Acquisition of CD30 and CD15 accompanied with simultaneous loss of all pan-T-cell antigens in a case of histological transformation of mycosis fungoides with involvement of regional lymph node: an immunophenotypic alteration resembling classical Hodgkin lymphoma

Am J Dermatopathol. 2015 Mar;37(3):249-53. doi: 10.1097/DAD.0b013e31828cf3d3.

Abstract

: Acquired expression of CD30 is frequently noted in histological transformation of mycosis fungoides (MF), but simultaneous gain of CD15 accompanied with loss of pan-T-cell antigens are extremely rare. We report an unusual case of transformed MF with such an immunophenotypic alteration resembling classical Hodgkin lymphoma. The patient was an 81-year-old male with MF, who was initially treated with topical steroids and phototherapy. Despite the initial response, the patient developed a tumor-like skin lesion that was confirmed to be CD30-positive large T-cell lymphoma and was subsequently found to have a regional lymph node involvement by pleomorphic large cell lymphoma. Besides CD30, pleomorphic large cells were positive for CD15 but negative for all B cell- and T cell-specific antigens. Epstein-Barr virus was negative. Polymerase chain reaction-based assays demonstrated a clonal rearrangement of T-cell receptor gamma gene but detected no B-cell clone. The mechanism and clinical significance of this phenotypic conversion remains to be elucidated.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Biomarkers, Tumor / analysis
  • Cell Transformation, Neoplastic / pathology*
  • Fucosyltransferases / biosynthesis
  • Hodgkin Disease / pathology*
  • Humans
  • Immunophenotyping
  • Ki-1 Antigen / biosynthesis
  • Lewis X Antigen / biosynthesis
  • Lymphoma, Primary Cutaneous Anaplastic Large Cell / pathology
  • Male
  • Mycosis Fungoides / pathology*
  • Skin Diseases / pathology*

Substances

  • Biomarkers, Tumor
  • Ki-1 Antigen
  • Lewis X Antigen
  • FUT4 protein, human
  • Fucosyltransferases