Difference between revisions of "HAEM5:Primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder"

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(Ahmed Eladely, MBBCh. Andrew Siref, MD.)
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==Epidemiology / Prevalence==
 
==Epidemiology / Prevalence==
  
uncommon disease accounting for < 1% of all primary cutaneous lymphomas. The disease predominates in male with M:F ratio of 2:1. The median age is 56 years. No pediatric cases are reported till now.<ref>{{Cite journal|last=Tjahjono|first=Leonardo A.|last2=Davis|first2=Mark D. P.|last3=Witzig|first3=Thomas E.|last4=Comfere|first4=Nneka I.|date=2019-09|title=Primary Cutaneous Acral CD8+ T-Cell Lymphoma-A Single Center Review of 3 Cases and Recent Literature Review|url=https://pubmed.ncbi.nlm.nih.gov/31433793/|journal=The American Journal of Dermatopathology|volume=41|issue=9|pages=644–648|doi=10.1097/DAD.0000000000001366|issn=1533-0311|pmid=31433793}}</ref>
+
Uncommon disease accounting for < 1% of all primary cutaneous lymphomas. The disease predominates in male with M:F ratio of 2:1. The median age is 56 years. No pediatric cases are reported till now.<ref>{{Cite journal|last=Tjahjono|first=Leonardo A.|last2=Davis|first2=Mark D. P.|last3=Witzig|first3=Thomas E.|last4=Comfere|first4=Nneka I.|date=2019-09|title=Primary Cutaneous Acral CD8+ T-Cell Lymphoma-A Single Center Review of 3 Cases and Recent Literature Review|url=https://pubmed.ncbi.nlm.nih.gov/31433793/|journal=The American Journal of Dermatopathology|volume=41|issue=9|pages=644–648|doi=10.1097/DAD.0000000000001366|issn=1533-0311|pmid=31433793}}</ref>
  
 
==Clinical Features==
 
==Clinical Features==
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|-
 
|-
 
|Negative
 
|Negative
|CD4, CD56, CD30, Perforin, Granzyme B, PD1, TdT, EBV
+
|CD4, CD56, CD30, Perforin, Granzyme B, PD1, TdT, EBV (always negative)
 
|}
 
|}
 
One reported case with CD8+, CD4+ phenotype. <ref>{{Cite journal|last=Toberer|first=Ferdinand|last2=Christopoulos|first2=Petros|last3=Lasitschka|first3=Felix|last4=Enk|first4=Alexander|last5=Haenssle|first5=Holger A.|last6=Cerroni|first6=Lorenzo|date=2019-03|title=Double-positive CD8/CD4 primary cutaneous acral T-cell lymphoma|url=https://pubmed.ncbi.nlm.nih.gov/30552698/|journal=Journal of Cutaneous Pathology|volume=46|issue=3|pages=231–233|doi=10.1111/cup.13403|issn=1600-0560|pmid=30552698}}</ref>
 
One reported case with CD8+, CD4+ phenotype. <ref>{{Cite journal|last=Toberer|first=Ferdinand|last2=Christopoulos|first2=Petros|last3=Lasitschka|first3=Felix|last4=Enk|first4=Alexander|last5=Haenssle|first5=Holger A.|last6=Cerroni|first6=Lorenzo|date=2019-03|title=Double-positive CD8/CD4 primary cutaneous acral T-cell lymphoma|url=https://pubmed.ncbi.nlm.nih.gov/30552698/|journal=Journal of Cutaneous Pathology|volume=46|issue=3|pages=231–233|doi=10.1111/cup.13403|issn=1600-0560|pmid=30552698}}</ref>
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==Chromosomal Rearrangements (Gene Fusions)==
 
==Chromosomal Rearrangements (Gene Fusions)==
  
None.
+
Chromosomal rearrangements contributing to tumor formation have not yet been described.
 
