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Schreiner S, Alotaibi A, Menz A, Siemann-Harms U, Booken N, Schneider SW. Ein interessanter Fall: Rezidivierendes Ulcus zentrofazial. J Dtsch Dermatol Ges 2021; 19 Suppl 1:5-7. [PMID: 33835656 DOI: 10.1111/ddg.14471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hartjen A, Booken N, Schneider SW. Schmerzhafte Rötung am Skrotum. J Dtsch Dermatol Ges 2020; 18:1059-1061. [DOI: 10.1111/ddg.14133_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hartjen AS, Booken N, Schneider SW. Painful erythema of the scrotum. J Dtsch Dermatol Ges 2020; 18:1059-1061. [PMID: 32488971 DOI: 10.1111/ddg.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hambsch J, Büttner S, Heck M, Nicolay JP, Felcht M, Booken N, Klemke CD. [Single-center retrospective analysis of extracorporal photopheresis in clinical practice : Peripheral venous compared to central venous access]. Hautarzt 2019; 70:193-203. [PMID: 30627743 DOI: 10.1007/s00105-018-4327-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Extracorporal photopheresis (ECP) was shown to be effective without severe side effects in the treatment of cutaneous T cell lymphoma (CTCL) and graft versus host disease (GvHD). However, only few studies investigated the practical aspects of ECP. METHODS Treatment protocols of 2038 ECP procedures in 52 patients (CTCL, n = 29; GvHD, n = 15; other, n = 8) were evaluated. The patients were treated with the UVAR® XTS™ ECP system (Therakos, Inc. Johnson & Johnson, Raritan, NJ, USA) between 2001 and 2010. All patients started with a peripheral venous access. During the course of treatment 7 patients were treated via a port and 4 via a central venous catheter. RESULTS In all, 1765 (86.6%) treatments were performed with a peripheral venous access; 239 (11.7%) ECPs were done via a port and 34 (1.7%) via a central venous catheter. The peripheral venous access showed a higher flow rate and longer photoactivation time. ECPs via port lead to higher UV-irradiated volumes, longer treatment times and higher differences in systolic blood pressure. The following side effects were observed: being unwell (n = 13), hypo- (n = 13) and hypertension (n = 7), vertigo (n = 4), headache (n = 4), shortness of breath (n = 4), fever (n = 3) and metallic taste (n = 3). Technical complications such as problems with venous access (9.6%) occurred in 385 (18.9%) treatments. CONCLUSIONS Peripheral venous access should be preferred for ECP treatments.
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Schreiner S, Siemann‐Harms U, Booken N, Schneider SW. Ein interessanter Fall: Die Erworbene Hemmkörper‐Hämophilie. J Dtsch Dermatol Ges 2019; 17 Suppl 2:25-27. [DOI: 10.1111/ddg.13786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tappe D, Booken N, Böer-Auer A, Rauch J, Schmiedel S, Reich K. Histology and Serum Cytokine Responses in an Imported Rickettsia slovaca Infection, Germany. Am J Trop Med Hyg 2018; 98:248-251. [PMID: 29141745 DOI: 10.4269/ajtmh.17-0392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rickettsia slovaca, a spotted fever group rickettsial pathogen, causes a syndrome consisting of scalp eschar and neck lymphadenopathy following tick bite. We analyzed the histologic skin reaction in the eschar, showing a prominent eosinophilic infiltration, as well as the presence of B lymphocytes and CD4- and CD8-positive T cells. Examination of the serum cytokine responses over time demonstrated an initial proinflammatory cytokine elevation followed by normalization.
