Fatal case of primary cutaneous aggressive T-cell lymphoma switching from a CD4+ to a CD8+ phenotype: Progressive disease with bexarotene and romidepsin treatment

William T. Johnson, Rebecca J. Leeman-Neill, Parth Patel, Jonhan Ho, Lisa M. Grandinetti, Jaroslaw Jedrych, Fiona E. Craig

Research output: Contribution to journalArticle

Abstract

A 77-year-old white male presented to the clinic with two isolated cutaneous tumors on his forehead. A cutaneous biopsy showed a focally folliculotropic CD4+ cutaneous lymphoma. The tumors were irradiated with a complete response, and he was started on oral bexarotene. He experienced localized cutaneous relapse 3 months into treatment. These new tumors now revealed a surprisingly CD8+ cytotoxic phenotype, but with the same clone. A systemic workup was negative. His regimen was switched to romidepsin, and he was treated with local radiation again. Another 3.5 months passed in remission until he developed widespread cutaneous tumors. Positron emission tomography/computed tomography revealed multifocal systemic disease involving his diaphragm, liver, distal duodenum, proximal jejunum, anterior chest wall including pectoral muscles, and lungs without significant adenopathy. He died a few days later. Given his full clinical and pathological course, he was given the diagnosis of an aggressive primary cutaneous T-cell lymphoma, unspecified.

Original languageEnglish (US)
Pages (from-to)832-837
Number of pages6
JournalAmerican Journal of Dermatopathology
Volume38
Issue number11
DOIs
StatePublished - Nov 1 2016
Externally publishedYes

Keywords

  • CD8 cutaneous T-cell lymphoma
  • Primary cutaneous aggressive epidermotropic CD8 T-cell lymphoma
  • cytotoxic cutaneous T-cell lymphoma
  • primary cutaneous peripheral T-cell lymphoma
  • unspecified

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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