51
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Abstract
T-cell lymphomas are a group of predominantly rare hematologic malignancies that tend to recapitulate different stages of T-cell development, in a similar way that B-cell lymphomas do. As opposed to B-cell lymphomas, the understanding of the biology and the classification of T-cell lymphomas are somewhat rudimentary, and numerous entities are still included as 'provisional categories' in the World Health Classification of hematolopoietic malignancies. A relevant and useful classification of these disorders have been difficult to accomplish because of the rarity nature of them, the relative lack of understanding of the molecular pathogenesis, and their morphological and immunophenotypical complexity. Overall, T-cell lymphomas represent only 15 % of all non-Hodgkin lymphomas. This review is focused on addressing the current status of the categories of mature T-cell leukemias and lymphomas (nodal and extranodal) using an approach that incorporates histopathology, immunophenotype, and molecular understanding of the nature of these disorders, using the same philosophy of the most recent revised WHO classification of hematopoietic malignancies.
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Affiliation(s)
- Alejandro Ariel Gru
- Department of Pathology and Dermatology, Divisions of Hematopathology and Dermatopathology, Cutaneous Lymphoma Program, The Ohio State University Wexner Medical Center, Richard Solove 'The James' Comprehensive Cancer Center, 333 W 10th Ave, Columbus, OH, 43210, USA,
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52
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Demirkesen C, Esirgen G, Engin B, Songur A, Oğuz O. The clinical features and histopathologic patterns of folliculotropic mycosis fungoides in a series of 38 cases. J Cutan Pathol 2014; 42:22-31. [DOI: 10.1111/cup.12423] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/14/2014] [Accepted: 10/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Cuyan Demirkesen
- Department of Pathology; Cerrahpaşa Medical Faculty, Istanbul University; Istanbul Turkey
| | - Galip Esirgen
- Department of Pathology; Cerrahpaşa Medical Faculty, Istanbul University; Istanbul Turkey
| | - Burhan Engin
- Departments of Dermatology; Cerrahpaşa Medical Faculty, Istanbul University; Istanbul Turkey
| | - Abdullah Songur
- Departments of Dermatology; Cerrahpaşa Medical Faculty, Istanbul University; Istanbul Turkey
| | - Oya Oğuz
- Departments of Dermatology; Cerrahpaşa Medical Faculty, Istanbul University; Istanbul Turkey
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53
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Marschalkó M, Erős N, Kontár O, Hidvégi B, Telek J, Hársing J, Jókai H, Bottlik G, Rajnai H, Szepesi Á, Matolcsy A, Kárpáti S, Csomor J. Folliculotropic mycosis fungoides: clinicopathological analysis of 17 patients. J Eur Acad Dermatol Venereol 2014; 29:964-72. [DOI: 10.1111/jdv.12743] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/11/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. Marschalkó
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - N. Erős
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - O. Kontár
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - J. Telek
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - J. Hársing
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - H. Jókai
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - G. Bottlik
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - H. Rajnai
- 1st Department of Pathology and Experimental Cancer Research; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - Á. Szepesi
- 1st Department of Pathology and Experimental Cancer Research; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - A. Matolcsy
- 1st Department of Pathology and Experimental Cancer Research; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - S. Kárpáti
- Department of Dermatology, Venerology and Dermatooncology; Semmelweis University; Faculty of Medicine; Budapest Hungary
| | - J. Csomor
- 1st Department of Pathology and Experimental Cancer Research; Semmelweis University; Faculty of Medicine; Budapest Hungary
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54
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Abstract
BACKGROUND Folliculotropic mycosis fungoides represents a rare variant of the CD4-positive cutaneous T-cell lymphoma mycosis fungoides. It is characterized by tropism of the lymphocytic infiltrate for hair follicle and other adnexal structures. CASE PRESENTATION Our patient presented with a 20-year history of pruritic skin lesions, which had been diagnosed as atopic dermatitis. The diagnosis of folliculotropic mycosis fungoides was confirmed by skin biopsy. Since topical therapy was ineffective, systemic therapy was initiated promptly. Treatment with pegylated interferon alpha-2b 25 µg/week led to significant improvement of the skin condition. CONCLUSION Due to its polymorphic clinical presentation, folliculotropic mycosis fungoides is diagnosed with delay and in a later stage than classical mycosis fungoides. Thus we recommend an early skin biopsy in patients with therapy-resistant pruritic skin lesions.
