title: Acneiform primary cutaneous CD4-positive small/medium pleomorphic T-cell lymphoma with prominent necrosis.
abstract: Primary cutaneous CD4-positive small/medium pleomorphic T-cell lymphoma (SMPTCL) is an indolent form of cutaneous lymphoma that usually presents in solitary fashion and is histopathologically characterized by nodular infiltration of small- to medium-sized pleomorphic T-cells. We report the case of a patient who presented with a 5-year history of acneiform lesions on his face. Histopathologic examination of two lesions revealed a nodular infiltrate of small to medium-sized lymphocytes with necrosis in the dermis. The proliferating cells were positive for CD2, CD3 and CD4 and negative for CD8, CD30 and CD56. They were positive for TIA-1 and negative for perforin and granzyme B. The Ki67 proliferation index was approximately 10%. The neoplastic cells expressed programmed death-1 and lacked expression of CXCL-13, bcl-6 and CD10. In situ hybridization for Epstein-Barr virus-encoded RNA yielded a negative result. T-cell receptor gene rearrangement showed identical T-lymphocyte monoclonality in both lesions. In brief, we report a rare case of acneiform SMPTCL with prominent necrosis.
authors.affiliation: Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xian, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.forename: Tianwen
authors.initials: T
authors.lastname: Gao
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy / Q000473:pathology*; D001706:Biopsy / Q000379:methods; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D011859:Radiography; D012878:Skin Neoplasms / Q000473:pathology*; D014463:Ultrasonography
keywords: acne; follicular T-helper cell; necrosis; primary cutaneous CD4-positive small/medium T-cell lymphoma