Folliculotropic T‐cell infiltrates associated with B‐cell chronic lymphocytic leukaemia or MALT lymphoma may reveal either true mycosis fungoides or pseudolymphomatous reaction: seven cases and review of the literature. (19th March 2014)

• Record Type: Journal Article
• Authors: Ingen‐Housz‐Oro, S.; Franck, N.; Beneton, N.; Fauconneau, A.; Do‐Pham, G.; Carlotti, A.; Petit, T.; Liolios, I.; Bara, C.; Carpentier, H.; Storelli, D.; Prophette, B.; Garderet, L.; Haioun, C.; Petit, E.; Delfau‐Larue, M.‐H.; Vergier, B.; Chosidow, O.; Beylot‐Barry, M.; Ortonne, N.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 29:Number 1(2015:Jan.)
• Page Start: 77
• Page End: 85
• Publication Date: 2014-03-19
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12454
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" id="jdv12454-abs-0001"> <title>Abstract</title> <sec id="jdv12454-sec-0001" sec-type="section"> <title>Background</title> <p>Mycosis fungoides (MF) and pseudo‐MF (or MF simulant) can be associated with B‐cell malignancies, but distinction between a true neoplasm and a reactive process may be difficult.</p> </sec> <sec id="jdv12454-sec-0002" sec-type="section"> <title>Objectives</title> <p>To report seven patients with B‐cell malignancy and folliculotropic MF or pseudo‐MF and emphasize on criteria allowing distinction between the two conditions.</p> </sec> <sec id="jdv12454-sec-0003" sec-type="section"> <title>Methods</title> <p>We retrospectively and prospectively included seven patients with B‐cell malignancy who presented skin lesions histologically consisting in a folliculotropic T‐cell infiltrate and reviewed the literature on the topic.</p> </sec> <sec id="jdv12454-sec-0004" sec-type="section"> <title>Results</title> <p>Four men and three women had a chronic lymphocytic leukaemia (<italic>n</italic> = 6) or a MALT‐type lymphoma (<italic>n</italic> = 1). Five patients had localized papules, and two had patches and plaques. Histological examination showed in all cases a diffuse dermal T‐cell infiltrate with folliculotropic involvement and follicular mucinosis associated with clusters of the B‐cell lymphoma, without significant expression of follicular helper T‐cell markers. T‐cell rearrangement studies showed a polyclonal pattern in the patients with papules and a monoclonal pattern in the cases of patches and plaques. Papular lesions had an indolent evolution, whereas patches and plaques persisted or worsened into transformed MF.</p> </sec> <sec id="jdv12454-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Folliculotropic T‐cell infiltrates associated with B‐cell malignancies can be either a true folliculotropic MF or a pseudo‐MF. The distinction between both conditions cannot rely only on the histopathological aspect, but needs both a clinical pathological correlation and the search for a dominant T‐cell clone. Whether the neoplastic T and B cells derive from a common ancestor or the T‐cell proliferation is promoted by the underlying B‐cell lymphoma remains unsolved, but interaction between B and T cell in the skin does not appear to be dependent on a TFH differentiation of the T‐cell infiltrate.</p> </sec> </abstract>