DISCUSSION
T-cell lymphoblastic lymphoma is a very rare form of non-Hodgkin lymphoma, accounting for approximately 20% of LL.1,2It commonly occurs in young male adults, more than children or elderly.2 T-LBL is frequently revealed by a mediastinal mass or peripheral lymphadenopathy. Skin localizations of all LBL are noted in fewer than 20% of affected patients.3 Unlike B-cell LBL (B-LBL), skin involvement concerns only a minority of patients with T-LBL, as well as lymph node involvement. To our knowledge, only 15 cases of T-LBL with cutaneous involvement have been reported in the literature.1,4,5Skin lesions mostly present as nodular lesions, located on the scalp, the trunc and the limbs. Skin lesions in T-LBL usually present as multiple nodules associated with multiple peripheral lymphadenopathy and bone marrow invasion. Our patient is particular by the revealing presentation of the lesions as CVG without other distant lesions. Only four cases of T-LBL diagnosed by cutaneous involvement have been reported so far.1
To our knowledge, secondary CVG revealing T-LBL has not been reported previously.
Dermoscopic features of skin lésions are not specific for LBL.6 However, they are comparable to that primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorders presenting as short fine irregular or serpiginous vessels over salmon-pink background. The authors correlate the presence of pinkish background with atypical lymphocytic infiltrates related angiogenesis.6
  1. Y. Chiba, N.Hirase, K.Yamasaki, et al. Mediastinal T-cell Lymphoblastic Lymphoma Diagnosed with a Skin Biopsy. Intern Med. 2020;59(11):1463-1464.
  2. S.Khurana, M.Beltran, L.Jiang, et al. Primary Cutaneous T-Cell Lymphoblastic Lymphoma: Case Report and Literature Review. Case Rep Hematol, 2019;2019:3540487.
  3. Lee WJ, Moon HR, Won CH,et al. Precursor B- or T-lymphoblastic lymphoma presentingwith cutaneous involvement: a series of 13 cases including7 cases of cutaneous T-lymphoblastic lymphoma. J Am Acad Dermatol 2014;70(2):318- 325.
  4. C. Nascimbenia, S. Chantepieb, C. Brugiere, et al. Localisations cutanées d’un lymphomalymphoblastique T.Ann DermatolVenereol (2017).
  5. Montes-Torres A, Llamas-Velasco M, Capusan TM, et al. Cutaneous involvement as the first manifestation of T lymphoblastic lymphoma and review of the literature. J Cutan Pathol 2019;46(5): 372-375.
  6. M. Sławi_nska, M. Sokołowska-Wojdyło, B. Olszewska, et al. Dermoscopic and trichoscopic features of primary cutaneous lymphomas – systematic review. J Eur Acad Dermatol Venereol.2021 ;35(7) : 1470-1484.