Adult T-cell leukemia/lymphoma (ATL) presenting in the skin: Clinical, histological and immunohistochemical features of 52 cases

Figures & data

Figure 1.  A patient of Africa descent with diffuse erythema and scaling (smoldering ATL).

Table I.  Demographic, clinical and histological features of the 52 cases of adult T-cell leukemia/lymphoma with cutaneous presentation.

Age (mean)	50.4 (range, 9–86)
Age ≤ 18 years	3 (6.5%)
Male:female ratio	1.3:1
Race
African descent	46 (88.5%)
White	6 (11.5%)
Association with HAM/TSP	10 (19.0%)
History of severe eczema in childhood	12/32 (37.5%)
Clinical types
Smoldering	22 (42.3%)
Acute	8 (15.4%)
Lymphomatous	5 (9.6%)
Chronic	12 (23.1%)
Primary cutaneous tumoral	5 (9.6%)
Histological patterns
Peripheral T-cell lymphoma, unspecified	31 (59.6%)
Mycosis fungoides	19 (36.5%)
Anaplastic large cell lymphoma	2 (3.9%)

Figure 2.  Mycosis fungoides pattern. Infiltration of atypical lymphocytes in the upper dermis with epidermotropism and Pautrier abscesses (HE, ×160).

Figure 3.  Peripheral Tcell lymphoma, unspecified pattern. Patient with primary cutaneous tumoral ATL. Medium and large cells infiltrating the dermis with Pautrier's abscesses (HE, ×100). Insert: Pleomorphic cells in greater magnification (HE, ×650).

Figure 4.  Anaplastic largecell lymphoma pattern. Large lymphoid cells with abundant and eosinophilic cytoplasm and anaplastic nuclei (HE, ×200). Insert: CD30+ cells (×200).

Figure 5.  Epithelioid and multinucleated giant cells admixed with neoplastic cells (HE, ×250).

Figure 6.  Survival curves in cases with primary and secondary skin involvement.