T-lymphoblastic lymphoma with cutaneous involvement. 2015

Emmanuelle Ginoux, and Fanny Julia, and Brigitte Balme, and Luc Thomas, and Stéphane Dalle
Emmanuelle Ginoux, Fanny Julia, Luc Thomas, Stéphane Dalle, Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69002 Lyon, France.

To study dermatological manifestation of T-lymphoblastic lymphoma and to help clinicians in the diagnosis, we report here the case of a 75-year-old patient who presented with violaceous nodules acquired during the last 4 wk and affecting the scalp and right arm. The diagnosis of systemic lymphoma was suggested upon the appearance of cutaneous tumors, palpable lymph nodes and general symptoms including asthenia and weight-loss. The pathology features: positive immunostaining for CD3 and terminal deoxynucleotidyl transferase (TdT) and staging, led us to the final diagnosis of T-lymphoblastic lymphoma (T-LBL) with cutaneous involvement. He received a CHOP regimen as first-line treatment. Unfortunately, the patient relapsed and died 8 mo after the treatment initiation. T-LBL may be diagnosed by skin lesions. Additional immunostaining including TdT and experienced histopathologists are needed to correctly classify this aggressive disease and discuss the correct management including bone-marrow transplantation where appropriate.

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