==Individual Region Genomic Gain / Loss / LOH==
 
==Individual Region Genomic Gain / Loss / LOH==
  
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Includes aberrations not involving gene fusions. Can include references in the table. Can refer to CGC workgroup tables as linked on the homepage if applicable.'') </span>
+
Individual region genomic gain, loss or LOH contributing to tumor formation have not yet been described
 
 
{| class="wikitable sortable"
 
|-
 
!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
 
|-
 
|EXAMPLE
 
 
 
7
 
|EXAMPLE Loss
 
|EXAMPLE
 
 
 
chr7:1- 159,335,973 [hg38]
 
|EXAMPLE
 
 
 
chr7
 
|Yes
 
|Yes
 
|No
 
|EXAMPLE
 
 
 
Presence of monosomy 7 (or 7q deletion) is sufficient for a diagnosis of AML with MDS-related changes when there is ≥20% blasts and no prior therapy (add reference).  Monosomy 7/7q deletion is associated with a poor prognosis in AML (add reference).
 
|-
 
|EXAMPLE
 
 
 
8
 
|EXAMPLE Gain
 
|EXAMPLE
 
 
 
chr8:1-145,138,636 [hg38]
 
|EXAMPLE
 
 
 
chr8
 
|No
 
|No
 
|No
 
|EXAMPLE
 
 
 
Common recurrent secondary finding for t(8;21) (add reference).
 
|}
 
 
==Characteristic Chromosomal Patterns==
 
==Characteristic Chromosomal Patterns==
  
Put your text here <span style="color:#0070C0">(''EXAMPLE PATTERNS: hyperdiploid; gain of odd number chromosomes including typically chromosome 1, 3, 5, 7, 11, and 17; co-deletion of 1p and 19q; complex karyotypes without characteristic genetic findings; chromothripsis'')</span>
+
Characteristic chromosomal patterns contributing to tumor formation have not yet been described
 
 
{| class="wikitable sortable"
 
|-
 
!Chromosomal Pattern
 
!Diagnostic Significance (Yes, No or Unknown)
 
!Prognostic Significance (Yes, No or Unknown)
 
!Therapeutic Significance (Yes, No or Unknown)
 
!Notes
 
|-
 
|EXAMPLE
 
 
 
Co-deletion of 1p and 18q
 
|Yes
 
|No
 
|No
 
|EXAMPLE:
 
 
 
See chromosomal rearrangements table as this pattern is due to an unbalanced derivative translocation associated with oligodendroglioma (add reference).
 
|}
 
 
==Gene Mutations (SNV / INDEL)==
 
==Gene Mutations (SNV / INDEL)==
  
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: This table is not meant to be an exhaustive list; please include only genes/alterations that are recurrent and common as well either disease defining and/or clinically significant. Can include references in the table. For clinical significance, denote associations with FDA-approved therapy (not an extensive list of applicable drugs) and NCCN or other national guidelines if applicable; Can also refer to CGC workgroup tables as linked on the homepage if applicable as well as any high impact papers or reviews of gene mutations in this entity.'') </span>
+
Gene mutations contributing to tumor formation have not yet been described
 
 
{| class="wikitable sortable"
 
|-
 
!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
 
|-
 
|EXAMPLE: TP53; Variable LOF mutations
 
 
 
EXAMPLE:
 
 
 
EGFR; Exon 20 mutations
 
 
 
EXAMPLE: BRAF; Activating mutations
 
|EXAMPLE: TSG
 
|EXAMPLE: 20% (COSMIC)
 
 
 
EXAMPLE: 30% (add Reference)
 
|EXAMPLE: IDH1 R123H
 
|EXAMPLE: EGFR amplification
 
|
 
|
 
|
 
|EXAMPLE:  Excludes hairy cell leukemia (HCL) (add reference).
 
<br />
 
|}
 
Note: A more extensive list of mutations can be found in cBioportal (https://www.cbioportal.org/), COSMIC (https://cancer.sanger.ac.uk/cosmic), ICGC (https://dcc.icgc.org/) and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.
 
