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Epidermotropic CD8+ cytotoxic T-cell lymphoma exhibiting a transition from the indolent to the aggressive phase, accompanied by emergence of CD7+ cells and formation of neutrophilic pustules.

Abstract
A 47-year-old-man presented with rashes on his trunk and limbs, and a diagnosis of parapsoriasis was made. Ten years later, the rashes had progressed gradually to form plaques and tumours. Gene rearrangement studies revealed monoclonality of the T-cell receptor β-chain (TCR-Jβ)1 gene, and results of flow cytometry and immunohistochemical examination confirmed a diagnosis of epidermotropic CD8+ cytotoxic T-cell lymphoma. The clinical course of the disease remained indolent for some time, but about 2 years later, neutrophilic pustules formed on the surface of the skin lesions, and tumours developed in the patient's testes. Using flow cytometry, emergence of CD7+ cells was found. The patient died the following year of respiratory failure due to brain herniation. On postmortem examination, CD8+ tumour cells were found in the brain. This case demonstrates an unusually protracted indolent phase in a patient with cutaneous aggressive epidermotropic CD8+ cytotoxic T-cell lymphoma; its transition into the aggressive phase was accompanied by emergence of CD7+ cells and formation of neutrophilic pustules.
AuthorsY Ito, M Goto, Y Hatano, M Kawamoto, M Ohishi, S Takayasu, K Katagiri, S Fujiwara
JournalClinical and experimental dermatology (Clin Exp Dermatol) Vol. 37 Issue 2 Pg. 128-31 (Mar 2012) ISSN: 1365-2230 [Electronic] England
PMID21883402 (Publication Type: Case Reports, Journal Article)
Copyright© The Author(s). CED © 2011 British Association of Dermatologists.
Chemical References
  • Antigens, CD7
Topics
  • Antigens, CD7 (immunology)
  • CD8-Positive T-Lymphocytes (immunology)
  • Disease Progression
  • Fatal Outcome
  • Humans
  • Lymphoma, T-Cell, Cutaneous (immunology, pathology)
  • Male
  • Middle Aged
  • Skin Diseases, Vesiculobullous (immunology, pathology)
  • Skin Neoplasms (immunology, pathology)
  • T-Lymphocytes, Cytotoxic (immunology)

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