The Same Dominant T Cell Clone Is Present in Multiple Regressing Skin Lesions and Associated T Cell Lymphomas of Patients with Lymphomatoid Papulosis

Abstract

This study was undertaken to determine the clonality of lymphomatoid papulosis (LyP), its clonal relationship to lymphomas, which occur at high frequency in LyP patients, and to define the cell lineage of Reed-Sternberg-like cells in type A lesions of LyP. Punch biopsies of skin of 11 adult patients with LyP were analyzed for morphologic subtype of LyP, surface antigens, and clonal T-cell receptor (TCR) gene rearrangements. Clonal rearrangements were identified by semiquantitative polymerase chain reaction amplification and sequencing of TCR-beta chain genes in nine patients and TCR-gamma chain genes in two patients. A single dominant clone was detected in multiple separate LyP lesions, often of different histologies, in nine patients. The same clone was detected in LyP lesions and the anaplastic large cell lymphoma (ALCL) of 2 patients and the mycosis fungoides (MF) of 2 other patients. No dominant clone could be detected in one patient with LyP uncomplicated by lymphoma or in a second patient with LyP and MF. A T-cell lineage was evident for RS-like cells in cell culture and in type A lesions. These results show that multiple regressing skin lesions and associated T cell lymphomas (MF and ALCL) are clonally related in most LyP patients, which suggest that the disease in these patients was initiated by a non-random genetic event.

Single-cell analysis of CD30+ cells in lymphomatoid papulosis demonstrates a common clonal T-cell origin

“…3 It was shown that LyP cases with associated lymphomas shared the same clonal rearrangement in most instances. 6,[9][10][11][12] Several attempts to demonstrate the presence of clonal T-cell populations in LyP lesions without complicating T-cell lymphomas, however, produced conflicting results. 11,[13][14][15][16] This might, besides the clinical benign course, be one reason why LyP is For personal use only.…”

“…6,[9][10][11][12] Several attempts to demonstrate the presence of clonal T-cell populations in LyP lesions without complicating T-cell lymphomas, however, produced conflicting results. 11,[13][14][15][16] This might, besides the clinical benign course, be one reason why LyP is For personal use only. on April 3, 2019. by guest www.bloodjournal.org From still assigned to the heterogeneous group of cutaneous pseudolymphomas, a group of benign reactive lymphoproliferative processes that clinically and/or histologically mimic cutaneous lymphomas.…”

“…This finding proves the observations of previous studies where the same TCR rearrangement was found within separate LyP lesions of one patient. 11,16 In 2 cases (patient nos. 1 and 5) a few single CD30 ϩ cells revealed unique TCR-␥ gene rearrangements unrelated to the clonal cell population (5 of a total of 123 CD30 ϩ cells).…”

“…[4][5][6][7][8] In many of these cases the same clonal T-cell receptor (TCR) rearrangements have been found in the LyP as well as in the associated lymphoma, identifying LyP as a precursor lesion. 6,[9][10][11][12] Most LyP cases are, however, not associated with T-cell lymphomas of various types. 4,7 In these cases, clonal T-cell populations were detectable only in a proportion of analyzed lesions, [13][14][15][16] which might, in addition, be different when taken at various times.…”

Coexistence of papillary carcinoma and anaplastic large cell lymphoma in a healthy 26-year-old male: A first case report

“…The pathophysiology of the underlying mechanism is poorly understood, with some theories relating to monotypic expansion of activated T cells that occurs with solid tumors, and it is possible that T cell lymphoma originates from cytotoxic CD30+ T cell expansion [20]. Secondary genetic abnormalities probably lead to the dominance of a T cell clone, leading to irreversible transformation to lymphoma [21]. Whether ALCL predisposes to, or is merely associated with papillary carcinoma, is still a controversial issue which requires a more detailed consideration.…”