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TYPICAL'IMAGES'OF'SÉZARY'CELLS'IN'PERIPHERAL'BLOOD'SMEAR'FROM'A'
POSTER'5'
PATIENT'WITH'STAGE'IIIB'OF'SÉZARY'SYNDROME'
'
Sanae! Sayagh1,2,! Adil! Jahdaoui1,2,! Fatima! Zahra! Rahali1,2,! Said! Amal3,4,! Mustapha! Ait! Ameur2,5!and!
Mohamed!Chakour2,5!
!
(1)Hematology!Laboratory,!University!Hospital!Mohammed!VI,!Marrakech,!Morocco,!(2)Hematology!
Laboratory,! Faculty! of! Medecine! and! Pharmacy,! Marrakech,! Morocco,! (3)Faculty! of! Medecine! and!
Pharmacy,! Marrakech,! Morocco,! (4)Dermatology! Department,! University! Hospital! Mohammed! VI,!
Marrakech,! Morocco,! (5)Hematology! Laboratory,! Military! Hospital! of! Instruction! Avicenne,!
Marrakech,!Morocco!
!
Objective:!Our! aim! is! to! share! typical! images! of! Sézary! cells! discovered! in! a! patient! with!
diffuse!erythroderma.!
Observation:!It!is!about!a!64JyearsJold!male,!old!storekeeper!in!cement!factory,!presenting!
since!three!years!itchy!erythroJsquamous!lesions!of!the!elbow!complicated!two!months!ago!
by! a! diffuse! erythroderma! with! bilateral! inguinal! lymphadenopathy! with! a! conservation! of!
general!condition.!The!patient!is!admitted!for!generalized!dry!erythroderma.!The!cell!blood!
count!showed!an!hyperleucocytosis!at!46G/l!with!hyperlymphocytosis!at!36G/l!and!a!normal!
rate!of!haemoglobin!and!platelets.!The!blood!smear!showed!the!presence!of!75%!(27!G/l)!of!
small!to!medium!sized!cells!with!high!nucleocytoplasmic!ratio!and!typical!cerebriform!nuclei!
of! Sézary! cells! and! suggests! the! diagnosis! of! a! SS.! Lymphocytic! immunophenotyping! was!
made! and! showed! a! CD4/CD8! ratio! up! than! 10! (43239/512).! Cytologic! examination! of!
cutanous! biopsy! showed! malignant! lymphocytic! proliferation.! Thoracoabdominopelvic!
tomodensitometry!showed!the!presence!of!bilateral!iliac!lymphadenopathies.!
Discussion':!SS!is!a!leukemic!form!of!T!cutaneous!epidermotropic!lymphoma.!It!is!defined!by!
the! WHO/EORTC! and! the! ISCL! as! the! association! of! erythroderma,! generalized!
lymphadenopathy! and! the! presence! of! clonally! related! neoplastic! TJcells! with! cerebriform!
nuclei!in!skin,!lymph!nodes!and!peripheral!blood.!
The! diagnosis! of! SS! can! be! challenging! because! skin! lesions! can! resemble! benign!
inflammatory! dermatoses! and! traditional! polymerase! chain! reaction! of! the! TJcell! receptor!
used!to!identify!the!presence!of!TJcell!clone!in!clinical!samples!present!a!lot!of!falseJnegative!
especially!in!the!early!stage.!
Conclusion':'Peripheral!blood!examination!still!have!an!important!place!in!the!diagnosis!of!
SS! and! cytologists! must! be! aware! of! the! presence! of! these! lymphomatous! cells! while!
examining!peripheral!blood!smear.!
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES