Search

Intrathoracic involvement with cutaneous T-cell lymphoma (CTCL) was documented in eight patients with mycosis fungoides and two patients with Sĕzary syndrome. The radiographic findings consisted of multiple bilateral parenchymal nodular densities (five patients), patchy areas of consolidation (two patients), diffuse reticulonodular or interstitial infiltration (two patients), and pleural effusion without underlying parenchymal disease (one patient). Dyspnea on exertion and nonproductive cough were the most frequent presenting symptoms, and physical examination of the lungs was usually normal. In one patient a partial Pancoast's syndrome developed from a pulmonary apical mass. Results of blood gas studies and pulmonary function tests indicated an alveolar-capillary block in gas diffusion. Although the antemortem diagnosis was often suggested on cytopathologic preparations or on tissue obtained by transbronchial or percutaneous needle aspiration biopsy, a definitive diagnosis of CTCL usually required an open-lung biopsy. The response of pulmonary infiltrates to various systemic chemotherapeutic agents was variable, and the mean survival after initiation of drug therapy was 9.5 months. The findings suggest that combined modality therapy should be considered for patients with extracutaneous CTCL.

A study was undertaken to evaluate the utility of the skin imprint technique and the Papanicolaou stain in the diagnosis of cutaneous T-cell lymphomas (CTCL), to better characterize cytologic findings in CTCL and to establish criteria for the cytologic diagnosis of CTCL. Differential cell counts of 17 specimens, including 12 cases of CTCL and 5 of benign skin infiltrates, were performed. There appear to be some significant differences between the groups in terms of cellularity, number of cerebriform mononuclear cells and presence of mitotic figures. The skin imprint technique, using Papanicolaou staining, seems to facilitate recognition of diagnostically important cells. The usefulness of skin imprint cytology resides in its potential for diagnosing early lesions of CTCL when diagnosis by other methods may be difficult.