CD8+ aggressive T-cell lymphoma (T-NHL) involving the liver and skin: a case study Article Swipe
Norlinah Mohamed Ibrahim
,
W Wang
,
Udit Naik
,
A Abu Qubo
,
Hongguang Zhu
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/ajcp/aqad150.170
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/ajcp/aqad150.170
Introduction/Objective Aggressive T-NHL involving cutaneous and visceral organs is rare. We report a case with a complex presentation that was found to have hepatic and skin lesions simultaneously. We emphasize the importance of the clinicopathological correlation and diagnostic work-up for such a rare case Methods/Case Report A 60-year-old male with alcoholic cirrhosis presented with abdominal pain, fever, and night sweats for over two weeks. Detailed physical evaluation revealed a tender, indurated, erythematous papule on the left upper back. Lab results showed leukopenia, anemia, and increased LDH. PET-CT showed multiple hypermetabolic lesions in the liver, skin, and deep soft tissue above and below the diaphragm. A liver biopsy revealed a diffuse sheath of large atypical lymphoid cells with small lymphocytes in the background. Atypical lymphoid cells stained positive for CD45, CD2, CD3, CD8, TIA-1, CD5 (partial), granzyme B (partial), βF1 (partial); and negative for ALK, BCL-2, CD4, CD7, CD10, CD30, CD56, and TCRδ. Ki-67 was 70%. The skin punch biopsy revealed epidermotropic infiltration of lymphocytes with a similar immunophenotype as the liver lesion. Bone marrow biopsy showed no involvement. The differential diagnosis includes primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-NHL with visceral dissemination, peripheral CD8+ T-NHL, lymphomatoid papulosis, CD8-positive mycosis fungoides, and hepatosplenic T-NHL. The visceral involvement excludes lymphomatoid papulosis and CD8-positive mycosis fungoides. The absence of bone marrow involvement excludes hepatosplenic T-NHL. The prominent liver involvement favors the diagnosis of peripheral CD8+ T-NHL. However CD8+ aggressive epidermotropic cytotoxic T-NHL still cannot be entirely excluded due to the epidermotropic CD8 positive T-cell infiltration of the dermis and subcutaneous adipose tissue. Further evaluation for JAK2 mutation and TBX21 amplification can help distinguish it from Peripheral CD8- positive T-NHL. Results (if a Case Study enter NA) NA Conclusion The subclassification of CD8+ T-NHL into distinct entities with overlapping clinical and histological characteristics is challenging without molecular tests. However, clinicopathological correlation with appropriate work-up can help narrow the differential diagnoses.
Related Topics
Concepts
Medicine
Pathology
Mycosis fungoides
Lymphoma
Immunophenotyping
Lymphomatoid papulosis
Skin biopsy
Liver biopsy
Biopsy
Atypical Lymphocyte
CD8
CD5
CD30
Immunology
Antigen
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ajcp/aqad150.170
- https://academic.oup.com/ajcp/article-pdf/160/Supplement_1/S76/53934520/aqad150.170.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4389122051
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4389122051Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ajcp/aqad150.170Digital Object Identifier
- Title
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CD8+ aggressive T-cell lymphoma (T-NHL) involving the liver and skin: a case studyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-01Full publication date if available
- Authors
-
Norlinah Mohamed Ibrahim, W Wang, Udit Naik, A Abu Qubo, Hongguang ZhuList of authors in order
- Landing page
-
https://doi.org/10.1093/ajcp/aqad150.170Publisher landing page
- PDF URL
-
https://academic.oup.com/ajcp/article-pdf/160/Supplement_1/S76/53934520/aqad150.170.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/ajcp/article-pdf/160/Supplement_1/S76/53934520/aqad150.170.pdfDirect OA link when available
- Concepts
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Medicine, Pathology, Mycosis fungoides, Lymphoma, Immunophenotyping, Lymphomatoid papulosis, Skin biopsy, Liver biopsy, Biopsy, Atypical Lymphocyte, CD8, CD5, CD30, Immunology, AntigenTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| primary_location.source.host_organization_lineage | https://openalex.org/P4310311648, https://openalex.org/P4310311647 |
| primary_location.source.host_organization_lineage_names | Oxford University Press, University of Oxford |
| primary_location.license | |
| primary_location.pdf_url | https://academic.oup.com/ajcp/article-pdf/160/Supplement_1/S76/53934520/aqad150.170.pdf |
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| primary_location.is_published | True |
| primary_location.raw_source_name | American Journal of Clinical Pathology |
| primary_location.landing_page_url | https://doi.org/10.1093/ajcp/aqad150.170 |
| publication_date | 2023-11-01 |
| publication_year | 2023 |
| referenced_works_count | 0 |
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