Aggressive Epidermotropic CD8+ Cutaneous T cell lymphoma: Rare Variant of Cutaneous T cell lymphomas

Capt James A lovell Federal health care center, 3001 Green bay Road, N.Chicago.

Corresponding Author: Dhauna P Karam, Capt James A lovell Federal health care center, 3001 Green bay Road, N.Chicago.

 Tel: 224-610-5554; E-Mail: [email protected]

Received Date: 30 Jan 2017

Accepted Date: 28 Mar 2017

Published Date: 31 Mar 2017

Copyright © 2017 Karam DP

Citation: Karam DP, Hakim H, Al-Khafaji K, Purohit PM, et al. (2017). Aggressive Epidermotropic CD8+ Cutaneous T cell lymphoma: Rare Variant of Cutaneous T cell lymphomas. M J Immu. 1(1): 005.

ABSTRACT

Primary cutaneous aggressive epidermotropic CD8+ cytotoxic T cell lymphomas (AECTCL) are extremely rare of all cutaneous primary T cell lymphomas (PTCL) with less than 1% incidence. A 77 year old male presented to emergency department for evaluation of head to toe rash. He was bit by a wolf spider 5-6 weeks earlier. Patient woke up with spider biting him on his face. Few days later, he developed a maculopapular rash in chest, which failed to respond to OTC ointments. On examination, patient was vitally stable, skin exam revealed multiple confluent erythematous lesions and bullae in the face, neck, back, chest, and extremities. The lesions had central ulceration with necrosis. Punch biopsy of lesion revealed cutaneous aggressive epidermotropic CD8+ cytotoxic T cell lymphoma (AECTCL). Whole body CT/PET scan revealed multiple cutaneous based mass lesions associated with subcutaneous edematous changes. Immunohistochemistry was positive for CD3/CD8/Granzyme B, beta-F1 and TIA-1 further confirming the diagnosis. Patient was treated with gemcitabine for this aggressive variant of T-cell lymphoma. This case highlights a rare and atypical, aggressive variant of cutaneous T cell lymphomas. A constellation of clinical, histopathological, immunophenotypic features aided in our diagnosis.

KEYWORDS

Cutaneous Lymphoma; T Cell; CD8 + Cell; Systemic Chemotherapy; Gemcitabine; Punch Biopsy; Cytotoxicity; and Primary Cutaneous Aggressive Epidermotropic CD8+ Cytotoxic T Cell Lymphomas.