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Ralser DJ, Takeuchi H, Fritz G, Basmanav FB, Effern M, Sivalingam S, El-Shabrawi-Caelen L, Degirmentepe EN, Kocatürk E, Singh M, Booken N, Spierings NMK, Schnabel V, Heineke A, Knuever J, Wolf S, Wehner M, Tronnier M, Leverkus M, Tantcheva-Poór I, Wenzel J, Oji V, Has C, Hölzel M, Frank J, Haltiwanger RS, Betz RC. Altered Notch Signaling in Dowling-Degos Disease: Additional Mutations in POGLUT1 and Further Insights into Disease Pathogenesis. J Invest Dermatol 2018; 139:960-964. [PMID: 30414910 DOI: 10.1016/j.jid.2018.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/25/2018] [Accepted: 10/03/2018] [Indexed: 10/27/2022]
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Boonk SE, Zoutman WH, Marie-Cardine A, van der Fits L, Out-Luiting JJ, Mitchell TJ, Tosi I, Morris SL, Moriarty B, Booken N, Felcht M, Quaglino P, Ponti R, Barberio E, Ram-Wolff C, Jäntti K, Ranki A, Bernengo MG, Klemke CD, Bensussan A, Michel L, Whittaker S, Bagot M, Tensen CP, Willemze R, Vermeer MH. Evaluation of Immunophenotypic and Molecular Biomarkers for Sézary Syndrome Using Standard Operating Procedures: A Multicenter Study of 59 Patients. J Invest Dermatol 2016; 136:1364-1372. [DOI: 10.1016/j.jid.2016.01.038] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/11/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
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Klemke CD, Booken N, Weiss C, Nicolay JP, Goerdt S, Felcht M, Géraud C, Kempf W, Assaf C, Ortonne N, Battistella M, Bagot M, Knobler R, Quaglino P, Arheiliger B, Santucci M, Jansen P, Vermeer MH, Willemze R. Histopathological and immunophenotypical criteria for the diagnosis of Sézary syndrome in differentiation from other erythrodermic skin diseases: a European Organisation for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Task Force Study of 97 cases. Br J Dermatol 2015; 173:93-105. [PMID: 25864856 DOI: 10.1111/bjd.13832] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with erythrodermic disease are a diagnostic challenge regarding the clinical and histological differential diagnosis. OBJECTIVES To evaluate histopathological and immunohistochemical diagnostic markers for Sézary syndrome. METHODS Ninety-seven erythrodermic cases [Sézary syndrome (SS), n = 57; erythrodermic inflammatory dermatoses (EIDs), n = 40] were collected by the EORTC Cutaneous Lymphoma Task Force histopathology group. Evaluation criteria were (i) epidermal and dermal changes; (ii) morphology of the infiltrate; (iii) immunohistochemical analysis of marker loss (CD2, CD3, CD4, CD5 and CD7); (iv) bystander infiltrate by staining for CD8, FOXP3 and CD25; and (v) expression of Ki-67, CD30, PD-1 and MUM-1. RESULTS The workshop panel made a correct diagnosis of SS in 51% of cases (cutaneous T-cell lymphoma 81%) and of EID in 80% without clinical or laboratory data. Histology revealed a significantly increased degree of epidermotropism (P < 0.001) and more intraepidermal atypical lymphocytes (P = 0.0014) in SS biopsies compared with EID. Pautrier microabscesses were seen only in SS (23%) and not in EID (P = 0.0012). SS showed significantly more dermal cerebriform and blastic lymphocytes than EID. Immunohistochemistry revealed a significant loss of CD7 expression (< 50%) in 33 of 51 (65%) cases of SS compared with two of 35 (6%) EID (P < 0.001). The lymphocytic infiltrate in SS skin samples was found significantly to express PD-1 (P = 0.0053), MUM-1 (P = 0.0017) and Ki-67 (P < 0.001), and showed less infiltration of CD8(+) lymphocytes (P < 0.001). A multivariate analysis identified CD7 loss, increased numbers of small cerebriform lymphocytes, low numbers of CD8(+) lymphocytes and increased proliferation (Ki-67(+) lymphocytes) as the strongest indicators for the diagnosis of SS. CONCLUSIONS A number of different histological and immunophenotypical criteria are required to differentiate between SS and EIDs.
