Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma in the practice of a dermatologist: A case report

Igor Kuklin,Galina Safonova,Olga Rimar,Muza Kokhan,Maria Kuklina,Natalia Zilberberg,Svetlana Ignatkova,Nikolay Kungurov,Valery Iglikov

doi:10.7241/ourd.2021e.67

Abstract

The article demonstrates a case of diagnosis of a rare variant of primary skin lymphoma, namely of primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma with an indolent course. The diagnosis of SMPTCL is based on the combination of the clinical picture, histological and immunomorphological data. A 70-year-old patient presented at the clinic with complaints about tumor-like formations on the skin of the face and back accompanied by moderate itching. The diagnosis was verified by pathomorphological and immunohistochemical studies of the biopsy of the affected skin. The presented clinical case emphasizes the importance of doctors’ clinical oncological alertness and the need for clinical and laboratory examination of the patient using modern histological and immunohistochemical methods for studying the skin biopsy.

Highlights

According to the WHO-EORTC classification, primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma (SMPTCL) is a subtype of primary cutaneous peripheral T-cell lymphoma with an indolent course
SMPTCL must be differentiated from primary cutaneous B-cell lymphoma, cutaneous anaplastic CD30+ large-cell lymphoma, tumor stage of mycosis fungoides, pseudolymphoma, which results from differences in therapeutic approaches and prognoses of the diseases [1 - 3]
We describe a clinical case of common clinical manifestations and pathomorphological diagnosis of primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma

Summary

INTRODUCTION

According to the WHO-EORTC classification, primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma (SMPTCL) is a subtype of primary cutaneous peripheral T-cell lymphoma with an indolent course. We describe a clinical case of common clinical manifestations and pathomorphological diagnosis of primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma. A 70-year-old patient B. presented at the clinic of the Ural Research Institute of Dermatovenerology and Immunopathology with complaints about tumorlike formations on the skin of the face and back accompanied by moderate itching. Primary cutaneous CD4+ small/ medium-sized pleomorphic T-cell lymphoma in the practice of a dermatologist: A case report. Status localis: Rounded tumor-like formations are localized on the skin of the parietal region, forehead, temples and cheeks These formations represent tuberous-surfaced nodes and plaques, having sizes from 1.5 to 7 cm, densely elastic consistency, and clear boundaries with pink, pale-red and cyanotic shade, without peeling; they are painless on palpation. Morphological and immunohistochemical data, the patient was diagnosed with the primary cutaneous CD4+ small/mediumsized pleomorphic T-cell lymphoma (ICD-O code 9709/3).

Findings

DISCUSSION

CONCLUSION