case_images: PMC11292030_01
case_images: Clinical presentation. (a-c) Widespread patches, plaques, and tumors involving the trunk and lower extremities. (d) Ulcerated tumor lesion on the left elbow.
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case_images: j_biol-2022-0925_fig_001
case_images: T-cell lymphoma with gamma/delta+ and CD8+ cytotoxic phenotypes. The patient was referred to the hospital and clinical examination showed widespread, partly confluent patches and indurated plaques with ulcerating tumors on both elbows (Figure 1).
case_images: Histopathological examination of the tumor lesion on the left elbow. (a) and (b) H&E-stained slide with a deep dermal infiltrate of atypical medium to large-sized lymphocytes. Immunhistochemical analysis demonstrated the tumor infiltrate consisted of (c) CD3 (+), (d) CD2 (-), (e) CD5dim, (f) CD4 (-), (g) CD8 (+), (h) TCRgamma (+), (i) TCRalphabeta (-), (j) CD30 (-), and (k) CD56 (-) T lymphocytes with a high proliferation index (l) Ki67 (~100%). Magnification (a) 10x, (b-e, l) 40x, and (f-k) 63x.
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case_images: T cells expressing CD3, CD8, TIA-1, and strong expression of TCRgamma (clone H-41). The gamma/delta+ lymphocytic tumor cells displayed a complete loss of CD2, partial downregulation of CD5, and showed no expression of CD4, CD30, CD56, TdT, or TCRalphabeta (clone 8A3/BetaF1) (Figure 2). c-Myc was positive in approximately 70% of the atypical lymphocytes and the proliferation marker Ki67 was near 100%.
case_images: Gene rearrangement analysis of TCRG Vgamma1-8/Jgamma (green) and TCRB Dbeta/Jbeta (blue) showed a monoclonal T-cell population with identical basepair peaks in the initial tumor biopsy and subsequent biopsies. (a) Onset tumor biopsy from the left elbow. (b) Tumor lesion right elbow. (c) Patch lesion on the left shoulder.
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case_images: IdentiClone TCRB + TCRG T-Cell Clonality Assay, ABI Fluorescence Detection (Invivoscribe). Identical clonal TCRG (Vgamma1-8/Jgamma) and an incomplete TCRB (Dbeta/Jbeta) rearrangement were found in the initial and subsequent biopsies (Figure 3).