Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2015; 3(8): 727-731
Published online Aug 16, 2015. doi: 10.12998/wjcc.v3.i8.727
T-lymphoblastic lymphoma with cutaneous involvement
Emmanuelle Ginoux, Fanny Julia, Brigitte Balme, Luc Thomas, Stéphane Dalle
Emmanuelle Ginoux, Fanny Julia, Luc Thomas, Stéphane Dalle, Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69002 Lyon, France
Emmanuelle Ginoux, Fanny Julia, Luc Thomas, Stéphane Dalle, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
Brigitte Balme, Unit of Pathology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 69002 Lyon, France
Luc Thomas, Stéphane Dalle, Cancer Research Center of Lyon, 69002 Lyon, France
Author contributions: Ginoux E, Julia F and Dalle S designed the research; all the authors performed the research; Ginoux E and Dalle S drafted of manuscript; all the authors contrubited to the critical revision of the manuscript and important intellectual input; Dalle S supervised this study.
Supported by The grants from Lyon 1 University (to Thomas L), the Hospices Civils de Lyon.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Stéphane Dalle, MD, PhD, Professor, Department of Dermatology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 43 boulevard du 11 Novembre 1918, 69002 Lyon, France.
Telephone: +33-4-78863333 Fax: +33-4-78861329
Received: November 24, 2014
Peer-review started: November 26, 2014
First decision: January 20, 2015
Revised: February 6, 2015
Accepted: May 26, 2015
Article in press: May 27, 2015
Published online: August 16, 2015

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.

Keywords: Cutaneous lymphoma, Lymphoblastic lymphoma, Skin

Core tip: The clinical presentation of our patient with disseminated erythematic patches and infiltrated nodules suggested a diagnosis of cutaneous involvement of T-lymphoblastic lymphoma (T-LBL). Finally, histopathological examination of a skin biopsy with immunohistochemical study established the diagnosis of T-LBL. For accurate diagnosis, experienced histopathologists are needed. We wish to add this case to the current literature of T-LBL with cutaneous involvement, emphasizing the importance of a correct diagnosis and aggressive treatment.