Volume 5, Issue 7, Pages (July 2019)

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Volume 5, Issue 7, Pages 582-586 (July 2019) Radiation therapy for primary cutaneous γδ T-cell lymphoma: Case report and literature review  Chris R. Kelsey, MD, Endi Wang, MD, PhD, Alexandra Stefanovic, MD, Meenal Kheterpal, MD  JAAD Case Reports  Volume 5, Issue 7, Pages 582-586 (July 2019) DOI: 10.1016/j.jdcr.2019.05.002 Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Histopathologic evaluation of the skin punch biopsy. The hematoxylin-eosin stained section (×100) shows an extensive lymphoid infiltrate in the papillary to reticular dermis (A). The lymphoid infiltrate appears mainly interstitial in distribution with significant perivascular and periadnexal infiltrates. Note the psoriasiform epidermal changes and epidermotropism with vacuolar degeneration in the basal layer of epidermis. Pigmentary incontinence and extravasation of red blood cells can be seen in the papillary dermis. A high magnification hematoxylin-eosin stained section shows an interstitial infiltrate by medium-to-large lymphocytes in the mid to reticular dermis (B). Note the oval, indented to irregular nuclear contours, vesicular chromatin and moderate amount of amphophilic or clear cytoplasm of the atypical lymphocytes. One mitotic figure (upper middle field of the image) and a few karyorrhexis can be seen. Scattered small lymphocytes with dense chromatin likely represent benign lymphoid components. CD3 (C) and CD2 (D) stains are positive in most lymphocytes. Note their medium-to-large size highlighted by the stains. The atypical lymphocytes are negative for CD5 (E). Note the scattered positive cells are small in size, in contrast to the larger size of the negative cells; these small CD5+ cells likely represent reactive T cells. The atypical lymphocytes are negative for β-F1 (F). As in the CD5 stain, scattered β-F1+ cells are smaller and likely represent reactive T cells. (Original magnifications: A, ×100; B, ×400.) JAAD Case Reports 2019 5, 582-586DOI: (10.1016/j.jdcr.2019.05.002) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Right hand before (A) and after (B) radiation therapy. Left hand before (C) and after (D) radiation therapy. JAAD Case Reports 2019 5, 582-586DOI: (10.1016/j.jdcr.2019.05.002) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Soles of feet before (A) and after (B) radiation therapy. Right lateral foot before (C) and after (D) radiation therapy. JAAD Case Reports 2019 5, 582-586DOI: (10.1016/j.jdcr.2019.05.002) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Left side of the back before (A) and after (B) radiation therapy. JAAD Case Reports 2019 5, 582-586DOI: (10.1016/j.jdcr.2019.05.002) Copyright © 2019 American Academy of Dermatology, Inc. Terms and Conditions