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Affiliation(s)
- J Baratli
- Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland,
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55
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Scarisbrick J, Kim Y, Whittaker S, Wood G, Vermeer M, Prince H, Quaglino P. Prognostic factors, prognostic indices and staging in mycosis fungoides and Sézary syndrome: where are we now? Br J Dermatol 2014; 170:1226-36. [DOI: 10.1111/bjd.12909] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2014] [Indexed: 12/28/2022]
Affiliation(s)
- J.J. Scarisbrick
- Department of Dermatology; University Hospital Birmingham; Birmingham U.K
| | - Y.H. Kim
- Stanford Cancer Centre & School of Medicine; Stanford CA U.S.A
| | - S.J. Whittaker
- Department of Dermatology; Guy's and St Thomas' NHS Trust; London U.K
| | - G.S. Wood
- Department of Dermatology; University of Wisconsin and Middleton VA Medical Center; Madison WI U.S.A
| | - M.H. Vermeer
- Department of Dermatology; Leiden University Medical Centre; Leiden the Netherlands
| | - H.M. Prince
- Peter MacCallum Cancer Centre and University of Melbourne; Melbourne VIC Australia
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic; University of Torino; Turin Italy
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56
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Bakar O, Seçkin D, Demirkesen C, Baykal C, Büyükbabani N. Two Clinically Unusual Cases of Folliculotropic Mycosis Fungoides: One with and the Other without Syringotropism. Ann Dermatol 2014; 26:385-91. [PMID: 24966641 PMCID: PMC4069652 DOI: 10.5021/ad.2014.26.3.385] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 01/12/2012] [Accepted: 01/19/2012] [Indexed: 11/18/2022] Open
Abstract
Mycosis fungoides is the most common form of cutaneous T-cell lymphoma, and it rarely exhibits predilection for hair follicle and eccrine gland infiltration. Here, we present 2 similar cases that display folliculotropism with varying amounts of follicular mucinosis, with and without syringotropism. The features observed in both cases were cystic, comedo-like, acneiform lesions; generalized involvement with loss of body hair; pruritus; and hidradenitis suppurativa-like lesions. Hypohidrosis as well as nail and palmoplantar involvement with lichen planopilaris-like clinical features were unique characteristics of the first case. Despite the well-known aggressive behavior of follicular mycosis fungoides, the presented cases had a subtle, slowly progressive, but persistent, clinical course. Folliculotropic and syringotropic mycosis fungoides are variants of cutaneous T-cell lymphoma. Clinical presentations might be challenging, and multiple, deep biopsy specimens containing adnexal structures are required for this critical diagnosis. Aggressive treatment may not be necessary in cases having an indolent course, especially in those with syringotropism.
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Affiliation(s)
- Ozgür Bakar
- Department of Dermatology, School of Medicine, Acibadem University, Istanbul, Turkey
| | - Dilek Seçkin
- Department of Dermatology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Cuyan Demirkesen
- Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nesimi Büyükbabani
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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57
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Abstract
Bexarotene is a retinoid that specifically binds retinoid X receptors and has numerous effects on cellular growth and differentiation. It is approved for the treatment of cutaneous T cell lymphoma both topically and systemically. Adverse effects include hyperlipidemia, central hypothyroidism, and neutropenia with bexarotene capsules, and an irritant dermatitis with bexarotene gel. With aggressive management of these potential side effects, bexarotene is an additional option in the armamentarium for management of cutaneous T cell lymphoma.
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Affiliation(s)
- Courtney R Schadt
- Medicine (Dermatology), University of Louisville, Louisville, Kentucky
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58
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Mycosis fongoïde avec mucinose folliculaire révélé par un spinulosis des plis. Ann Dermatol Venereol 2014; 141:482-4. [DOI: 10.1016/j.annder.2014.04.115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 03/27/2014] [Accepted: 04/07/2014] [Indexed: 11/20/2022]
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59
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Abstract
Mycosis fungoides (MF) is a cutaneous T-cell lymphoma that usually manifests as patches and plaques with a propensity for nonphotoexposed areas. MF is a common mimicker of inflammatory and infectious skin diseases, because it can be manifested with a wide variety of clinical and pathologic presentations. These atypical presentations of MF may be difficult to diagnose, requiring a high level of suspicion and careful clinicopathologic correlation. Within this array of clinical presentations, the World Health Organization classification recognizes 3 MF variants: folliculotropic MF, pagetoid reticulosis, and granulomatous slack skin. These 3 variants, as well as hypopigmented MF, are addressed in this article.
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Affiliation(s)
- M Estela Martínez-Escala
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 1600, Chicago, IL 60611, USA; Department of Pathology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 1600, Chicago, IL 60611, USA
| | - Belén Rubio González
- Dermatology Department, Hospital 12 de Octubre, Avda de Córdoba s/n, 28041 - Madrid, Spain
| | - Joan Guitart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 1600, Chicago, IL 60611, USA; Department of Pathology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 1600, Chicago, IL 60611, USA; Division of Hematology/Oncology Department, Robert H. Lurie Comprehensive Cancer Center, 675 North Saint Clair Street, Suite 19 100, Chicago, IL 60611, USA.
