Cutaneous involvement in T-lymphoblastic lymphoma

• Published in: Annales de dermatologie et de vénéréologie 2017-04, Vol.144 (4), p.268-274
• Main Authors: Nascimbeni, C, Chantepie, S, Brugiere, C, Comoz, F, Salaun, V, Verneuil, L
• Format: Article
• Language: fre
• Subjects: Acute Kidney Injury - etiology; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone and Bones - pathology; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Humans; Immunophenotyping; Leukemic Infiltration - pathology; Lymph Nodes - pathology; Male; Mercaptopurine - administration & dosage; Methotrexate - administration & dosage; Organ Specificity; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - pathology; Prednisone - administration & dosage; Retroperitoneal Space; Skin - pathology; Vincristine - administration & dosage
• ISSN: 0151-9638
• DOI: 10.1016/j.annder.2017.01.001

Lymphoblastic lymphoma (LBL) is a rare form of non-Hodgkin's lymphoma (NHL). Cutaneous LBL is seen in less than 20% of patients. Herein, we report the case of a 66-year-old male patient without any previous disease history of note and who was presenting a gradually spreading tumoral lesion of the scalp, several purplish macules and nodules on the trunk, and a single spinal adenopathy. A thoracic-abdominal-pelvic CT scan performed for acute renal failure, revealed extensive infiltration of retroperitoneal tissue. Skin biopsies and staging tests indicated LBL-T with associated cutaneous, bone and lymph node retroperitoneal lesions with no mediastinal mass. After two months of treatment with CHOP (four courses), the cutaneous lesions and abdominal tumoral mass had regressed and renal function had returned to normal. There have been 13 reported cases of LBL with cutaneous involvement; most of these patients were young (under 30 years) and presented multiple cutaneous lesions (nodules or tumors) associated with numerous peripheral adenopathies, invasion of the bone marrow, and in many cases, a mediastinal mass. The clinical presentation of LBL-T in our case is novel on account of the cutaneous sites, associated with abdominal tumoral syndrome, without mediastinal infiltration, and with a single peripheral adenopathy, in an elderly subject.