Coexistence of large cell transformed mycosis fungoides and diffuse large B-cell lymphoma in one patient

IF 1.6 4区 医学 Q3 DERMATOLOGY Journal of Cutaneous Pathology Pub Date : 2024-07-05 DOI:10.1111/cup.14673
Thomas Z. Rohan BS, Jayson Suriano BA, Volkan Tekmen BS, Safiyyah Bhatti MD, Sahithi Talasila BS, Daniel Joffe BS, Caleb Holtmeyer MD, Jason B. Lee MD, Onder Alpdogan MD, Neda Nikbakht MD, PhD
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Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common and aggressive subtype of non-Hodgkin lymphoma. The overall risk of developing DLBCL is increased in patients with other lymphomas, such as mycosis fungoides (MF). In this report, we present an 81-year-old female with early-stage MF who simultaneously progressed to tumor stage, large-cell transformed (LCT) MF and developed a primary DLBCL in a lymph node (LN). She presented with a tumor on her leg and new lymphadenopathy in her right axilla. Skin biopsy of the tumor revealed infiltration of large atypical CD3+, CD4+, and CD30+ cells, and a smaller portion of CD8+ cells in the dermis, consistent with LCT MF. Biopsy of the axillary LN revealed diffuse sheets of CD20+, BCL-2+, c-MYC+, and CD10 cells, highly suggestive of double expressor DLBCL. High-throughput sequencing revealed monoclonal T cells in the skin tumor and a monoclonal B-cell population in the LN. The above findings led to simultaneous diagnoses of LCT MF and nodal double expressor DLBCL. Our case demonstrates the importance of performing a full pathological workup in cutaneous T-cell lymphoma patients presenting with lymphadenopathy.

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一名患者同时患有大细胞变异真菌病和弥漫大 B 细胞淋巴瘤。
弥漫大 B 细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤中最常见、最具侵袭性的亚型。患有其他淋巴瘤(如放线菌病(MF))的患者罹患 DLBCL 的总体风险会增加。在本报告中,我们介绍了一名患有早期 MF 的 81 岁女性患者,她的病情同时发展为肿瘤分期、大细胞转化(LCT)MF,并在淋巴结(LN)中出现原发性 DLBCL。她出现腿部肿瘤和右腋窝淋巴结肿大。肿瘤的皮肤活检显示,真皮层有大量非典型CD3+、CD4+和CD30+细胞浸润,还有一小部分CD8+细胞,这与LCT MF一致。腋窝淋巴结活检发现CD20+、BCL-2+、c-MYC+和CD10-细胞弥漫成片,高度提示为双表达型DLBCL。高通量测序显示,皮肤肿瘤中有单克隆T细胞,而LN中有单克隆B细胞群。根据上述结果,我们同时确诊为 LCT MF 和结节双表达 DLBCL。我们的病例表明,对出现淋巴结病的皮肤T细胞淋巴瘤患者进行全面病理检查非常重要。
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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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