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Teichert M, Stumpf C, Booken N, Wobser M, Nashan D, Hallermann C, Mogler C, Müller CSL, Becker JC, Moritz RKC, Andrulis M, Nicolay JP, Goerdt S, Thomas M, Klemke CD, Augustin HG, Felcht M. Aggressive primary cutaneous B-cell lymphomas show increased Angiopoietin-2-induced angiogenesis. Exp Dermatol 2015; 24:424-9. [PMID: 25776770 DOI: 10.1111/exd.12688] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/19/2022]
Abstract
Primary cutaneous large B-cell lymphomas, leg type (PCLBCL/LT) are primary cutaneous B-cell lymphoma (PCBCL) with an intermediate prognosis. Therefore, antracycline-based polychemotherapy combined with rituximab has been recommended as first-line treatment. Yet, despite this regimen, the 5-year survival rate remains 50-66% only. Angiogenesis, the formation of a vascular network, is essential for the pathogenesis of nodal lymphomas. So far, no study has analysed angiogenesis and its key factors in PCLBCL/LT. The present study was aimed at characterizing angiogenesis in PCLBCL/LT to identify the angiogenic molecules as potential therapeutic targets. The intra-tumoral microvessel density (MVD) was assessed by immunohistochemical studies of CD20 and CD31. The MVD was higher in PCLBCL/LT compared with indolent PCBCL. Analyses of open-source microarray data showed correlation between the angiogenic molecule angiopoietin-2 (Ang-2) and pan-endothelial cell markers. ELISA studies determined a shift between Ang-2 and Ang-1 towards Ang-2 in the peripheral blood of PCLBCL/LT patients. Immunofluorescence costainings against the Ang receptor Tie2/angiogenic integrins/CD34 revealed that the vasculature in both aggressive and indolent PCBCL tumors harbours an endothelial cell subpopulation with reduced expression of Tie2. In contrast, the alternative Ang-2 binding partners, angiogenic integrins, are strongly expressed in PCBCL. In line with these findings, downstream targets of Ang-2-integrin signalling, that is phosphorylation of focal adhesion kinase at Tyr397, and sprouting angiogenesis are enhanced in PCLBCL/LT. Our data present Ang-2 as a promising therapeutic target and anti-angiogenic therapy as a new line in treatment of PCLBCL/LT as a hitherto intractable disease.
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Stadler S, Booken N, Schneider SW, Goerdt S, Klemke CD, Utikal J. Acid citrate dextrose extracorporeal photopheresis is an alternative treatment option for patients with heparin allergy. Int J Dermatol 2015; 54:e266-7. [PMID: 25784218 DOI: 10.1111/ijd.12789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/10/2014] [Accepted: 06/22/2014] [Indexed: 11/29/2022]
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Linke M, Booken N. Risikofaktoren für ein vermindertes Ansprechen in der Behandlung des Erysipels. J Dtsch Dermatol Ges 2015. [DOI: 10.1111/ddg.12575_suppl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Linke M, Booken N. Risk factors associated with a reduced response in the treatment of erysipelas. J Dtsch Dermatol Ges 2015; 13:217-25. [PMID: 25706926 DOI: 10.1111/ddg.12575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND In most cases, erysipelas may be adequately treated using first-line antibiotic therapy. However, clinicians are sometimes confronted with complicated cases, in which patients do not respond to initial antibiotic therapy. The objective of this study was to identify risk factors associated with a reduced response to antibiotic therapy and, thus, a more complicated disease course. PATIENTS AND METHODS We retrospectively analyzed the clinical course of 98 patients with erysipelas treated with standard antibiotic therapy. Patient groups showing different therapeutic responses were compared with respect to clinical data, medical history, and laboratory parameters. RESULTS Patients with bullous or hemorrhagic erysipelas (p = 0.0008), stasis dermatitis (p = 0.01) or chronic venous insufficiency (p = 0.0004) showed a significantly reduced response to initial therapy with cefuroxime or clindamycin, respectively. Furthermore, the response to initial therapy significantly depended on C-reactive protein (p = 0.007) and neutrophil (p = 0.02) levels. CONCLUSION In erysipelas patients with clinical complications, abnormal laboratory parameters or preexisting local skin damage, an intensified antibiotic regimen should be considered.