  
 
==Epigenomic Alterations==
 
==Epigenomic Alterations==
  
Put your text here
+
Epigenomic alterations contributing to tumor formation have not yet been described
  
 
==Genes and Main Pathways Involved==
 
==Genes and Main Pathways Involved==
  
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Can include references in the table.'')</span>
+
Gene mutations contributing to tumor formation have not yet been described
{| class="wikitable sortable"
 
|-
 
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome
 
|-
 
|EXAMPLE: BRAF and MAP2K1; Activating mutations
 
|EXAMPLE: MAPK signaling
 
|EXAMPLE: Increased cell growth and proliferation
 
|-
 
|EXAMPLE: CDKN2A; Inactivating mutations
 
|EXAMPLE: Cell cycle regulation
 
|EXAMPLE: Unregulated cell division
 
|-
 
|EXAMPLE:  KMT2C and ARID1A; Inactivating mutations
 
|EXAMPLE:  Histone modification, chromatin remodeling
 
|EXAMPLE:  Abnormal gene expression program
 
|}
 
 
==Genetic Diagnostic Testing Methods==
 
==Genetic Diagnostic Testing Methods==
  
Put your text here
+
In nearly all cases, the neoplastic T cells exhibit clonal rearrangements of TR (TCR) genes.<ref name=":2">{{Cite journal|last=Kempf|first=Werner|last2=Petrella|first2=Tony|last3=Willemze|first3=Rein|last4=Jansen|first4=Patty|last5=Berti|first5=Emilio|last6=Santucci|first6=Marco|last7=Geissinger|first7=Eva|last8=Cerroni|first8=Lorenzo|last9=Maubec|first9=Eve|date=2022-05|title=Clinical, histopathological and prognostic features of primary cutaneous acral CD8+ T-cell lymphoma and other dermal CD8+ cutaneous lymphoproliferations: results of an EORTC Cutaneous Lymphoma Group workshop|url=https://pubmed.ncbi.nlm.nih.gov/34988968/|journal=The British Journal of Dermatology|volume=186|issue=5|pages=887–897|doi=10.1111/bjd.20973|issn=1365-2133|pmid=34988968}}</ref>
  
 
==Familial Forms==
 
==Familial Forms==
  
Put your text here <span style="color:#0070C0">(''Instructions: Include associated hereditary conditions/syndromes that cause this entity or are caused by this entity.'') </span>
+
None.
  
 
==Additional Information==
 
==Additional Information==
  
Put your text here
+
The tumor generally has an excellent prognosis, with no reported fatal outcomes. Complete remission following surgical excision or local radiation therapy is common. Recurrence after treatment is possible, more frequently in younger patients, and can occasionally occur at other cutaneous sites. Dissemination to extracutaneous sites has been reported in only one case.<ref name=":2" /><ref>{{Cite journal|last=Alberti-Violetti|first=Silvia|last2=Fanoni|first2=Daniele|last3=Provasi|first3=Matteo|last4=Corti|first4=Laura|last5=Venegoni|first5=Luigia|last6=Berti|first6=Emilio|date=2017-11|title=Primary cutaneous acral CD8 positive T-cell lymphoma with extra-cutaneous involvement: A long-standing case with an unexpected progression|url=https://pubmed.ncbi.nlm.nih.gov/28796362/|journal=Journal of Cutaneous Pathology|volume=44|issue=11|pages=964–968|doi=10.1111/cup.13020|issn=1600-0560|pmid=28796362}}</ref>
  
 
==Links==
 
==Links==

Revision as of 16:59, 5 July 2024


Haematolymphoid Tumours (5th ed.)

(General Instructions – The main focus of these pages is the clinically significant genetic alterations in each disease type. Use HUGO-approved gene names and symbols (italicized when appropriate), HGVS-based nomenclature for variants, as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples). Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see Author_Instructions and FAQs as well as contact your Associate Editor or Technical Support)

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 acral CD8-positive T-cell lymphoproliferative disorder

Cancer Sub-Classification / Subtype

None

Definition / Description of Disease

Primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder is a rare type of lymphoproliferative disorder characterized by slow-growing papules and nodules primarily affecting acral sites such as the ears with benign clinical course. [1]

Synonyms / Terminology

None

Epidemiology / Prevalence

Uncommon disease accounting for < 1% of all primary cutaneous lymphomas. The disease predominates in male with M:F ratio of 2:1. The median age is 56 years. No pediatric cases are reported till now.[2]

Clinical Features

Put your text here and fill in the table (Instruction: Can include references in the table)

Signs and Symptoms Cutaneous, slowly progressive papule or nodule

Solitary or multiple (rare) [1] [3] [4]

Laboratory Findings None

Sites of Involvement

Ears (the commonest), nose, and feet.

