A histo-immunopathologic and prognostic study of erythrodermic cutaneous T-cell lymphoma.

Autor: Vonderheid EC; Sydney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutes, Baltimore, Maryland., Kantor GR; Dermatopathologist, Dermpath Diagnostics, Institute for Dermatopathology, Newtown Square, Pennsylvania., Telang GH; Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island., Bujanouskas P; Mid-Atlantic Permanente Medical Group, Falls Church, Virginia., Kadin ME; Department of Dermatology, Boston University and Roger Williams Medical Center, Providence, Rhode Island.
Jazyk: angličtina
Zdroj: Journal of cutaneous pathology [J Cutan Pathol] 2019 Dec; Vol. 46 (12), pp. 913-924. Date of Electronic Publication: 2019 Sep 04.
DOI: 10.1111/cup.13564
Abstrakt: Background: Sézary syndrome (SS) and erythrodermic mycosis fungoides (E-MF) represent two expressions of erythrodermic cutaneous T-cell lymphoma (E-CTCL).
Methods: Histopathologic features were compared on skin specimens from 41 patients with SS and 70 patients with E-MF. Immunopathologic findings were compared on 42 SS and 79 E-MF specimens.
Results: Specimens of SS usually showed band-like dermal infiltrates with intermediate-sized lymphoid cells and few plasma cells; on the other hand E-MF more often had a perivascular infiltrative pattern, predominance of small/mixed lymphoid cells and eosinophils. SS also had lower numbers of CD8+ cells and higher numbers of CD62L+ cells compared to E-MF. For E-MF patients, the presence of large Pautrier collections, infiltrates with intermediate-sized cells, increased number of mitotic figures and ≥50% CD62L+ cells in the dermal infiltrate correlated with a relatively poor disease-specific survival. However, only the presence of mitotic figures retained prognostic significance with clinical stage as a covariate.
Conclusions: Clinical stage provides the most important prognostic information for patients with E-CTCL. However, mitotic activity for E-MF and CD8+ cells <20% for SS have additional value. We hypothesize that observed differences in plasma cell and eosinophil numbers may reflect the influence of CD62L+ central memory T-cells in the microenvironment.
(© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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