Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma
Haematolymphoid Tumours (5th ed.)
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Primary Author(s)*
Ahmed Eladely, MBBCh. Andrew Siref, MD.
Creighton University, Omaha, NE.
Cancer Category / Type
Book | WHO Classification of Disease - Haematolymphoid Tumours (5th ed.) |
---|---|
Category | T-cell and NK-cell lymphoid proliferations and lymphomas |
Family | Mature T-cell and NK-cell neoplasms |
Type | Primary cutaneous T-cell lymphoid proliferations and lymphomas |
Subtype | Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma |
Cancer Sub-Classification / Subtype
None
Definition / Description of Disease
Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma (PCAETL) is a rare and poorly characterized neoplastic proliferation of T lymphocytes with CD8 expression and cytotoxic molecules. PACETL is marked by epidermal necrosis, a high proliferation index, and aggressive clinical behavior. It should be distinguished from other rare epidermotropic subtypes of cutaneous gamma-delta T-cell lymphomas (such as gamma-delta mycosis fungoides), CD8+ mycosis fungoides, localized pagetoid reticulosis, type D lymphomatoid papulosis and Woringer-Kolopp disease.[1][2][3]
Synonyms / Terminology
Ketron–Goodman, disseminated pagetoid reticulosis, Berti lymphoma (Historical)
Epidemiology / Prevalence
PCAETL is rare, comprising less than 1% of all cutaneous T-cell lymphomas. It typically occurs in adults and shows a predilection for males.[1][3]
Clinical Features
Signs and Symptoms | Localized papules (less common)
Diffusely distributed papules (common) Ulcerated nodules, tumors, and plaques Erosion or central necrosis Preceded by chronic, poorly defined patches (subset) Disseminate to visceral sites (lungs, testes, CNS) Lymph nodes spared |
Laboratory Findings | None |
Sites of Involvement
PACETL can present with either localized or generalized skin lesions and may affect oral mucosa.[4]
Morphologic Features
Put your text here
Immunophenotype
Put your text here and fill in the table (Instruction: Can include references in the table)
Finding | Marker |
---|---|
Positive (universal) | EXAMPLE CD1 |
Positive (subset) | EXAMPLE CD2 |
Negative (universal) | EXAMPLE CD3 |
Negative (subset) | EXAMPLE CD4 |
Chromosomal Rearrangements (Gene Fusions)
Chromosomal Rearrangement | Genes in Fusion (5’ or 3’ Segments) | Pathogenic Derivative | Prevalence | Diagnostic Significance (Yes, No or Unknown) | Prognostic Significance (Yes, No or Unknown) | Therapeutic Significance (Yes, No or Unknown) | Notes |
---|---|---|---|---|---|---|---|
JAK2 fusions | KHDRBS1-JAK2, PCM1-JAK2, TFG-JAK2 | Self-oligo/dimerization of JAK2 | Detected in 3 out of 12 patients | Yes | Unknown | Yes | Confer cytokine-independent survival ability, potential therapeutic target with JAK inhibitors.[5] |
Individual Region Genomic Gain / Loss / LOH
Chr # | Gain / Loss / Amp / LOH | Minimal Region Genomic Coordinates [Genome Build] | Minimal Region Cytoband | Diagnostic Significance (Yes, No or Unknown) | Prognostic Significance (Yes, No or Unknown) | Therapeutic Significance (Yes, No or Unknown) | Notes |
---|---|---|---|---|---|---|---|
1p | Deletion | 1p | Yes | Unknown | No | Associated with chromatin remodeling and tumor suppression. | |
8p | Deletion | 8p | Yes | Unknown | No | Common in fusion-negative cases.[5] |
Characteristic Chromosomal Patterns
Chromosomal Pattern | Diagnostic Significance (Yes, No or Unknown) | Prognostic Significance (Yes, No or Unknown) | Therapeutic Significance (Yes, No or Unknown) | Notes |
---|---|---|---|---|
Deletions within 1p, 8p, 9q, 10p, 11q and 13q; gains within 7q, 8q, 17q and 21q | Yes | Unknown | Unknown | Identified in fusion-negative cases.[5] |
Gene Mutations (SNV / INDEL)
Gene; Genetic Alteration | Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other) | Prevalence (COSMIC / TCGA / Other) | Concomitant Mutations | Mutually Exclusive Mutations | Diagnostic Significance (Yes, No or Unknown) | Prognostic Significance (Yes, No or Unknown) | Therapeutic Significance (Yes, No or Unknown) | Notes |
