Tags

Type your tag names separated by a space and hit enter

Lymph node involvement by mycosis fungoides and Sézary syndrome mimicking angioimmunoblastic T-cell lymphoma.
Hum Pathol 2015; 46(9):1382-9HP

Abstract

Clinical management of cutaneous T-cell lymphoma (CTCL) and angioimmunoblastic T-cell lymphoma (AITL) differs markedly. Diagnostic distinction is critical. Herein, we describe a series of 4 patients with clinically, molecularly, and histopathologically annotated mycosis fungoides or Sézary syndrome whose nodal disease mimicked AITL. The patients otherwise exhibited classic clinical manifestations of mycosis fungoides/Sézary syndrome preceding the onset of lymphadenopathy by 1 to 5 years. Skin biopsies revealed epidermotropic infiltrates characteristic of CTCL. Lymph node biopsies revealed dense CD4+ T-cell infiltrates that coexpressed follicular helper T-cell markers and were accompanied by proliferations of high endothelial venules and arborizing CD21+ follicular dendritic cell networks. Two patients had T-cell receptor gene rearrangement studies performed on their skin, lymph node, and peripheral blood demonstrating identical polymerase chain reaction clones in all 3 tissues. A small secondary clonal B-cell population was present in 1 patient that mimicked the B-cell proliferations known to accompany AITL and persisted on successive nodal biopsies over several years. This latter phenomenon has not previously been described in CTCL. The potential for patients to be misdiagnosed with AITL for lack of consideration of advanced-stage CTCL with nodal involvement underscores the necessity of information sharing among the various pathologists and clinicians involved in the care of each patient.

Authors+Show Affiliations

Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305.Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305.Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305.Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305. Electronic address: ditag@stanford.edu.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26193796

Citation

LeBlanc, Robert E., et al. "Lymph Node Involvement By Mycosis Fungoides and Sézary Syndrome Mimicking Angioimmunoblastic T-cell Lymphoma." Human Pathology, vol. 46, no. 9, 2015, pp. 1382-9.
LeBlanc RE, Lefterova MI, Suarez CJ, et al. Lymph node involvement by mycosis fungoides and Sézary syndrome mimicking angioimmunoblastic T-cell lymphoma. Hum Pathol. 2015;46(9):1382-9.
LeBlanc, R. E., Lefterova, M. I., Suarez, C. J., Tavallaee, M., Kim, Y. H., Schrijver, I., ... Gratzinger, D. (2015). Lymph node involvement by mycosis fungoides and Sézary syndrome mimicking angioimmunoblastic T-cell lymphoma. Human Pathology, 46(9), pp. 1382-9. doi:10.1016/j.humpath.2015.05.024.
LeBlanc RE, et al. Lymph Node Involvement By Mycosis Fungoides and Sézary Syndrome Mimicking Angioimmunoblastic T-cell Lymphoma. Hum Pathol. 2015;46(9):1382-9. PubMed PMID: 26193796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymph node involvement by mycosis fungoides and Sézary syndrome mimicking angioimmunoblastic T-cell lymphoma. AU - LeBlanc,Robert E, AU - Lefterova,Martina I, AU - Suarez,Carlos J, AU - Tavallaee,Mahkam, AU - Kim,Youn H, AU - Schrijver,Iris, AU - Kim,Jinah, AU - Gratzinger,Dita, Y1 - 2015/06/10/ PY - 2015/03/16/received PY - 2015/05/28/revised PY - 2015/05/29/accepted PY - 2015/7/22/entrez PY - 2015/7/22/pubmed PY - 2015/11/17/medline KW - Angioimmunoblastic T-cell lymphoma KW - Clinicopathologic correlation KW - Cutaneous T-cell lymphoma KW - Mycosis fungoides KW - Sézary syndrome KW - T-cell receptor gene rearrangement SP - 1382 EP - 9 JF - Human pathology JO - Hum. Pathol. VL - 46 IS - 9 N2 - Clinical management of cutaneous T-cell lymphoma (CTCL) and angioimmunoblastic T-cell lymphoma (AITL) differs markedly. Diagnostic distinction is critical. Herein, we describe a series of 4 patients with clinically, molecularly, and histopathologically annotated mycosis fungoides or Sézary syndrome whose nodal disease mimicked AITL. The patients otherwise exhibited classic clinical manifestations of mycosis fungoides/Sézary syndrome preceding the onset of lymphadenopathy by 1 to 5 years. Skin biopsies revealed epidermotropic infiltrates characteristic of CTCL. Lymph node biopsies revealed dense CD4+ T-cell infiltrates that coexpressed follicular helper T-cell markers and were accompanied by proliferations of high endothelial venules and arborizing CD21+ follicular dendritic cell networks. Two patients had T-cell receptor gene rearrangement studies performed on their skin, lymph node, and peripheral blood demonstrating identical polymerase chain reaction clones in all 3 tissues. A small secondary clonal B-cell population was present in 1 patient that mimicked the B-cell proliferations known to accompany AITL and persisted on successive nodal biopsies over several years. This latter phenomenon has not previously been described in CTCL. The potential for patients to be misdiagnosed with AITL for lack of consideration of advanced-stage CTCL with nodal involvement underscores the necessity of information sharing among the various pathologists and clinicians involved in the care of each patient. SN - 1532-8392 UR - https://www.unboundmedicine.com/medline/citation/26193796/Lymph_node_involvement_by_mycosis_fungoides_and_Sézary_syndrome_mimicking_angioimmunoblastic_T_cell_lymphoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0046-8177(15)00200-2 DB - PRIME DP - Unbound Medicine ER -