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Primary cutaneous T‐cell lymphoproliferative disorder of donor origin after allogeneic haematopoietic stem‐cell transplantation
Author(s) -
SantosBriz A.,
Romo A.,
Antúnez P.,
Román C.,
Alcoceba M.,
Garcia J. L.,
Vazquez L.,
González M.,
Unamuno P.
Publication year - 2009
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2009.03509.x
Subject(s) - transplantation , pathology , lymphoproliferative disorders , hematopoietic stem cell transplantation , fluorescence in situ hybridization , lymphoma , medicine , gene rearrangement , stem cell , biopsy , biology , biochemistry , genetics , chromosome , gene
Summary A 56‐year‐old male patient had a history of mantle‐cell lymphoma, which was treated with polychemotherapy and reduced‐intensity conditioning allogeneic haematopoietic stem cell transplantation (ASCT) from his healthy sister with an identical human leucocyte antigen profile. Six years after transplantation, the patient developed asymptomatic eczema‐like cutaneous lesions. Histologically the lesions contained a dense superficial lichenoid infiltrate, mainly consisting of CD4+ atypical medium to large lymphocytes showing indented hyperchromatic nuclei. In situ hybridization for Epstein–Barr virus was negative. PCR amplification of the T‐cell receptor‐γ chain gene from several lesions revealed a monoclonal rearrangement without clonal variation. Two‐colour fluorescence in situ hybridization (X and Y chromosomes) and microsatellite genotyping were used to compare samples from the patient (transplant recipient), his sister (donor) and the skin biopsy sample, which confirmed that the origin of the neoplastic cells was the donor graft. To our knowledge, this is the first case of post‐transplant primary cutaneous T‐cell lymphoproliferative disorder after ASCT.