European Journal of Dermatology


Clinicopathological aspects of HTLV-1 positive and negative cutaneous T-cell lymphoma Volume 7, issue 4, June 1997


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Department of Pathology and Internal Medicine, School of Medicine, Federal University of Bahia, Brazil.

The clinico-pathological and immunohistochemical features of 17 cases of HTLV-1+ cutaneous T-cell lymphoma (CTCL) are compared with 17 cases of HTLV-1– CTCL. All patients were from the same geographical area in Northeastern Brazil, an area endemic for HTLV-1+ infection. In all patients, cutaneous lesions were the first clinical manifestation of disease. In both the HTLV-1+ and the HTLV-1– groups, 12 patients had pleomorphic lymphoma and 5 had mycosis fungoides (MF). Clinical subtypes in the HTLV-1+ group included five cases of acute, two cases of chronic, nine cases of smoldering and one case of lymphoma type adult T-cell leukemia/lymphoma (ATL). A few clinical differences were noticed between the two groups: a marked predominance of black, mulatto and male subjects, a more aggressive course and a higher frequency of erythroderma and disseminated skin lesions in the HTLV-1+ patients. However, around 40% of the HTLV-1+ patients had an indolent course of disease with an evolution of up to 20 years. No specific histopathological features that could allow a distinction between HTLV-1+ and HTLV-1– lymphomas were found. No significant differences were observed between the two groups concerning the intensity of cellular pleomorphism, cellular size, epidermotropism, frequency and size of Pautrier’s abscesses, fibrosis of the papillary derma, and eosinophilic infiltrate. In two HTLV-1+ lymphomas, atypical multinucleated giant cells were present. Considering the present knowledge concerning ATL and CTCL, it seems more appropriate to designate CTCL as HTLV-1+ or HTLV-1– and morphologically as pleomorphic, MF, large cell anaplastic lymphoma or other histological types. The use of the terminology, cutaneous type of ATL, is confusing since there are HTLV-1+ cutaneous lymphomas with clinical and histological features distinctly different from ATL.