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High-Scatter Lymphocytes in the Blood of Erythrodermic Cutaneous T-Cell Lymphoma: Evidence for Large-Cell
Eric C Vonderheid1, Jennifer Jakubowski2, J Steve Hou2
1Department of Oncology, Sydney Kimmel Cancer Center, Johns Hopkins Medical Institutes, Baltimore, MD.
Background:
Erythrodermic cutaneous T-cell lymphoma consists of erythrodermic mycosis fungoides and Sézary syndrome. Previous studies have indicated that very large Sézary cells (> 14 μm diameter) or the presence of aneuploid cells in the blood might reflect large-cell transformation, with a corresponding poor prognosis.
Patients And Methods:
A retrospective study assessed data between June 1997 and April 2002 of 32 patients with erythrodermic cutaneous T-cell lymphoma, 4 patients with leukemic mycosis fungoides, and 19 patients with nonneoplastic inflammatory conditions who were referred for evaluation of possible cutaneous T-cell lymphoma. Data were studied by 2-parameter flow cytometry gated on the lymphocyte population.
Results:
High-scatter T lymphocytes (HSL) were detected in initial blood samples from 10 of 19 patients with Sézary syndrome, 1 of 13 patients with erythrodermic mycosis fungoides, and no patient with nonneoplastic inflammatory conditions. A significant correlation was found between HSL and very large Sézary cells and histopathologic evidence of large-cell transformation. Moreover, the presence of HSL suggests a poor prognosis even for patients with advanced disease.
Conclusion:
We propose that HSL are often large transformed neoplastic Sézary cells that may be detected in patients with clinically unapparent large-cell transformation.
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