Unveiling the Rarity: CD20 Expression in Mycosis Fungoides and Its Clinical Significance.

IF 1.1 4区 医学 Q4 DERMATOLOGY American Journal of Dermatopathology Pub Date : 2024-10-01 Epub Date: 2024-06-28 DOI:10.1097/DAD.0000000000002787
Nada Shaker, Omar P Sangueza
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Abstract

Abstract: Although CD20 expression is typically scarce in mycosis fungoides (MF), it is more commonly associated with T-cell lymphomas. Nevertheless, isolated instances of CD20-positive MF have been documented infrequently. Here, we present a unique case of CD20-positive MF in a 30-year-old man who manifested with a hypopigmented patch on the anterior chest. Histopathological examination revealed epidermotropic infiltrates of small- to medium-sized lymphocytes with hyperchromatic and cerebriform nuclei aligned along the basal and low-mid layers of the epidermis. Immunophenotypic analysis demonstrated neoplastic T cells expressing CD4+, CD8+, and CD3+ with the loss of CD7. Intriguingly, a notable subset of the neoplastic T cells exhibited CD20 expression. This case contributes to the sparse literature on CD20-positive MF and underscores its diagnostic and clinical ramifications. The role of B cells has been more thoroughly characterized in T-cell lymphomas other than MF. However, its significance in MF remains unclear due to the scarcity of reported cases. Some hypotheses propose that the B cells' expression might indicate immune dysregulation or complex interactions within the tumor microenvironment. Another perspective suggests it could signify a progression of the disease towards a more aggressive lymphoma phenotype. Further investigation and documentation of similar cases is imperative to elucidate the clinical features, prognosis, and optimal therapeutic strategies. The long-term prognosis and outcomes in patients with hypopigmented MF and CD20 positivity remain ambiguous, underscoring the necessity for continued research and scrutiny of analogous cases.

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揭开罕见性的面纱:真菌病中 CD20 的表达及其临床意义。
摘要:尽管CD20在真菌病(MF)中通常很少表达,但它更常见于T细胞淋巴瘤。然而,CD20阳性的MF病例并不多见。这里,我们介绍了一例独特的 CD20 阳性 MF 病例,患者为一名 30 岁男性,表现为前胸色素减退斑。组织病理学检查显示,小到中等大小的淋巴细胞沿表皮基底层和中低层浸润,细胞核呈高色素和小脑状排列。免疫表型分析显示,肿瘤性T细胞表达CD4+、CD8+和CD3+,但CD7缺失。耐人寻味的是,肿瘤性T细胞中有一个显著的亚群表现为CD20。该病例为有关 CD20 阳性 MF 的稀少文献做出了贡献,并强调了其诊断和临床意义。除 MF 外,B 细胞在 T 细胞淋巴瘤中的作用已得到更全面的描述。然而,由于报告的病例很少,B 细胞在 MF 中的作用仍不明确。一些假设认为,B 细胞的表达可能表明肿瘤微环境中的免疫失调或复杂的相互作用。另一种观点认为,这可能意味着疾病向更具侵袭性的淋巴瘤表型发展。为了阐明临床特征、预后和最佳治疗策略,进一步调查和记录类似病例势在必行。色素减退型 MF 和 CD20 阳性患者的长期预后和疗效仍不明确,因此有必要继续对类似病例进行研究和仔细检查。
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来源期刊
CiteScore
1.80
自引率
9.10%
发文量
453
审稿时长
3 months
期刊介绍: The American Journal of Dermatopathology offers outstanding coverage of the latest diagnostic approaches and laboratory techniques, as well as insights into contemporary social, legal, and ethical concerns. Each issue features review articles on clinical, technical, and basic science advances and illuminating, detailed case reports. With the The American Journal of Dermatopathology you''ll be able to: -Incorporate step-by-step coverage of new or difficult-to-diagnose conditions from their earliest histopathologic signs to confirmatory immunohistochemical and molecular studies. -Apply the latest basic science findings and clinical approaches to your work right away. -Tap into the skills and expertise of your peers and colleagues the world over peer-reviewed original articles, "Extraordinary cases reports", coverage of practical guidelines, and graphic presentations. -Expand your horizons through the Journal''s idea-generating forum for debating controversial issues and learning from preeminent researchers and clinicians
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