A Rare Case of Cutaneous Gamma Delta T-Cell Lymphoma With Complete Body Involvement

Abstract

A 57-year-old female presented to the emergency department of our hospital with painful skin lesions since 3 months. On examination, ulcerating tumors and plaques occupied 100% of her body and enlarged firm left axillary lymph nodes were present. On imaging, PET scan revealed hypermetabolic cutaneous lesion, and hyperactive B/L axillary, inguinal and intra-parotid lymph nodes. Punch biopsy from right medial thigh skin lesion showed phenomenon of epidermotropism. PCR studies showed strong expression of TCR gamma by atypical cells. FNAC of axillary lymph node and bone marrow biopsy was negative. Based on histo-immunological evidence and dermatologist input, the diagnosis of cytotoxic cutaneous gamma delta T-cell lymphoma (CGDTCL) was made. Patient received five cycles of total skin electron beam therapy. Contrary to the present literature that suggests that cutaneous gamma delta T-cell lymphomas are resistant to chemotherapy and radiation, our patient responded very well to total skin electron beam radiation therapy. The tumors on her body flattened with complete resolution of pain and pruritis. This case report summarizes the unusual presentation of CGDTCL and response to treatment. J Med Cases. 2016;7(8):364-367 doi: http://dx.doi.org/10.14740/jmc2584w