Abstract

A 66 year old woman with a recently treated primary cutaneous acral CD8+ T-cell lymphoma (PCATCL) on the nose and no evidence of systemic disease, complained of a new foot lesion of several months’ duration. Physical examination revealed a painless brown nodule and basal cell carcinoma was suspected. The biopsy showed a perivascular and band like infiltrate of monomorphous small hyperchromatic lymphocytes. The lymphocytes expanded the dermal papillae without epidermotropism, expressed CD3 and CD8, and were negative for CD4 and CD20. These findings were compatible with PCATCL. In 2016 PCATCL was added to the WHO classification of lymphoid neoplasms as a provisional entity. It has an indolent behavior with papules, nodules, or plaques commonly appearing on the ears, face, or legs. Only a few cases of multifocal or symmetrically bilateral PCATCL have been previously described [1,2]. Despite this multifocality, systemic disease progression has not been observed in such cases. Our case adds to the body of knowledge about this rare cutaneous lymphoma. It is essential to differentiate between PCATCL and the more aggressive CD8+ lymphomas to avoid excessive treatment. 1. Greenblatt D, Ally M, Child F, Scarisbrick J, Whittaker S, Morris S, Calonje E, Petrella T, Robson A. Indolent CD8(+) lymphoid proliferation of acral sites: a clinicopathologic study of six patients with some atypical features. J Cutan Pathol. 2013 Feb;40(2):248-58. doi: 10.1111/cup.12045. Epub 2012 Nov 29. PMID: 23189944. 2. Kluk J, Kai A, Koch D, Taibjee SM, O'Connor S, Persic M, Morris S, Whittaker S, Cerroni L, Kempf W, Petrella T, Robson A. Indolent CD8-positive lymphoid proliferation of acral sites: three further cases of a rare entity and an update on a unique patient. J Cutan Pathol. 2016 Feb;43(2):125-36. doi: 10.1111/cup.12633. Epub 2015 Nov 13. PMID: 26423705.

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