FULMINANT HEAD AND NECK CONGESTION IN ADVANCED CUTANEOUS T-CELL LYMPHOMA - A POOR PROGNOSTIC INDICATOR

Background. Clinical factors associated with a poor prognosis in patie nts with cutaneous T cell lymphoma (CTCL) include the extent and type of skin involvement and the presence and extent of lymphadenopathy. Ma terials. We report retrospectively the clinical course and survival ti me of four patients with advanced CTCL after the development of fulmin ant head and neck congestion. Methods, All four patients presented wit h marked erythema and edema of the head and neck with marked cervical adenopathy. Treatment with multidrug chemotherapy and radiation induce d only brief remissions. The clinical picture was felt to be due to ex tensive tumor infiltration of the skin as well as lymphatic compressio n due to cervical adenopathy rather than venous compression at the lev el of the mediastinum. Survival from onset of this fulminant head and neck congestion was 1-5 months. Conclusion. Development of this fulmin ant head and neck congestion in patients with advanced CTCL heralds a progressively deteriorating clinical course with a poor prognosis.