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Blanchard M, Morren MA, Busschots AM, Hauben E, Alberti-Violetti S, Berti E, Avallone G, Tavoletti G, Panzone M, Quaglino P, Colonna C, Melchers RC, Vermeer MH, Gniadecki R, Mitteldorf C, Gosmann J, Stadler R, Jonak C, Oren-Shabtai M, Hodak E, Friedland R, Gordon E, Geskin LJ, Scarisbrick JJ, Mayo Martínez F, Noguera Morel L, Pehr K, Amarov B, Faouzi M, Nicolay JP, Kempf W, Blanchard G, Guenova E. Paediatric-onset lymphomatoid papulosis: results of a multicentre retrospective cohort study on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG). Br J Dermatol 2024; 191:233-242. [PMID: 38595050 DOI: 10.1093/bjd/ljae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. OBJECTIVES To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. METHODS This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. RESULTS Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0-14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0-19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01-88.99). CONCLUSIONS We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.
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Affiliation(s)
- Maël Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gabriela Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
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2
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Magro CM, Mo JH, Telang G. Localized lymphomatoid papulosis: Unilesional lymphomatoid papulosis, regional lymphomatoid papulosis, and persistent agmination of lymphomatoid papulosis. Clin Dermatol 2022; 40:622-638. [PMID: 35907581 DOI: 10.1016/j.clindermatol.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lymphomatoid papulosis (LYP), the most common primary cutaneous CD30-positive lymphoproliferative disorder, is heralded by multiple papular and nodular lesions at anatomically discontiguous cutaneous sites. The histologic patterns are protean. An uncommon form of LYP is one that is anatomically confined. Cases of unilesional LYP, regional LYP, and persistent agmination of LYP were encountered in the routine and consultative practices of Weill Cornell Medicine, Division of Dermatopathology. The clinical presentation, outcomes, light microscopic findings, and phenotypic profile are reviewed. There were 10 cases of LYP presenting as solitary plaques or nodules primarily occurring in older patients and without a relevant medical history in most. Most cases occurred at an acral site with many localized to the foot; the morphology was one of a necrotizing angiocentric type E pattern and borderline type C morphology. Two of the unilesional patients in our series went on to develop mycosis fungoides, one at the initial site of unilesional type A LYP, and the other at a discontiguous site. Excluding one case, the solitary lesions underwent complete regression; after the lesions regressed, some cases had no apparent recurrence. The second anatomically confined variant of LYP in our series was regional LYP exhibiting a type E morphology in two cases and a hybrid type A and granulomatous eccrinotropic morphology in one case. There was no subsequent development of lymphoma, nor was there any spread to additional anatomic sites. The final category was persistent agmination of LYP, whereby the agminated papules of LYP were superimposed on a plaque of cutaneous T-cell lymphoma represented by mycosis fungoides in two and follicular helper T-cell lymphoma in one. In conclusion, anatomically confined LYP defines an uncommon form of LYP, but it is an important one to recognize because the histology can be worrisome despite an indolent clinical course. The clinical presentation, the infrequent association with lymphoma/leukemia, and histology are similar to conventional LYP, although there appears to be a greater tendency for complete regression without recurrence, excluding cases of persistent agmination of LYP whereby the clinical course warrants categorization as a form of cutaneous T cell lymphoma (CTCL).
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Affiliation(s)
- Cynthia M Magro
- Division of Dermatopathology, Weill Cornell Medicine, New York, New York, USA.
