Clinicopathologic characterization of cutaneous adult T-cell leukemia/lymphoma: A single tertiary care center experience in the United States.

Autor:	Modi MB; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US.; Loyola University Chicago Stritch School of Medicine, Maywood, IL, US., Kiszluk A; Loyola University Chicago Stritch School of Medicine, Maywood, IL, US., Chai JN; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US., Edema U; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US., Ma MY; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US., Sica RA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US., Wang Y; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US., Shi Y; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, US.
Jazyk:	angličtina
Zdroj:	American journal of clinical pathology [Am J Clin Pathol] 2024 Feb 01; Vol. 161 (2), pp. 140-148.
DOI:	10.1093/ajcp/aqad120
Abstrakt:	Objectives: Adult T-cell leukemia/lymphoma (ATLL) is a rare aggressive T-cell leukemia/lymphoma associated with human T lymphotropic virus type 1 infection. The patients might present with skin rash before, at, or after the diagnosis. The dermatopathologic finding might be diagnostically very challenging. Methods: We retrospectively identified 110 patients with ATLL at a single institution in a 19-year period, with 19 patients having skin biopsies. Clinical, dermatopathologic, immunophenotypic, and molecular findings were studied. Results: The cohort included 13 skin-first (5 acute, 5 lymphomatous, 2 chronic, 1 smoldering), 6 skin-second (4 acute, 1 lymphomatous, 1 smoldering), and 91 patients without skin biopsy. Some nonphotoprotected areas of body such as the forearm and lower lip were also seen. Skin manifestations included papular (5), erythroderma (1), nodulotumoral (3), plaques (1), patches (1), and a combination of skin rashes (2). Histopathologic findings included large pleomorphic cells, angiocentrism, epidermal infiltration with large Pautrier-like microabscesses, and folliculotropism. Fifteen (78.9%) cases showed CD4+/CD7-/CD25+. Next-generation sequencing study was conducted on 5 patients using either blood or bone marrow samples, revealing multiple genetic mutations across multiple signaling pathways. Conclusions: Pleomorphic large, atypical cells with CD4+/CD25+/CD7- immunophenotype from a non-"bathing trunk" location, especially in a patient from endemic regions, raise suspicion for ATLL. T-cell receptor gene rearrangement is almost always positive, and the neoplasm usually demonstrates multiple mutations by next-generation sequencing study. (© The Author(s) 2023. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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