Gamma/delta T-cell lymphoma with mycosis fungoides-like clinical course transforming to "T-cell-receptor-silent" aggressive lymphoma: Description of one case

J Cutan Pathol. 2021 Sep;48(9):1197-1203. doi: 10.1111/cup.14063. Epub 2021 Jun 4.

Abstract

Primary cutaneous γδ T-cell lymphomas (PCGDTLs) are a heterogeneous group of lymphomas representing about 1% of primary cutaneous T-cell lymphomas (CTCLs) and mostly regarded as clinically aggressive. Current WHO-EORTC classification recognizes different clinic-pathologic subsets of PCGDTL, but it suggests that cases showing a mycosis fungoides (MF)-like clinical presentation and histopathology should be classified as MF irrespective of phenotype for their indolent course. Herein, we describe a case of γδ-MF, featuring at onset a granulomatous pattern, with subsequent clinical worsening signaled by the development of an ulcero-necrotic lesion and systemic dissemination, leading to death in 5 months. Clinical progression was sustained by a shift to mature T-cell lymphoma composed of medium to large-sized blastoid T-cells featuring a T-cell receptor (TCR) silent immunophenotype.

Keywords: cutaneous T-cell lymphoma; hematopathology; immunophetotypic; mycosis fungoides; primary cutaneous γδ T-cell lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy / methods
  • Disease Progression
  • Fatal Outcome
  • Gene Rearrangement, delta-Chain T-Cell Antigen Receptor / immunology
  • Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / immunology
  • Humans
  • Immunophenotyping / methods
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / metabolism
  • Lymphoma, Non-Hodgkin / pathology*
  • Lymphoma, T-Cell, Cutaneous / complications
  • Lymphoma, T-Cell, Cutaneous / diagnosis
  • Lymphoma, T-Cell, Cutaneous / metabolism
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Male
  • Mycosis Fungoides / pathology*
  • Receptors, Antigen, T-Cell / immunology
  • Skin Neoplasms / pathology*
  • T-Lymphocytes / pathology

Substances

  • Receptors, Antigen, T-Cell