Marrow Involvement in Cutaneous T-Cell Lymphoma: A Clinicopathologic Study of 60 Cases
- 1 December 1989
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Clinical Pathology
- Vol. 92 (6) , 747-754
- https://doi.org/10.1093/ajcp/92.6.747
Abstract
Cutaneous T-cell lymphomas (CTCLs), including Sézary syndrome, are generally assumed to spare the marrow until the disease is far advanced. The authors reviewed marrow sections from 60 patients with CTCL, looking carefully for aggregates of cere-briform cells, and found marrow involvement in 13 patients (21.7%); another 19 had abnormal lymphoid nodules that were not diagnostic of involvement, and 28 had marrows with negative results. Involved marrows had nodules or infiltrates of dysplastic cerebriform cells that were often subtle, without a significant increase in cellularity; only one case showed massive involvement. Patients with CTCL with an infiltrative component of marrow involvement had associated peripheral blood involvement (eight of eight), generalized erythroderma (six of eight), lymph node involvement (five of eight), visceral progression (five of eight), and significantly shortened median survival compared with patients with CTCL with negative marrows (11 months and 70 months, respectively; P = 0.007). In contrast, five patients with nodules of tumor in the marrow but lacking an infiltrative component did not have peripheral blood involvement; only one patient had adenopathy or visceral progression develop, and two patients have died. Significant hematologic abnormalities were generally absent. Eight of 13 patients with marrow involvement had advanced skin disease, but skin disease was limited to plaques in five patients. Eight patients had marrow involvement develop within three months of initial diagnosis. Thus, marrow involvement occurs in approximately 20% of patients with CTCL, is often present at initial diagnosis, and is associated with wide-spread dissemination and shortened survival time when an in-filtrative component is present.This publication has 12 references indexed in Scilit:
- A histologic study of lymph nodes from patients with the sézary syndromeCancer, 1986
- Clonal Rearrangements of T-Cell Receptor Genes in Mycosis Fungoides and Dermatopathic LymphadenopathyNew England Journal of Medicine, 1985
- DIAGNOSTIC AND PROGNOSTIC-SIGNIFICANCE OF SEZARY CELLS IN PERIPHERAL-BLOOD SMEARS FROM PATIENTS WITH CUTANEOUS T-CELL LYMPHOMA1985
- Recombinant Leukocyte A Interferon: An Active Agent in Advanced Cutaneous T-Cell LymphomasAnnals of Internal Medicine, 1984
- Prospective Staging Evaluation of Patients with Cutaneous T-Cell LymphomasAnnals of Internal Medicine, 1980
- Frequencies and patterns of bone marrow involvement in non‐hodgkin lymphomas: Observations on the value of bilateral biopsiesAmerican Journal of Hematology, 1977
- Lymphoid Follicles in Bone Marrow AspiratesAmerican Journal of Clinical Pathology, 1977
- Cutaneous T-cell lymphomaCancer, 1976
- Cutaneous T-Cell Lymphomas: The Sézary Syndrome, Mycosis Fungoides, and Related DisordersAnnals of Internal Medicine, 1975
- Mycosis fungoides. Hematologic findings and terminal courseArchives of Dermatology, 1966