Case 152 - Discussion

Uploaded: 2007-11-28, Updated: 2007-11-28

CD3

CD4

CD5 CD7
CD8 CD20
CD79a Ki67
   

TCR GENE REARRANGEMENT

Two clonal T-cell receptor gamma chain gene rearrangements are detected by DNA amplification using primers to the J gamma 1 & 2 and J gamma P 1 & 2 gene segments.

 

DIAGNOSIS:

         CUTANEOUS T-CELL LYMPHOMA

     

COMMENT

Examination of the H & E stained slides reveals extensive atypical lymphoid infiltration in the dermis with occasional atypical lymphocytes in the epidermis.  The lymphocytes range from small to large in size with irregular nuclear contour. Many large lymphocytes have open chromatin and prominent nucleoli. Frequent mitotic figures are present.  The lymphocytes are predominately CD4+ T-cells with loss of CD7 expression.  90% of the lymphocytes are positive for Ki-67. The above features suggest an aggressive course and may represent high grade transformation of patient's known mycosis fungoides.