Rare sites: Leg, trunk, genital, and eyelid.[1][4] [5]

Morphologic Features

On H&E, the tumor is dense, monotonous dermal proliferation of atypical medium-sized lymphocytes. Lymphocytes have irregular and frequently folded nuclei with fine chromatin and moderate nuclear pleomorphism. [6]A perivascular pattern maybe seen (less common).

Usually epidermis is pared, but focal minimal epidermotropism and focal folliculotropism may be seen. Grenz zone separates epidermis from the dermal infiltrate in one third of cases. The proliferation may extend into the subcutis.

Absent or low mitotic activity. Absent or few Plasma cells, histiocytes, neutrophils, and eosinophils.[1][7]

Immunophenotype

Put your text here and fill in the table (Instruction: Can include references in the table)

Finding Marker
Positive CD3, CD8, βF1+, TIA1, CD99
Positive (Golgi dot-like) CD68
Ki-67/MIB1 <10%
Negative ( or Weak) CD2, CD5, CD7
Negative CD4, CD56, CD30, Perforin, Granzyme B, PD1, TdT, EBV (always negative)

One reported case with CD8+, CD4+ phenotype. [8]

Few reported cases had high proliferation index.[9]

The Golgi dot-like staining pattern of CD68 in tumor cells is unique to this entity.[10]

Chromosomal Rearrangements (Gene Fusions)

Chromosomal rearrangements contributing to tumor formation have not yet been described.

Individual Region Genomic Gain / Loss / LOH

Individual region genomic gain, loss or LOH contributing to tumor formation have not yet been described

Characteristic Chromosomal Patterns

Characteristic chromosomal patterns contributing to tumor formation have not yet been described

Gene Mutations (SNV / INDEL)

Gene mutations contributing to tumor formation have not yet been described

Epigenomic Alterations

Epigenomic alterations contributing to tumor formation have not yet been described

Genes and Main Pathways Involved

Gene mutations contributing to tumor formation have not yet been described

Genetic Diagnostic Testing Methods

In nearly all cases, the neoplastic T cells exhibit clonal rearrangements of TR (TCR) genes.[11]

Familial Forms

None.

Additional Information

The tumor generally has an excellent prognosis, with no reported fatal outcomes. Complete remission following surgical excision or local radiation therapy is common. Recurrence after treatment is possible, more frequently in younger patients, and can occasionally occur at other cutaneous sites. Dissemination to extracutaneous sites has been reported in only one case.[11][12]

Links

Put your text placeholder here (or anywhere appropriate on the page) and use the "Link" icon at the top of the page (Instructions: Once you have a text placeholder entered to which you want to add a link, highlight that text, select the "Link" icon at the top of the page, and search the name of the internal page to which you want to link this text, or enter an external internet address including the "http://www." portion.)

