Lymphomatoid papulosis associated with mycosis fungoides: clinicopathological and molecular studies of 12 cases.

The association of mycosis fungoides and a primary cutaneous CD30+ lymphoproliferative disorder has been reported and probably represents different clinical aspects of a unique T-cell monoclonal expansion. In this study, 12 patients (6 men and 6 women) presented with lymphomatoid papulosis and mycosis fungoides. A TCRgamma gene rearrangement study was performed by an automated high-resolution PCR fragment analysis method on skin biopsy specimens taken from the different clinical lesions in each patient. An indolent clinical course was observed in the majority of patients. T-cell clonality was identified in 7 of 12 lymphomatoid papulosis lesions (58%) and in 6 skin biopsies of plaque stage mycosis fungoides (50%). In each individual case, where T-cell clonality was detected, both mycosis fungoides and lymphomatoid papulosis specimens exhibited an identical peak pattern by automated high-resolution PCR fragment analysis, confirming a common clonal origin. Only one case showed a clonal TCRgamma rearrangement from the lymphomatoid papulosis lesion, which could not be demonstrated in the mycosis fungoides specimen. The demonstration of an identical clone seems to confirm that both disorders are different clinical manifestations of a unique T-cell monoclonal proliferation. Our results also seem to confirm that the association of mycosis fungoides with a primary cutaneous CD30+ lymphoproliferative disorder usually carries a favourable prognosis.

[1]  J. Zehnder,et al.  Lymphomatoid papulosis associated with mycosis fungoides: a study of 21 patients including analyses for clonality. , 2003, Journal of the American Academy of Dermatology.

[2]  C. Klemke,et al.  Common clonal T‐cell origin in a patient with T‐prolymphocytic leukaemia and associated cutaneous T‐cell lymphomas , 2003, British journal of haematology.

[3]  H. Stein,et al.  Single-cell analysis of CD30+ cells in lymphomatoid papulosis demonstrates a common clonal T-cell origin. , 2002, Blood.

[4]  S. Chang,et al.  Coexistence of CD30‐positive anaplastic large cell lymphoma and mycosis fungoides , 2002, Clinical and experimental dermatology.

[5]  D. Hossfeld.  E.S. Jaffe, N.L. Harris, H. Stein, J.W. Vardiman (eds). World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues , 2002 .

[6]  E. Berg,et al.  World Health Organization Classification of Tumours , 2002 .

[7]  GARY S. Woody.  Analysis of Clonality in Cutaneous T Cell Lymphoma and Associated Diseases , 2001 .

[8]  G. Wood.  Analysis of clonality in cutaneous T cell lymphoma and associated diseases. , 2001, Annals of the New York Academy of Sciences.

[9]  Jee-ho Choi,et al.  A Case of Mycosis Fungoides after CD30 Positive Anaplastic Large Cell Lymphoma , 2000, The Journal of dermatology.

[10]  C. Meijer,et al.  Primary and secondary cutaneous CD30+lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment , 2000 .

[11]  M. Kadin,et al.  Lymphomatoid papulosis and anaplastic large cell lymphomas of the skin. , 2000, Seminars in cutaneous medicine and surgery.

[12]  C. Hsieh,et al.  Increased risk of lymphoid and nonlymphoid malignancies in patients with lymphomatoid papulosis , 1999, Cancer.

[13]  H. Stein,et al.  Clonal T‐cell receptor γ‐chain gene rearrangement by PCR‐based GeneScan analysis in advanced cutaneous T‐cell lymphoma: a critical evaluation , 1999, The Journal of pathology.

[14]  S. Whittaker,et al.  Lymphomatoid papulosis in association with mycosis fungoides: a study of 15 cases , 1998, The British journal of dermatology.

[15]  H. Kerl,et al.  EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer. , 1997, Blood.

[16]  T. Ise,et al.  A Case of Ki‐1 Positive Anaplastic Large Cell Lymphoma Transformed from Mycosis Fungoides , 1996, The Journal of dermatology.

[17]  R. Russell Jones,et al.  Mycosis fungoides with spontaneously regressing CD30‐positive tumorous lesions , 1996, Clinical and experimental dermatology.

[18]  P. Leboit.  Lymphomatoid papulosis and cutaneous CD30+ lymphoma. , 1996, The American Journal of dermatopathology.