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Booken N, Heck M, Peitsch WK, Goerdt S, Klemke CD. Ulcerated nodules on the oral mucosa and fingers: lymphomatoid papulosis, type A. Acta Derm Venereol 2013; 93:250-1. [PMID: 23165794 DOI: 10.2340/00015555-1488] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Booken N, Nicolay JP, Weiss C, Klemke CD. Die kutane Tumorzelllast korreliert mit dem Überleben von Patienten mit Sézary-Syndrom. J Dtsch Dermatol Ges 2013. [DOI: 10.1111/j.1610-0387.2012.08027_suppl.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Brechmann M, Mock T, Nickles D, Kiessling M, Weit N, Breuer R, Müller W, Wabnitz G, Frey F, Nicolay JP, Booken N, Samstag Y, Klemke CD, Herling M, Boutros M, Krammer PH, Arnold R. A PP4 holoenzyme balances physiological and oncogenic nuclear factor-kappa B signaling in T lymphocytes. Immunity 2012; 37:697-708. [PMID: 23084358 DOI: 10.1016/j.immuni.2012.07.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 07/09/2012] [Indexed: 11/24/2022]
Abstract
Signal transduction to nuclear factor-kappa B (NF-κB) involves multiple kinases and phosphorylated target proteins, but little is known about signal termination by dephosphorylation. By RNAi screening, we have identified protein phosphatase 4 regulatory subunit 1 (PP4R1) as a negative regulator of NF-κB activity in T lymphocytes. PP4R1 formed part of a distinct PP4 holoenzyme and bridged the inhibitor of NF-κB kinase (IKK) complex and the phosphatase PP4c, thereby directing PP4c activity to dephosphorylate and inactivate the IKK complex. PP4R1 expression was triggered upon activation and proliferation of primary human T lymphocytes and deficiency for PP4R1 caused sustained and increased IKK activity, T cell hyperactivation, and aberrant NF-κB signaling in NF-κB-addicted T cell lymphomas. Collectively, our results unravel PP4R1 as a previously unknown activation-associated negative regulator of IKK activity in lymphocytes whose downregulation promotes oncogenic NF-κB signaling in a subgroup of T cell lymphomas.
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Booken N, Nicolay JP, Weiss C, Klemke CD. Cutaneous tumor cell load correlates with survival in patients with Sézary syndrome. J Dtsch Dermatol Ges 2012; 11:67-79. [DOI: 10.1111/j.1610-0387.2012.08027.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Felcht M, Heck M, Weiss C, Becker JC, Dippel E, Müller CSL, Nashan D, Sachse MM, Nicolay JP, Booken N, Goerdt S, Klemke CD. Expression of the T-cell regulatory marker FOXP3 in primary cutaneous large B-cell lymphoma tumour cells. Br J Dermatol 2012; 167:348-58. [PMID: 22512270 DOI: 10.1111/j.1365-2133.2012.10987.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Primary cutaneous B-cell lymphomas (PCBCL) are subdivided into the aggressive form, primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL, LT) and two subtypes of indolent behaviour (primary cutaneous follicle centre lymphoma and primary cutaneous marginal zone B-cell lymphoma). The difference in clinical behaviour can be explained by the tumour cell itself, or the lymphoma microenvironment including the antitumour immune response. OBJECTIVES To investigate the presence of regulatory T cells (Treg), CD4+CD25+FOXP3+, in the microenvironment of PCBCL in correlation with clinical outcome. METHODS Tumour specimens of 55 consecutive cases of PCBCL were blinded and analysed for FOXP3, CD4 and CD25 expression by immunohistochemistry. Confocal images were taken with a Leica SP5. Statistical analyses were performed to determine significance. The test was considered significant when P<0.05. RESULTS The CD4 and FOXP3 expression as well as the CD4/FOXP3 ratio were significantly increased in PCBCL of indolent behaviour in contrast to PCLBCL, LT (P=0.0002 for CD4, P<0.0001 for FOXP3 and P=0.0345 for FOXP3/CD4 ratio). CD25 expression did not differ in the three groups (P=0.9414). Within the group of patients with PCLBCL, LT we identified a subgroup with FOXP3+ tumour cells as demonstrated by CD20/FOXP3 double stainings. Patients with FOXP3+ PCLBCL, LT tumour cells showed a better prognosis on Kaplan-Meier analysis. CONCLUSION High numbers of Treg in the lymphoma microenvironment correlate with a better prognosis in PCBCL. In PCLBCL, LT the presence of FOXP3+ tumour cells is beneficial for prognosis suggesting that FOXP3 expression of PCLBCL, LT tumour cells might serve as a tumour suppressor.