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. 1.0 1.1 1.2 1.3 Greenblatt, Danielle; et al. (2013-02). "Indolent CD8(+) lymphoid proliferation of acral sites: a clinicopathologic study of six patients with some atypical features". Journal of Cutaneous Pathology. 40 (2): 248–258. doi:10.1111/cup.12045. ISSN 1600-0560. PMID 23189944. Check date values in: |date= (help)
  2. Tjahjono, Leonardo A.; et al. (2019-09). "Primary Cutaneous Acral CD8+ T-Cell Lymphoma-A Single Center Review of 3 Cases and Recent Literature Review". The American Journal of Dermatopathology. 41 (9): 644–648. doi:10.1097/DAD.0000000000001366. ISSN 1533-0311. PMID 31433793. Check date values in: |date= (help)
  3. Beltraminelli, Helmut; et al. (2010-01). "Indolent CD8+ lymphoid proliferation of the ear: a phenotypic variant of the small-medium pleomorphic cutaneous T-cell lymphoma?". Journal of Cutaneous Pathology. 37 (1): 81–84. doi:10.1111/j.1600-0560.2009.01278.x. ISSN 1600-0560. PMID 19602068. Check date values in: |date= (help)
  4. 4.0 4.1 Kempf, Werner; et al. (2013-04). "Primary cutaneous CD8(+) small- to medium-sized lymphoproliferative disorder in extrafacial sites: clinicopathologic features and concept on their classification". The American Journal of Dermatopathology. 35 (2): 159–166. doi:10.1097/DAD.0b013e31825c3a33. ISSN 1533-0311. PMID 22885550. Check date values in: |date= (help)
  5. Hagen, Joshua W.; et al. (2014-02). "Indolent CD8+ lymphoid proliferation of the face with eyelid involvement". The American Journal of Dermatopathology. 36 (2): 137–141. doi:10.1097/DAD.0b013e318297f7fd. ISSN 1533-0311. PMID 24556898. Check date values in: |date= (help)
  6. Petrella, Tony; et al. (2007-12). "Indolent CD8-positive lymphoid proliferation of the ear: a distinct primary cutaneous T-cell lymphoma?". The American Journal of Surgical Pathology. 31 (12): 1887–1892. doi:10.1097/PAS.0b013e318068b527. ISSN 0147-5185. PMID 18043044. Check date values in: |date= (help)
  7. Butsch, Florian; et al. (2012-03). "Bilateral indolent epidermotropic CD8-positive lymphoid proliferations of the ear". Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology: JDDG. 10 (3): 195–196. doi:10.1111/j.1610-0387.2011.07859.x. ISSN 1610-0387. PMID 22142195. Check date values in: |date= (help)
  8. Toberer, Ferdinand; et al. (2019-03). "Double-positive CD8/CD4 primary cutaneous acral T-cell lymphoma". Journal of Cutaneous Pathology. 46 (3): 231–233. doi:10.1111/cup.13403. ISSN 1600-0560. PMID 30552698. Check date values in: |date= (help)
  9. Swick, Brian L.; et al. (2011-02). "Indolent CD8+ lymphoid proliferation of the ear: report of two cases and review of the literature". Journal of Cutaneous Pathology. 38 (2): 209–215. doi:10.1111/j.1600-0560.2010.01647.x. ISSN 1600-0560. PMID 21083681. Check date values in: |date= (help)
  10. Wobser, M.; et al. (2015-06). "CD68 expression is a discriminative feature of indolent cutaneous CD8-positive lymphoid proliferation and distinguishes this lymphoma subtype from other CD8-positive cutaneous lymphomas". The British Journal of Dermatology. 172 (6): 1573–1580. doi:10.1111/bjd.13628. ISSN 1365-2133. PMID 25524664. Check date values in: |date= (help)
  11. 11.0 11.1 Kempf, Werner; et al. (2022-05). "Clinical, histopathological and prognostic features of primary cutaneous acral CD8+ T-cell lymphoma and other dermal CD8+ cutaneous lymphoproliferations: results of an EORTC Cutaneous Lymphoma Group workshop". The British Journal of Dermatology. 186 (5): 887–897. doi:10.1111/bjd.20973. ISSN 1365-2133. PMID 34988968 Check |pmid= value (help). Check date values in: |date= (help)
  12. Alberti-Violetti, Silvia; et al. (2017-11). "Primary cutaneous acral CD8 positive T-cell lymphoma with extra-cutaneous involvement: A long-standing case with an unexpected progression". Journal of Cutaneous Pathology. 44 (11): 964–968. doi:10.1111/cup.13020. ISSN 1600-0560. PMID 28796362. Check date values in: |date= (help)

EXAMPLE Book

  1. 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 acral CD8-positive T-cell lymphoproliferative disorder”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated 07/5/2024, https://ccga.io/index.php/HAEM5:Primary_cutaneous_acral_CD8-positive_T-cell_lymphoproliferative_disorder.