| | - Joshua H Mo
- Department of Dermatology, Brown University Alpert School of Medicine, Providence, Rhode Island, USA
| | - Gladys Telang
- Department of Dermatology, Brown University Alpert School of Medicine, Providence, Rhode Island, USA
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Abstract
Primary cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphomas that present in the skin with no evidence of extracutaneous disease at the time of diagnosis. CTCL subtypes demonstrate a variety of clinical, histological, and molecular features, and can follow an indolent or a very aggressive course. The underlying pathogenetic mechanisms are not yet entirely understood. The pathophysiology of CTCL is complex and a single initiating factor has not yet been identified. Diagnosis is based on clinicopathological correlation and requires an interdisciplinary team. Treatment decision is made based on short-term and long-term goals. Therapy options comprise skin-directed therapies, such as topical steroids or phototherapy, and systemic therapies, such as monoclonal antibodies or chemotherapy. So far, the only curative treatment approach is allogeneic haematopoietic stem cell transplantation. Novel therapies, such as chimeric antigen receptor T cells, monoclonal antibodies or small molecules, are being investigated in clinical trials. Patients with CTCL have reduced quality of life and a lack of effective treatment options. Further research is needed to better identify the underlying mechanisms of CTCL development and course as well as to better tailor treatment strategies to individual patients.
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4
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Bergqvist C, Beylot-Barry M, Ram-Wolff C, Vergier B, Bagot M, Battistella M, Dalle S, Balme B, Merlio JP, Durupt F, Le Corre Y, Bonnet N, Le Bozec P, Skowron F, Vivard-Wallee I, Dereure O, Brunet-Possenti F, Ingen-Housz-Oro S, Ortonne N. Lymphomatoid papulosis types D and E: a multicentre series of the French Cutaneous Lymphomas Study Group. Clin Exp Dermatol 2021; 46:1441-1451. [PMID: 33987864 DOI: 10.1111/ced.14730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) type D (LyP D) and type E (LyP E) have recently been described in small series of cases or isolated case reports. AIM To further describe the clinical and histological features of LyP D and E based on a retrospective multicentre study. METHODS The clinical and histopathological features of 29 patients with an initial diagnosis of LyP D or LyP E were retrospectively assessed using standardized forms. RESULTS After exclusion of 5 cases, 24 patients (14 LyP D, 10 LyP E) were enrolled in the study. The median follow-up was 2.5 years (range 1 month to 13 years). LyP D was characterized by multiple recurrent self-regressing small papules that developed central erosion or necrosis, whereas LyP E presented as papulonodular lesions that rapidly evolved into necrotic eschar-like lesions > 10 mm in size. Epidermal changes were more frequent in LyP D, whereas dermal infiltrates were deeper in LyP E. Anaplastic cytology was rare and the DUSP22 rearrangement was never observed. Two patients (8%) had an associated cutaneous lymphoma. CONCLUSION LyP D and E have distinct clinical findings and may be associated with other cutaneous lymphomas.
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Affiliation(s)
- C Bergqvist
- Department of, Dermatology, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - M Beylot-Barry
- Department of, Dermatology, Bordeaux University Hospital, Bordeaux, France.,Cutaneous Lymphoma Oncogenesis Team, INSERM U1053 Bordeaux Research in Translational Oncology (BaRITOn), Bordeaux University, Bordeaux, France.,French Cutaneous Lymphomas Study Group, Paris, France
| | - C Ram-Wolff
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of, Dermatology, AP-HP, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - B Vergier
- Department of, Pathology, Bordeaux University Hospital, Bordeaux, France.,French Cutaneous Lymphomas Study Group, Paris, France
| | - M Bagot
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of, Dermatology, AP-HP, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - M Battistella
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of, Pathology, AP-HP, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - S Dalle
