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A Rare Case of Primary Cutaneous Gamma-Delta T-cell Lymphoma with Aberrant B-cell Marker Expression
Apoorva Trivedi1, Mariko Yabe2, Ahmet Dogan2
1Dermatopathology Service, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Insights
This study reports an extremely rare case of primary cutaneous gamma-delta T-cell lymphoma (PCGDTL) with aberrant B-cell marker expression. This finding challenges current diagnostic criteria for this rare skin lymphoma.
Area of Science:
- Oncology
- Dermatology
- Immunology
Background:
- Primary cutaneous gamma-delta T-cell lymphoma (PCGDTL) is a rare and diagnostically challenging skin lymphoma.
- Accurate diagnosis is crucial for appropriate patient management and prognosis.
Observation:
- A 78-year-old man presented with nonhealing nodules on his right posterior calf.
- Initial biopsy revealed atypical lymphoid infiltrate with gamma-delta and cytotoxic T-cell immunophenotypes, suggesting PCGDTL.
Findings:
- Concurrent flow cytometry unexpectedly showed expression of aberrant B-cell markers (CD19, cytoplasmic CD79a).
- Subsequent immunohistochemical studies confirmed these aberrant B-cell markers.
- This represents the first formally reported case of aberrant B-cell marker expression in PCGDTL.
Implications:
- This case highlights the diagnostic complexities of PCGDTL.
- It suggests potential B-cell lineage infidelity or co-expression in rare T-cell lymphomas.
- Further research is needed to understand the mechanisms and clinical significance of aberrant marker expression in PCGDTL.
Abstract:
Primary cutaneous gamma-delta T-cell lymphoma (PCGDTL) is a rare and diagnostically challenging primary skin lymphoma. We present a case of a 78-year-old otherwise healthy man who developed nonhealing nodules on his right posterior calf. Initial biopsy showed a dense, atypical, lymphoid infiltrate with gamma-delta and cytotoxic T-cell immunophenotypes. The diagnosis of PCGDTL was rendered; however, concurrent flow cytometry revealed expression of aberrant B-cell markers, including CD19 and cytoplasmic CD79a. Subsequent immunohistochemical studies corroborated this result. We report the extremely rare phenomenon of aberrant B-cell marker expression in PCGDTL, the first formally reported case to our knowledge.