---|---|---|---|---|---|---|---|---|
JAK2
Fusion genes: KHDRBS1-JAK2, PCM1-JAK2, TFG-JAK2 |
Self-oligo/dimerization | Detected in 3 out of 12 patients | MYC fusions | PTPRC, SH2B3 | Yes | Unknown | Yes | Potential therapeutic target with JAK inhibitors.[5] |
Epigenomic Alterations
Unknown
Genes and Main Pathways Involved
Gene; Genetic Alteration | Pathway | Pathophysiologic Outcome |
---|---|---|
JAK2;Fusion with KHDRBS1, PCM1, TFG | JAK-STAT signaling | Upregulation leads to cytokine-independent activation. |
SH2B3;Deletion | JAK-STAT negative regulation | Loss leads to hyperactivation of JAK2 signaling.[5] |
Genetic Diagnostic Testing Methods
JAK2 by Next-generation sequencing (NGS). SH2B3 by PCR or FISH.[5]
Familial Forms
Unknown
Additional Information
Links
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References
(use the "Cite" icon at the top of the page) (Instructions: Add each reference into the text above by clicking on where you want to insert the reference, selecting the “Cite” icon at the top of the page, and using the “Automatic” tab option to search such as by PMID to select the reference to insert. The reference list in this section will be automatically generated and sorted. If a PMID is not available, such as for a book, please use the “Cite” icon, select “Manual” and then “Basic Form”, and include the entire reference.)
- ↑ 1.0 1.1 1.2 Berti, E.; et al. (1999-08). "Primary cutaneous CD8-positive epidermotropic cytotoxic T cell lymphomas. A distinct clinicopathological entity with an aggressive clinical behavior". The American Journal of Pathology. 155 (2): 483–492. doi:10.1016/S0002-9440(10)65144-9. ISSN 0002-9440. PMC 1866866. PMID 10433941. Check date values in:
|date=
(help) - ↑ 2.0 2.1 Guitart, Joan; et al. (2017-05). "Primary cutaneous aggressive epidermotropic cytotoxic T-cell lymphomas: reappraisal of a provisional entity in the 2016 WHO classification of cutaneous lymphomas". Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc. 30 (5): 761–772. doi:10.1038/modpathol.2016.240. ISSN 1530-0285. PMC 5413429. PMID 28128277. Check date values in:
|date=
(help) - ↑ 3.0 3.1 3.2 Robson, Alistair; et al. (2015-10). "Aggressive epidermotropic cutaneous CD8+ lymphoma: a cutaneous lymphoma with distinct clinical and pathological features. Report of an EORTC Cutaneous Lymphoma Task Force Workshop". Histopathology. 67 (4): 425–441. doi:10.1111/his.12371. ISSN 1365-2559. PMID 24438036. Check date values in:
|date=
(help) - ↑ Travassos, Daphine Caxias; et al. (2022-06). "Primary cutaneous CD8+ cytotoxic T-cell lymphoma of the face with intraoral involvement, resulting in facial nerve palsy after chemotherapy". Journal of Cutaneous Pathology. 49 (6): 560–564. doi:10.1111/cup.14199. ISSN 1600-0560. PMID 35001425 Check
|pmid=
value (help). Check date values in:|date=
(help) - ↑ 5.0 5.1 5.2 5.3 5.4 5.5 Bastidas Torres, Armando N.; et al. (2022-03-01). "Deregulation of JAK2 signaling underlies primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma". Haematologica. 107 (3): 702–714. doi:10.3324/haematol.2020.274506. ISSN 1592-8721. PMC 8883537 Check
|pmc=
value (help). PMID 33792220 Check|pmid=
value (help).
EXAMPLE Book
- Arber DA, et al., (2017). Acute myeloid leukaemia with recurrent genetic abnormalities, in World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, and Siebert R, Editors. IARC Press: Lyon, France, p129-171.
Notes
*Primary authors will typically be those that initially create and complete the content of a page. If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage). Additional global feedback or concerns are also welcome. *Citation of this Page: “Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated 07/13/2024, https://ccga.io/index.php/HAEM5:Primary_cutaneous_CD8-positive_aggressive_epidermotropic_cytotoxic_T-cell_lymphoma.