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Booken N, Goerdt S, Klemke CD. Klinisches Spektrum kutaner CD30-positiver anaplastisch großzelliger Lymphome: Analyse des Mannheimer Lymphomregisters*. J Dtsch Dermatol Ges 2012. [DOI: 10.1111/j.1610-0387.2011.07794_suppl.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Booken N, Goerdt S, Klemke CD. Clinical spectrum of primary cutaneous CD30-positive anaplastic large cell lymphoma: an analysis of the Mannheim Cutaneous Lymphoma Registry. J Dtsch Dermatol Ges 2012; 10:331-9. [DOI: 10.1111/j.1610-0387.2011.07794.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Booken N, Heck M, Nicolay JP, Klemke CD, Goerdt S, Utikal J. Oral aprepitant in the therapy of refractory pruritus in erythrodermic cutaneous T-cell lymphoma. Br J Dermatol 2011; 164:665-7. [PMID: 21039410 DOI: 10.1111/j.1365-2133.2010.10108.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Felcht M, Booken N, Stroebel P, Goerdt S, Klemke CD. The value of molecular diagnostics in primary cutaneous B-cell lymphomas in the context of clinical findings, histology, and immunohistochemistry. J Am Acad Dermatol 2011; 64:135-43, 143.e1-4. [PMID: 21167409 DOI: 10.1016/j.jaad.2009.12.062] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Revised: 12/31/2009] [Accepted: 12/31/2009] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary cutaneous B-cell lymphoma (PCBCL) is classified into 3 major subtypes: primary cutaneous follicle center lymphoma (PCFCL); primary cutaneous marginal zone B-cell lymphoma (PCMZL); and primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL, LT). Diagnosis of PCBCL is mainly based on clinical and (immuno)-histochemical grounds. OBJECTIVE We investigated the diagnostic value of the BIOMED-2 Concerted Action BMH4 CT98-3936 protocol in PCBCL. METHODS We analyzed with the BIOMED-2 Concerted Action BMH4 CT98-3936 protocol skin specimens from patients with well-defined clinical and (immuno)-histologic PCBCL (n = 18) in comparison with benign lymphocytic infiltrates (n = 9). For molecular staging we also investigated 13 extracutaneous samples from 6 patients with PCLBCL, LT. Each sample was investigated at least twice. RESULTS Monoclonality was detected in all of 5 PCFCL; 5 of 6 PCMZL; all of 6 PCLBCL, LT; and 2 of 9 benign lymphocytic infiltrates. In 5 of 6 patients with PCLBCL, LT, a clone corresponding to the clone detected in the skin was detected in 3 of 5 bone-marrow, 4 of 5 blood, and 1 of 3 lymph node specimens. DNA amplification using tubes A and B of IgH was not possible in PCFCL/PCMZL, benign lymphocytic infiltrates, and extracutaneous specimens of PCLBCL, LT, even after repeated analysis up to 11 times. Pseudomonoclonality was identified by repeated analyses in one case of PCMZL and in one case of benign lymphocytic infiltrate. LIMITATIONS A multicentric, randomized, blinded study is necessary to confirm our results. CONCLUSION Molecular diagnosis supports the clinical and (immuno)-histologic diagnosis in PCBCL. In PCLBCL, LT, molecular staging may be useful. Tubes C through E of IgH and Igκ analyses seem to be superior to tubes A and B of IgH. Each sample should be analyzed at least twice to assess the possibility of pseudomonoclonality.
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Booken N, Weiß C, Utikal J, Felcht M, Goerdt S, Klemke CD. Die Kombinationstherapie mit extrakorporaler Photopherese, Interferon-α, PUVA und lokalen Glukokortikoiden in der Behandlung des Sézary-Syndroms. J Dtsch Dermatol Ges 2010. [DOI: 10.1111/j.1610-0387.2010.07319_supp.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Felcht M, Dikow N, Goebeler M, Stroebel P, Booken N, Voßmerbäumer U, Merx K, Henzler T, Marx A, Moog U, Goerdt S, Klemke CD. Warty skin changes, chronic scrotal lymphoedema, and facial dysmorphism. BMJ Case Rep 2010; 2010:2010/may19_1/bcr0820092214. [PMID: 22750922 DOI: 10.1136/bcr.08.2009.2214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 49-year-old Caucasian man whose main complaints were wart-like skin changes and scrotal lymphoedema. Furthermore, our patient showed signs of a common hereditary disease: lymphoedema, short stature, webbed neck, low frontal and posterior hairline, downslanting palpebral fissures, pale blue iris, broad nose, flat philtrum, and prominent nasolabial folds. His ears were low set and retroverted with a thick helix. However, no diagnosis was made for 49 years. The interdisciplinary dialogue of various specialists to make the final diagnosis is presented and discussed.
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