[19]  A. Chott,et al.  The dominant T cell clone is present in multiple regressing skin lesions and associated T cell lymphomas of patients with lymphomatoid papulosis. , 1996, The Journal of investigative dermatology.

[20]  G. Wood,et al.  Lymphomatoid papulosis and associated cutaneous lymphoproliferative disorders exhibit a common clonal origin. , 1995, The Journal of investigative dermatology.

[21]  D. Weisenburger,et al.  Lymphomatoid Papulosis: A T-Cell Dyscrasia with a Propensity To Transform into Malignant Lymphoma , 1995, Annals of Internal Medicine.

[22]  E. Jaffe,et al.  Lymphomatoid papulosis associated with Ki‐1‐positive anaplastic large cell lymphoma. A report of two cases and a review of the literature , 1994, Cancer.

[23]  E. Berti,et al.  Heteroduplex analysis of T-cell receptor gamma gene rearrangements for diagnosis and monitoring of cutaneous T-cell lymphomas. , 1994, Blood.

[24]  M. Pittelkow,et al.  Lymphomatoid papulosis: a clinical and histopathologic review of 53 cases with leukocyte immunophenotyping, DNA flow cytometry, and T-cell receptor gene rearrangement studies. , 1994, Journal of the American Academy of Dermatology.

[25]  J. Bertino,et al.  Molecular evidence for a clonal relationship between lymphomatoid papulosis and Ki-1 positive large cell anaplastic lymphoma. , 1993, Journal of dermatological science.

[26]  R. Warnke,et al.  Transformation of mycosis fungoides: T-cell receptor beta gene analysis demonstrates a common clonal origin for plaque-type mycosis fungoides and CD30+ large-cell lymphoma. , 1993, The Journal of investigative dermatology.

[27]  P. Leboit,et al.  Lymphomatoid papulosis followed by Hodgkin's lymphoma. Differential response to therapy. , 1993, Archives of dermatology.

[28]  R. Willemze,et al.  The prognosis of patients with lymphomatoid papulosis associated with malignant lymphomas , 1992, The British journal of dermatology.

[29]  C. Morton,et al.  Hodgkin's disease, lymphomatoid papulosis, and cutaneous T-cell lymphoma derived from a common T-cell clone. , 1992, The New England journal of medicine.

[30]  M. Kadin.  Lymphomatoid papulosis, Ki-1+ lymphoma, and primary cutaneous Hodgkin's disease. , 1991, Seminars in dermatology.

[31]  L. Luzzatto,et al.  Analysis of β, γ, and δ T-cell receptor genes in lymphomatoid papulosis: Cellular basis of two distinct histologic subsets , 1991 .

[32]  H. Stein,et al.  Lymphomatoid papulosis followed by large‐cell lymphoma: immunophenotypical and genotypical analysis , 1991, The British journal of dermatology.

[33]  H. Stein,et al.  Hodgkin's disease followed by lymphomatoid papulosis. Immunophenotypic evidence for a close relationship between lymphomatoid papulosis and Hodgkin's disease. , 1990, Journal of the American Academy of Dermatology.

[34]  M. Kadin.  The spectrum of Ki-1+ cutaneous lymphomas. , 1990, Current problems in dermatology.

[35]  D. Weisenburger,et al.  Lymphomatoid papulosis and progression to T cell lymphoma: an immunophenotypic and genotypic analysis. , 1989, Journal of the American Academy of Dermatology.

[36]  M. Kadin.  The Spectrum of Ki-1+ Cutaneous Lymphomas1 , 1989 .

[37]  R. Warnke,et al.  Clonal T-cell populations in lymphomatoid papulosis. Evidence of a lymphoproliferative origin for a clinically benign disease. , 1986, The New England journal of medicine.

[38]  N. Fenske,et al.  Lymphomatoid papulosis: a premalignant T cell disorder. , 1985, Journal of the American Academy of Dermatology.

[39]  M. Kadin.  COMMON ACTIVATED HELPER-T-CELL ORIGIN FOR LYMPHOMATOID PAPULOSIS, MYCOSIS FUNGOIDES, AND SOME TYPES OF HODGKIN'S DISEASE , 1985, The Lancet.

[40]  J. Larsen,et al.  Lymphomatoid papulosis. Development into cutaneous T-cell lymphoma. , 1985, Archives of dermatology.

[41]  N. Jonsson,et al.  Transient lymphomatoid papulosis in mycosis fungoides. , 1982, Acta dermato-venereologica.