Primary cutaneous follicular helper T-cell lymphoma treated with allogeneic bone marrow transplantation: immunohistochemical comparison with angioimmunoblastic T-cell lymphoma

Acta Derm Venereol. 2014 Jan;94(1):54-7. doi: 10.2340/00015555-1626.

Abstract

Primary cutaneous follicular helper T (TFH)-cell lymphoma has recently been proposed, and is characterized by proliferation of malignant T cells expressing TFH-cell markers, such as CXCL13, accompanied by numerous reactive B cells. We report here a patient whose skin histology showed massive infiltration of both T and B cells, with a proliferation of arborizing high endothelial venules and follicular dendritic cells. Infiltrating T cells were positive for CXCL13, programmed death (PD)-1, inducible T-cell co-stimulator, and BCL-6. Southern blot analyses using DNA from the skin revealed monoclonality of both T and B cells. The patient had marked resistance to treatments, and complete remission was achieved only after allogeneic stem cell transplantation. The present case showed overlapping features with angio-immunoblastic T-cell lymphoma (AITL), although systemic symptoms were not observed. Further study is needed to define the criteria of this provisional entity, representing the cutaneous counterpart of the nodal follicular peripheral T-cell lymphoma or AITL.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Antigens, Surface / analysis
  • Bone Marrow Transplantation
  • Chemokine CXCL13 / analysis
  • Dendritic Cells, Follicular / chemistry
  • Endothelial Cells / chemistry
  • Female
  • Humans
  • Inducible T-Cell Co-Stimulator Protein / analysis
  • Lymphoma, T-Cell, Cutaneous / chemistry*
  • Lymphoma, T-Cell, Cutaneous / pathology*
  • Lymphoma, T-Cell, Cutaneous / therapy
  • Membrane Proteins / analysis
  • Programmed Cell Death 1 Receptor / analysis
  • Receptors, Complement 3d / analysis
  • Skin Neoplasms / chemistry*
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy
  • T-Lymphocytes, Helper-Inducer
  • Transplantation, Homologous
  • Venules / chemistry

Substances

  • Antigens, Surface
  • CXCL13 protein, human
  • Chemokine CXCL13
  • ICOS protein, human
  • Inducible T-Cell Co-Stimulator Protein
  • L-selectin counter-receptors
  • Membrane Proteins
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Receptors, Complement 3d