PMC9514779_01
(A-D) papules, necrosis, atrophic scars and depigmentation on the scalp, face, hands, feet were significantly improved after the treatment.
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One year prior, the boy developed skin lesions mainly on his scalp, face, and the distal limbs without obvious causes (Figure 1A and B). The patient was in continued remission at 6 months of follow-up (Figure 1C and D).
Skin biopsy showing diffuse infiltration of the dermis and superficial subcuits by dense lymphoid cells with perivascular and periadnexal patterns (Hematoxylineosin magnifications, (A) x40, (B) x400). Tumor cells were positive for CD3 (C), TdT (D), CD4 (E). Biopsy of mediastinal mass showing the tumor cells were infiltrated and most of the tumors were necrotic.(Hematoxylineosin magnifications, (F) x40, (G) x400) Positive staining of tumor infiltrate for CD3 (H), TdT (I), CD4 (J).
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A skin biopsy of the left foot skin lesion was performed and histopathologic findings revealed dense lymphoid cell infiltration throughout the dermis and surrounding perivascular area, focal necrosis, and the presence of atypical lymphocytes (Figure 2A and B). Immunohistochemistry stains were positive for CD2, CD3, CD4, CD8, GrB, TIA-1, and TdT, but negative for, CD20, CD30, CD56 and CD79a (Figure 2C-E). A biopsy of the mass was performed and revealed that the tumor composed of malignant polymorphic lymphoid cells with massive necrosis (Figure 2F and G). TdT and Bcl-2 protein (Figure 2H-J). The proliferative rate by Ki-67 was high at 90%.
CT examination. Mediastinal mass was significantly decreased than before (A) after the chemotherapy (B) (red arrow).
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A CT scan revealed a large mediastinal mass with a maximum cross section of about 50 mmx37 mm (Figure 3A). A CT scan revealed the maximum cross section of the mediastinal mass was 26 mm x 21 mm, which was significantly decreased than before after the chemotherapy (Figure 3B).