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60
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Juvenile mycosis fungoides: Cutaneous T-cell lymphoma with frequent follicular involvement. J Am Acad Dermatol 2014; 70:993-1001. [DOI: 10.1016/j.jaad.2013.12.029] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 12/11/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022]
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61
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Jawed SI, Myskowski PL, Horwitz S, Moskowitz A, Querfeld C. Primary cutaneous T-cell lymphoma (mycosis fungoides and Sézary syndrome). J Am Acad Dermatol 2014; 70:205.e1-16; quiz 221-2. [DOI: 10.1016/j.jaad.2013.07.049] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 06/25/2013] [Accepted: 07/01/2013] [Indexed: 02/08/2023]
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62
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Wang L, Wang G, Gao T. Granulomatous syringotropic mycosis fungoides with two lesions having reactive B-cell proliferation. J Cutan Pathol 2014; 41:400-6. [PMID: 24438472 DOI: 10.1111/cup.12284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/25/2013] [Accepted: 11/17/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Lei Wang
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
| | - Gang Wang
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
| | - Tianwen Gao
- Department of Dermatology; Xijing Hospital, Fourth Military Medical University; Xian China
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63
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Kutane Lymphome. MEDIKAMENTÖSE TUMORTHERAPIE IN DER DERMATO-ONKOLOGIE 2014. [PMCID: PMC7122836 DOI: 10.1007/978-3-642-24837-5_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Kutane Lymphome (cutaneous lymphomas: CL) umfassen die Gruppe der kutanen T-Zell-Lymphome (cutaneous T-cell lymphomas: CTCL), kutanen B-Zell-Lymphome (cutaneous B-cell lymphomas: CBCL) und die sog. hämatodermischen Neoplasien (HN). CL gehören zur Gruppe der Non-Hodgkin-Lymphome (NHL) und stellen in der Subgruppe der extranodalen NHL die zweithäufigste Gruppe hinter den gastrointestinalen Lymphomen dar (Jaffe et al. 2009). Man unterscheidet zwischen primären und sekundären CL. Primäre CL
haben ihren Ursprung in der Haut und bleiben in der Regel darauf auch längere Zeit beschränkt, während sekundäre LymphomekutaneCL kutane Manifestationen von primär nodalen oder extranodalen Lymphomen darstellen (Willemze 2005). Die primären CL unterscheiden sich hinsichtlich klinischem Verlauf, Therapieoptionen und Prognose erheblich von nodalen und extrakutanen Lymphomen. So zeigen z. B. die primär kutanen CD30+ Lymphome einen gutartigen Verlauf, wogegen die nodalen Varianten als aggressiv eingestuft werden. Da die CL zumeist weniger aggressiv sind, werden sie weniger aggressiv behandelt.
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64
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Reduced-intensity conditioning followed by cord blood transplantation in a patient with refractory folliculotropic mycosis fungoides. Int J Hematol 2013; 98:491-5. [DOI: 10.1007/s12185-013-1410-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 08/05/2013] [Accepted: 08/06/2013] [Indexed: 10/26/2022]
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65
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Levidou G, Siakantaris M, Papadaki T, Papadavid E, Vassilakopoulos TP, Angelopoulou MK, Marinos L, Nikolaou V, Economidi A, Antoniou C, Patsouris E, Korkolopoulou P. A comprehensive immunohistochemical approach of AKT/mTOR pathway and p-STAT3 in mycosis fungoides. J Am Acad Dermatol 2013; 69:375-84. [PMID: 23685026 DOI: 10.1016/j.jaad.2013.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 12/19/2012] [Accepted: 04/08/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although the expression pattern of phosphorylated (p)-mTOR pathway components has attracted scientific interest in several neoplasms, to our knowledge, there is no published information regarding its significance in mycosis fungoides (MF). OBJECTIVE We sought to perform a comprehensive simultaneous assessment of key members of AKT/mTOR pathway along with p-extracellular signal-regulated kinase (ERK), NOTCH1, and p-STAT3 in patients with MF. METHODS In all, 54 skin biopsy specimens (21 tumors, 30 plaques, and 3 folliculotropic MF) from 50 patients with MF were analyzed immunohistochemically for p-mTOR, its upstream p-AKT, its downstream effectors p-p70S6K and p-4E-BP1, and for p-ERK1/2, NOTCH1, and p-STAT3. RESULTS p-mTOR was coexpressed with p-p70S6K in 67.3% of lesions, but coexpression with other molecules was less common. p-p70S6K and marginally NOTCH1 displayed higher H-scores in tumors than in plaques. Significant correlations were recorded between p-ERK and p-4E-BP1, as well as between NOTCH1 and p-p70S6K or p-4E-BP1. NOTCH1, p-4E-BP1, and p-p70S6K expression were associated with advanced stage. In survival analysis simultaneous overexpression of p-AKT and p-p70S6K, along with p-4E-BP1 positivity, adversely affected cancer-specific, disease-free, and progression-free survival in advanced-stage cases. LIMITATIONS A limitation may be the small number of cases included in our investigation, precluding multivariate survival analysis. CONCLUSIONS Activation of AKT/mTOR pathway in MF appears to be correlated with NOTCH1, p-ERK, and p-STAT3 and is implicated in the acquisition of a more aggressive phenotype. The combination of p-AKT, p-p70S6K, and p-4E-BP1 emerges as a significant potential prognostic marker in patients with advanced stage.
