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Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
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Cutaneous T-cell lymphoma occurring with a melanocytic proliferation, masquerading as a nonhealing ulcer with

William A Kanner1, Kevin P White, Catherine I Barry

  • 1Department of Pathology, University of Virginia Health System, Charlottesville, VA 22908-0214, USA. wk3g@virginia.edu

Journal of Cutaneous Pathology
|December 17, 2009
PubMed

Insights

This case study describes a rare occurrence of peripheral T-cell lymphoma (PTCL) alongside an intradermal melanocytic nevus. The simultaneous presence of these two distinct neoplasms in a scalp lesion highlights unusual dermatopathology findings.

Area of Science:

  • Dermatopathology
  • Oncology
  • Hematopathology

Background:

  • Lymphoproliferative disorders and melanocytic lesions are challenging diagnostic areas in dermatopathology.
  • Co-occurrence of distinct neoplasms presents diagnostic complexities.

Purpose of the Study:

  • To report a unique case of peripheral T-cell lymphoma (PTCL) coexisting with an intradermal melanocytic proliferation.
  • To discuss the diagnostic implications of encountering two separate neoplasms in a single patient presentation.

Main Methods:

  • Histopathological examination of scalp biopsies.
  • Immunohistochemical staining for T-cell markers (CD3, CD45RO, CD43, CD5, CD7, CD4, CD8, CD56, CD57) and melanocytic markers (S100, Melan-A).
  • Molecular studies including T-cell receptor gamma chain gene rearrangement analysis.

Main Results:

  • Biopsies revealed a peripheral T-cell lymphoma, unspecified, characterized by small to intermediate angulated cells with specific immunophenotype (positive for CD3, CD45RO, CD43; decreased CD5, CD7; absent CD4, CD8, CD56, CD57, EBV) and clonal T-cell receptor gamma rearrangement.
  • A separate biopsy identified a melanocytic nevus with enlarged cells positive for S100 and Melan-A, embedded within the same lymphocytic infiltrate.

Conclusions:

  • The case represents an extraordinary coincidence of two distinct neoplasms: peripheral T-cell lymphoma and a melanocytic nevus.
  • This presentation underscores the importance of comprehensive evaluation in complex dermatopathology cases, even when seemingly distinct entities are identified.

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