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of, Dermatology, University Hospital of Lyon-Sud, Lyon, France
| | - B Balme
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of, Dermatology, University Hospital of Lyon-Sud, Lyon, France.,Department of, Pathology, University Hospital of Lyon-Sud, Lyon, France
| | - J P Merlio
- Cutaneous Lymphoma Oncogenesis Team, INSERM U1053 Bordeaux Research in Translational Oncology (BaRITOn), Bordeaux University, Bordeaux, France.,French Cutaneous Lymphomas Study Group, Paris, France
| | - F Durupt
- Department of Dermatology, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Y Le Corre
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of Dermatology, CHU Angers, Angers, France
| | - N Bonnet
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of Dermatology, Hôpitaux de Marseille, Marseille, France
| | - P Le Bozec
- Department of Dermatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - F Skowron
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of Dermatology, Centre Hospitalier de Valence, Valence, France
| | | | - O Dereure
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of Dermatology, CHU de Montpellier, Montpellier, France
| | - F Brunet-Possenti
- French Cutaneous Lymphomas Study Group, Paris, France.,Department of Dermatology, AP-HP, Hôpital Bichat, Paris, France
| | - S Ingen-Housz-Oro
- Department of, Dermatology, AP-HP, Hôpital Henri Mondor, Créteil, France.,French Cutaneous Lymphomas Study Group, Paris, France
| | - N Ortonne
- Department of, Pathology, AP-HP, Hôpital Henri Mondor, Créteil, France.,French Cutaneous Lymphomas Study Group, Paris, France.,Paris Est Creteil University (UPEC) and IMRB, INSERM U955 Team Ortonne (NFL), Créteil, France
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5
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Melchers RC, Willemze R, Bekkenk MW, de Haas ERM, Horvath B, van Rossum MM, Sanders CJG, Veraart JCJM, Putter H, Jansen PM, Vermeer MH, Quint KD. Frequency and prognosis of associated malignancies in 504 patients with lymphomatoid papulosis. J Eur Acad Dermatol Venereol 2019; 34:260-266. [PMID: 31715046 PMCID: PMC7028293 DOI: 10.1111/jdv.16065] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/24/2019] [Indexed: 12/18/2022]
Abstract
Background Lymphomatoid papulosis (LyP) can be associated with other haematological malignancies (HM), but reported percentages vary from 20% to over 50%. Objective To evaluate the frequency and prognostic significance of associated HM and non‐HM in LyP patients. Methods In this multicentre cohort study, the complete Dutch LyP population was included from the Dutch Cutaneous Lymphoma Registry between 1985 and 2018. Clinical and histopathological information was retrieved from every individual patient. Results After a median follow‐up of 120 months (range, 6–585), an associated HM was observed in 78/504 (15.5%) patients. Most common associated HM were mycosis fungoides (MF; n = 31) and anaplastic large‐cell lymphoma (ALCL; n = 29), while 19 patients had another HM of B‐cell (n = 14) or myeloid origin (n = 5). Even after a 25‐year follow‐up period, percentages of associated HM did not exceed 20%. Thirty‐nine of 465 patients (8.4%) without a prior or concurrent associated HM developed an associated HM during follow‐up, after a median of 68 months (range of 3–286 months). Nine of 78 patients died of associated HM, including 6/22 patients developing extracutaneous ALCL, while all patients with associated MF or skin‐limited ALCL had an excellent prognosis. Compared with the general population, LyP patients showed an increased risk (relative risk, 2.8; 95% confidence intervals, 2.4–3.3) for non‐HM, in particular cutaneous squamous cell carcinoma, melanoma and intestinal/lung/bladder cancer. Conclusions An associated HM was reported in 15.5% of the LyP patients, particularly MF and ALCL. Although the frequency of associated HM is lower than suggested and the prognosis of most patients with associated HM is excellent, a small subgroup will develop aggressive disease, in particular extracutaneous ALCL. Furthermore, LyP patients have a higher risk of developing other malignancies. Clinicians should be aware of these risks, and LyP patients require close monitoring. Linked article: F. Rongioletti. J Eur Acad Dermatol Venereol 2020; 34: 216–217. https://doi.org/10.1111/jdv.16157.
