Premium
A histo‐immunopathologic and prognostic study of erythrodermic cutaneous T‐cell lymphoma
Author(s) -
Vonderheid Eric C.,
Kantor Gary R.,
Telang Gladys H.,
Bujanouskas Paul,
Kadin Marshall E.
Publication year - 2019
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13564
Subject(s) - mycosis fungoides , pathology , lymphoma , cd8 , eosinophil , cutaneous t cell lymphoma , medicine , immunophenotyping , immunology , flow cytometry , immune system , asthma
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.