Aida Khaled
Mehdi Sfia
Becima Fazaa
Nadia Kourda
Rachida Zermani
Kamel Baccouche
Sara Ben Jilani
Mohamed Ridha Kamoun


Background: Cutaneous manifestations in angio-immunoblastic T cell lymphoma (AITL) can be seen in almost 50% of patients. They are especially represented by maculo-papular pseudotoxic exanthema. The other manifestations, like nodular prurigo are rarely observed. We report a case of AITL diagnosed after an etiologic
screening for chronic prurigo.
Aim : The objective of our work is to stress on the possibility to diagnose a hemopathy in etiologic screening of chronic pruritus.
Case report: A45-year-old patient presented a chronic pruritus of 18 months associated with general manifestations (fever, night sweating and weight loss). Physical examination showed diffuse adenomegalies. On histology, the lymph nodes were composed of polymorphous lymphoid proliferation made of middle to large sized
cells with clusters of epithelioid cells and post-capillary veinules hyperplasia. Immunohistochemical study showed T cell phenotype (CD3+). Large cells were CD30+. Latent Protein of EBV virus was not expressed. Molecular biological analysis of a lymph node showed a T cell clonal proliferation. Cutaneous biopsy showed a little dermic perivascular lymphocytic inflammatory infiltrate. The diagnosis of angio-immunoblastic T cell lymphoma was made. The abdomino-pelvian CT scanner showed multiple inter-aortico-cave lymph nodes and a splenomegaly. Apolychemotherapy was initiated.
Conclusion : In front of chronic prurigo with general manifestations, a careful etiologic screening should be done to detect internal disorders especially malignant hemopathies.


Chronic prurigo, an angio-immunoblastic T cell lymphoma



  1. Aractingi S, Mansouri S. Manifestations cutanées associées aux hémopathies malignes. Press med 1997; 26: 678-83.
  2. Martel P et al. Cutaneous involvement in patients with Angioimmunobastic lymphadenopathy with dysproteinemia. A clinical, immunohistological and Molecular analysis. Arch Dermatol 2000; 136: 881-6.
  3. Jayaraman AG, Cassarino D, Advani R, Kim YH, Tsai E, Kohler S. Cutaneous involvement by Angioimmunoblastic T-cell lymphoma: a unique histologic presentation, mimicking an infectious etiology. J Cutan Pathol 2006; 33: 6-11.
  4. Greer JP, Therapy of peripheral T/NK neoplasms. Hematology Am Soc Hematol Educ Program. 2006:331-7. Review.
  5. Bernstein JE, Soltani K, Lorienz AL. Cutaneous manifestations of angioimmunoblastic lymphadenopathy: J Am Acad Dermatol 1979; 1: 227-32.
  6. Maltoff RB, Neimann RS. Angioimmunoblastic lymhadenopathy: A generalized lymphoproliferative disorder with cutaneous manifestations. Arch dermatol 1978; 114: 92-94.
  7. Murakami T, Ohtsuki M, Hakagawa H. Angioimmunoblastic lymphadenopathy-type T-cell lymphoma with cutaneous infiltration: report of a case and its gene expression profile. Br J Dermatol 2001; 144: 878-84.
  8. Yoon GS, Chang SE, Kim HH, Choi JH, Sung KJ, Moon KC. Cutaneous relapse of angioimmunoblastic lymphadenopathy-type peripheral T-cell lymphoma mimicking an exanthematous drug eruption: a unique histologic presentation, mimicking an infectious etiology. Int J Dermatol 2003; 42: 816-8.
  9. Wechsler HL, stavrides A. Immunoblastic lymphadenopathy with purpura and cryoglobulinemia. Arch Dermatol 1977; 113: 636-41
  10. Kluin-Neleman HC, Elbers HR, Ramselaar CG. Angioimmunoblastic lymphadenopathy followed by Kaposi's sarcoma. Arch Dermatol 1983; 120: 958-9.
  11. Helm TN, Steck WD, Proffitt MR, Bergfeld WF, Tubbs RR, Lo J. Kaposi's sarcoma, angioimmunoblastic lymphadenopathy, and antibody to HIV-1 p24 antigen in a patient nonreactive for HIV-1 with use of ELISA. J Am Acad Dermatol. 1990; 23: 317-8.
  12. Mihaljevic B et al. Angioblastic lymphadenopathy-its course and prognosis. Srp Arch Celok Lek. 1999;127: 376-82.
  13. Schmuth M et Al. Cutaneous involvement by Angioimmunoblastic lymphadenopathy. J Am Acad Dermatol 1997; 36: 290-5.
  14. Jones D et al. Expression pattern of T-cell-associated chemokine receptors and their chemokines correlates with specific subtypes of T-cell non-Hodgkin lymphoma. Blood 2000; 96: 685-90.
  15. Attygalle A et Al. Neoplastic T cells in angioimmunobalstic t-cell lymphoma express CD10. Blood 2002; 99: 627-33.
  16. Schlegelberger B, et al. Significance of cytogenetic finding for the clinical outcome in patients with T-cell lymphoma of angioimmunoblastic lymphoadenopathy type. J Clin Oncol 1996; 14: 593-9.
  17. Siegert W et al. Angioimmunoblastic lymphadenopathy (AILD)- type T-cell lymphoma: prognostic impact of clinical observations and laboratory findings at presentation. The Kiel Lymphoma Study Group. Ann Oncol 1995; 6:659-64.
  18. Went P et al. Marker expression in peripheral T-cell lymphoma: a proposed clinical_pathologic prognostic score. J Clin Oncol.2006; 24:2472-9
  19. Smith JL, Hodges E, Quin TC, McCarthy KP, Wright DH. Frequent T and B cell oligoclones in histologically and immunophenotypically characterized angioimmunoblastic lymphadenopathy. Am J Pathol 2000; 156: 661-64.