Submitted March 31, 2003
Accepted June 22, 2003
Bone marrow precursor of extranodal T-cell lymphoma
Robert Gniadecki*, Ansgar Lukowsky, Kristian Rossen, Hans O Madsen, Kristian Thomsen, and Hans Christian Wulf
Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
Department of Dermatology, Humboldt University Charite, Berlin, Germany
Department of Pathology, University of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
Department of Clinical Immunology, The National University Hospital (Rigshospitalet), Copenhagen, Denmark
* Corresponding author; email: rg01{at}bbh.hosp.dk.
The development of extranodal lymphomas is thought to be initiated by the transformation event in peripheral organs. Lymphomatoid papulosis (LyP) is a low-grade cutaneous lymphoma and may progress into the cutaneous anaplastic lymphoma. We identified two patients who 3 and 4 years before the development of LyP were treated for an unrelated malignancy (Burkitt lymphoma and small-cell B-cell lymphoma). We analyzed the T-cell receptor gene (TCR) rearrangement pattern in their skin, blood and bone marrow, including the archival bone marrow sampled years before the development of clinically evident LyP. In all samples we detected the unique monoclonal TCR rearrangements. This observation suggests that the initial malignant transformation in lymphomatoid papulosis occurred in bone marrow and not, as could be supposed, in the skin.
