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Leukemic and Lymphomatous Infiltrates of the Skin

»Define lymphoma.

Mycosis Fungoides

»Is there a lymphoma that begins in the skin?
»What type of lymphoma is mycosis fungoides?
»How common is mycosis fungoides?
»How does mycosis fungoides begin?
»What is parapsoriasis?
»What type of skin lesions are seen in patients with mycosis fungoides?
»Describe the three subtypes of mycosis fungoides.
»What is the TNM classification of mycosis fungoides?
»How is mycosis fungoides treated?
»Describe topical nitrogen mustard (HN2) therapy.
»If a patient develops allergic contact dermatitis to topical nitrogen mustard, does the treatment have to be permanently discontinued?
»Is photochemotherapy an effective treatment of mycosis fungoides?
»What are the major side effects of bexarotene in the treatment of patients with cutaneous T-cell lymphoma?
»How does one manage the side effects of bexarotene?
»Are interferons effective in treating mycosis fungoides?
»Is chemotherapy an effective treatment of mycosis fungoides?
»What is extracorporeal photophoresis?
»Are there any other FDA-approved treatments for cutaneous T-cell lymphoma?

Other Lymphomas and Leukemias

»Outline the Ann Arbor clinical staging system for Hodgkin’s disease.
»What is a Reed-Sternberg cell?
»What are the histologic classes of Hodgkin’s disease?
»Does Hodgkin’s disease occur in the skin?
»How are cells immunophenotyped? What does the CD nomenclature mean?
»What is lymphomatoid papulosis?
»Are CD30-positive cells specific for lymphomatoid papulosis?
»What is HTLV-1 virus? What is its significance?
»Can multiple myeloma present with skin lesions only?
»What is pseudolymphoma of the skin?
»Can B-cell lymphomas present with skin lesions?
»What is the most common type of leukemia in adults?
»Can leukemia present with specific skin lesions?
»What are some nonspecific skin lesions seen in patients with leukemia?

 
 
 

How are cells immunophenotyped? What does the CD nomenclature mean?

 
“CD” stands for cluster designation and is a nomenclature for identification of specific cell surface antigens defined by monoclonal antibodies. The procedure can be applied to both formalin-fixed and frozen tissue. It is very helpful in identifying subpopulations of T- and B-cell lymphocytes (Table 46-2).
Table 46-2. Cells Marked by CD Antigens
 
CD2
 
T cells (E rosette receptor)
 
CD3
 
T-cell receptor
 
CD4
 
Helper T cells
 
CD5
 
Mature thymocytes, some B-cell subsets
 
CD7
 
T cells, natural killer (NK) cells
 
CD8
 
T cells, NK cells
 
CD10
 
Pre-B cells, lymphoblastic leukemia cells
 
CD14
 
Monocytes
 
CD15
 
Reed-Sternberg cells, myeloid cells
 
CD19
 
Pan-B cells
 
CD20
 
Pan-B cells, dendritic cells
 
CD21
 
Receptor for complement 2 and Epstein-Barr virus
 
CD23
 
Activated B cells, monocytes, eosinophils, and platelets
 
CD25
 
Activated T and B cells, monocytes (interleukin-2 receptor)
 
CD30
 
Ki-1–related cells, Reed-Sternberg cells, T-cell NHL
 
CD34
 
Lymphoid and myeloid precursor cells
 
CD43
 
T cells, myeloid cells
 
CD45
 
Leukocytes
 
CD45R
 
T cells, myeloid cells
 
CD56
 
NK cells
 
CD74
 
HLA-invariant chain
 
CD75
 
Follicular center cells
 CD, Cluster of differentiation; HLA, histocompatibility locus antigen; NHL, non-Hodgkin’s lymphoma.