Non Hodgkin T cell lymphoma: an atypical clinical presentation Linfoma não Hodgkin de células T citotóxico: uma apresentação clínica atípica

• Main Authors: Paula Maio, Diogo Bento, Raquel Vieira, Ana Afonso, Fernanda Sachse, Heinz Kutzner
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Dermatologia 2013-04-01
• Series: Anais Brasileiros de Dermatologia
• Subjects: Citotoxicidade imunológica; Hanseníase; Linfoma cutâneo de células T; Polineuropatia paraneoplásica; Cytotoxicity, immunologic; Leprosy; Lymphoma, T-Cell, cutaneous; Paraneoplastic polyneuropathy
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962013000200264
• ISSN: 0365-0596; 1806-4841

Cytotoxic lymphomas comprise a spectrum of peripheral T-cell lymphomas that can have a initial or late cutaneous presentation. We describe a 46-year-old man from Cape Verde, with a dermatosis involving his face and trunk, consisting of monomorphic papules with a smooth surface and both motor and sensory polyneuropathy.The hypothesis of leprosy was supported by the clinical and initial hystopathological findings and the patient was referred to our hospital with suspected Hansen's disease. In the new skin and lymph node biopsies a lymphocyte population was identified whose immunohystochemistry study allowed the diagnosis of T-cell lymphoma with expression of cytotoxic markers. The patient was started on chemotherapy with initial remission of the skin lesions but, subsequently, progression of systemic disease.<br>Os linfomas citot&#243;xicos compreendem um espectro de linfomas de c&#233;lulas T perif&#233;ricos e linfomas Natural Killer que podem ter express&#227;o cut&#226;nea prim&#225;ria ou secund&#225;ria. Descrevemos o caso de um homem com 46 anos de idade, natural de Cabo Verde,com dermatose envolvendo a face e tronco constitu&#237;da por p&#225;pulas monomorfas superf&#237;cie lisa e polineuropatia sensitivo motora.A hip&#243;tese de Hansen&#237;ase foi colocada suportada por achados histopatol&#243;gicos sugestivos sendo o doente referenciado &#224; consulta de Doen&#231;a de Hansen do nosso hospital. Em biopsia de pele e de g&#226;nglio identificou-se prolifera&#231;&#227;o linfocit&#225;ria cujo estudo imunohistoqu&#237;mico permitiu o diagn&#243;stico de linfoma T com express&#227;o de marcadores citot&#243;xicos. Iniciou quimioterapia verificando-se inicialmente remiss&#227;o parcial das les&#245;es cut&#226;neas mas posteriormente a progress&#227;o da doen&#231;a sist&#233;mica.