Agammaglobulinemia / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D000368:Aged; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D017074:Common Variable Immunodeficiency / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D018450:Disease Progression; D040181:Genetic Diseases, X-Linked / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D006099:Granuloma / Q000276:immunology / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D016410:Lymphoma, T-Cell, Cutaneous / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009182:Mycosis Fungoides / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000276:immunology / Q000378:metabolism / Q000473:pathology*
keywords: X-linked agammaglobulinemia; common variable immunodeficiency; cutaneous T-cell lymphoma; cytotoxic; granulomatous; immunodeficiency; mycosis fungoides