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Affiliation(s)
- Georgia Levidou
- Department of Pathology, University of Athens, Medical School, Athens, Greece.
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66
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Debu A, Bessis D, Girard C, Du Thanh A, Guillot B, Dereure O. Photodynamic therapy with methyl aminolaevulinate for cervical and/or facial lesions of folliculotropic mycosis fungoides: interest and limits. Br J Dermatol 2012; 168:896-8. [DOI: 10.1111/bjd.12064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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67
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68
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Kempf W, Kazakov DV, Schermesser M, Buechner SA, Parmentier L, Wysocki A, Palmedo G, Häusermann P. Unilesional follicular mycosis fungoides: report of two cases with progression to tumor stage and review of the literature. J Cutan Pathol 2012; 39:853-60. [DOI: 10.1111/j.1600-0560.2012.01965.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/22/2012] [Accepted: 06/17/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz; Histologische Diagnostik; Zurich; Switzerland
| | - Dmitry V. Kazakov
- Department of Pathology; Faculty of Medicine in Pilsen; Charles University in Prague; Prague; Czech Republic
| | | | | | | | - Anja Wysocki
- Department of Dermatology; Kantonsspital Lucerne; Lucerne; Switzerland
| | - Gabriele Palmedo
- Dermatopathologie Friedrichshafen Bodensee; Friedrichshafen; Germany
| | - Peter Häusermann
- Department of Dermatology; University Hospital Basel; Basel; Switzerland
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69
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Chan D, Aneja S, Honda K, Carlson S, Yao M, Katcher J, Cooper K. Radiation therapy in the management of unilesional primary cutaneous T‐cell lymphomas. Br J Dermatol 2012; 166:1134-7. [DOI: 10.1111/j.1365-2133.2011.10728.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]
Affiliation(s)
| | - S. Aneja
- Case Western Reserve School of Medicine, Cleveland, OH, U.S.A
| | - K. Honda
- Departments of Dermatology and
- Case Western Reserve School of Medicine, Cleveland, OH, U.S.A
- Case Comprehensive Cancer Center, Cleveland, OH, U.S.A
| | - S. Carlson
- Department of Dermatology, Ohio State University, Columbus, OH, U.S.A.
E‐mail:
| | - M. Yao
- Radiation Oncology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Lakeside 3500, Cleveland, OH 44124, U.S.A
- Case Western Reserve School of Medicine, Cleveland, OH, U.S.A
- Case Comprehensive Cancer Center, Cleveland, OH, U.S.A
| | - J. Katcher
- Radiation Oncology, University Hospitals Case Medical Center, 11100 Euclid Avenue, Lakeside 3500, Cleveland, OH 44124, U.S.A
- Case Western Reserve School of Medicine, Cleveland, OH, U.S.A
- Case Comprehensive Cancer Center, Cleveland, OH, U.S.A
| | - K.D. Cooper
- Departments of Dermatology and
- Case Western Reserve School of Medicine, Cleveland, OH, U.S.A
- Case Comprehensive Cancer Center, Cleveland, OH, U.S.A
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70
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Beylot-Barry M, Dereure O, Vergier B, Barete S, Laroche L, Machet L, Delfau-Larue MH, D’Incan M, Grange F, Ortonne N, Merlio JP, Bagot M. Prise en charge des lymphomes T cutanés : recommandations du Groupe français d’étude des lymphomes cutanés. Ann Dermatol Venereol 2010; 137:611-21. [DOI: 10.1016/j.annder.2010.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 04/19/2010] [Accepted: 06/22/2010] [Indexed: 10/19/2022]
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