BENEFIT'OF'THE'BLOOD'SMEAR'IN'THE'DIAGNOSIS'OF'SEZARY'SYNDROME:''
POSTER'4'
A'CASE'REPORT'
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Wafa!Quiddi,!Hiba!Boumaazi!and!Sanae!Sayagh!
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Laboratoire!d'hématologie,!hôpital!ARRAZI,!CHU!MOhamed!VI,!Marrakech,!Morocco!
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Sezary! syndrome! is! a! rare! aggressive! leukemic! variant! of! cutaneous! TJcell! lymphomas,! a!
spectrum!of!the!malignant!clonal!proliferation!of!T!lymphocytes!with!a!predilection!for!skin!
involvement.!
Here,! we! report! a! case! of! a! 65JyearJold! Moroccan! female! with! Sezary! syndrome! who! has!
been! treated! initially! as! psoriasis! since! May! 2015.! On! February! 2019,! the! patient! was!
presented! with! papulo! verrucous! lesions,! whose! skin! biopsy! showed! molluscum!
contagiusum.!In!August!2020,!the!patient!presented!to!the!emergency!unit!for!worsening!of!
her!skin!lesions.!A!blood!count!was!performed!which!revealed!hyperlymphocytosis!at!21.65!
G!/!L.!We!did!a!blood!smear!which!showed!3.90!G/L!of!lymphocytes!of!mediumJsized!cells,!
with! mature! chromatin! and! the! nucleus! was! irregular! in! outline,! sometimes! showing! a!
cerebriform! appearance.! Immunophenotyping! showed! a! CD3! +! CD4! +! CD7J! T! lymphocyte!
count!of!96%,!with!a!CD4!/!CD8!ratio!of!97.!Skin!biopsy!supported!Sézary!syndrome.The!CT!
showed! hepatomegaly,! as! well! as! bilateral! cervical,! axillary! and! abdominal!
lymphadenopathy.!Finally,!the!patient!is!scheduled!for!chemotherapy.!
The!identification!and!quantification!of!Sézary!cells!on!a!blood!smear!is!an!essential!part!of!
the! diagnosis.! It! is! necessary! to! underline! the! interest! of! reading! the! blood! smear! by! an!
experienced!biologist!in!order!to!help!the!diagnosis!at!an!early!stage!of!the!disease.!
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