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Affiliation(s)
- R C Melchers
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - R Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - M W Bekkenk
- Department of Dermatology, Academic Medical Center, Vrije University Medical Center, Amsterdam, The Netherlands
| | - E R M de Haas
- Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - B Horvath
- Department of Dermatology, University Medical Center of Groningen, Groningen, The Netherlands
| | - M M van Rossum
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C J G Sanders
- Department of Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J C J M Veraart
- Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - H Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - P M Jansen
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - M H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - K D Quint
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
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6
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Moy A, Sun J, Ma S, Seminario-Vidal L. Lymphomatoid Papulosis and Other Lymphoma-Like Diseases. Dermatol Clin 2019; 37:471-482. [DOI: 10.1016/j.det.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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7
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Su C, Nguyen KA, Bai HX, Zogg CK, Cao Y, Karakousis G, Zhang PJ, Zhang G, Xiao R. Ethnic disparity in primary cutaneous CD30 + T-cell lymphoproliferative disorders: an analysis of 1496 cases from the US National Cancer Database. Br J Haematol 2018; 181:752-759. [PMID: 29676444 DOI: 10.1111/bjh.15222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/28/2017] [Indexed: 11/30/2022]
Abstract
Primary cutaneous CD30+ T cell lymphoproliferative disorders (PCLPD), the second most common type of primary cutaneous T cell lymphomas, accounts for approximately 25-30% of cutaneous T-cell lymphoma cases. However, only small retrospective studies have been reported. We aimed to identify prognostic factors and evaluate the overall survival (OS) of patients with PCLPD stratified by ethnicity. We identified 1496 patients diagnosed with PCLPD between 2004 and 2014 in the US National Cancer Database. Chi-square test and anova were used to evaluate differences in demographic and disease characteristics, socioeconomic factors and treatments received. OS was evaluated with the log-rank test, Cox proportional hazard regression analysis, and propensity score matching. The study included 1267 Caucasians, 153 African Americans (AA), 43 Asians, and 33 of other/unknown ethnicity. Older age, higher Charlson-Deyo score, higher clinical stage and receipt of chemotherapy were predictors of shorter OS. Primary disease site on a lower extremity was associated with shorter OS, while a head and neck location was associated with longer OS. AA patients had shorter OS when compared to Caucasian patients on multivariate analysis. This ethnic disparity persisted on propensity-score matched analysis and after matching Caucasian and AA patients on demographic and disease characteristics, socioeconomic factors and treatments received, and age and gender-matched relative survival analyses.
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Affiliation(s)
- Chang Su
- The Second Xiangya Hospital, Central South University, Department of Dermatology, Changsha, Hunan, China.,Yale School of Medicine, New Haven, CT, USA
| | - Kevin A Nguyen
- Department of Molecular Biophysics and Biochemistry, Yale School of Medicine, New Haven, CT, USA
| | - Harrison X Bai
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Ya Cao
- Central South University, Cancer Research Institute, School of Basic Medicine, Changsha, Hunan, China
| | - Giorgos Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Paul J Zhang
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Guiying Zhang
- The Second Xiangya Hospital, Central South University, Department of Dermatology, Changsha, Hunan, China
| | - Rong Xiao
- The Second Xiangya Hospital, Central South University, Department of Dermatology, Changsha, Hunan, China
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8
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Abstract
Primary cutaneous CD30+ lymphoproliferative disorders encompass lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (pcALCL), and indeterminate cases. LyP is a benign disorder characterized by recurrent crops of red or violaceous papulonodules. Patients with LyP are at an increased risk of a secondary malignancy. pcALCL is characterized by a solitary red to violaceous nodule or tumor larger than 20 mm. LyP is benign, is limited to the skin, and self-resolves, with a 5-year survival rate of 100%; pcALCL is limited to the skin and responsive to directed therapies, with a 5-year survival rate of over 95%. Aggressive chemotherapeutic regimens should be avoided.
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MESH Headings
- Disease-Free Survival
- Humans
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, Large-Cell, Anaplastic/metabolism
- Lymphoma, Large-Cell, Anaplastic/mortality
- Lymphomatoid Papulosis/diagnosis
- Lymphomatoid Papulosis/drug therapy
- Lymphomatoid Papulosis/metabolism
- Lymphomatoid Papulosis/mortality
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/mortality
- Risk Factors
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/metabolism
- Skin Neoplasms/microbiology
- Survival Rate
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Affiliation(s)
- Maxwell B Sauder
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - John T O'Malley
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA.
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Marschalkó M, Gyöngyösi N, Noll J, Károlyi Z, Wikonkál N, Hársing J, Kuroli E, Csomor J, Matolcsy A, Sarolta K, Szepesi Á. Histopathological aspects and differential diagnosis of CD8 positive lymphomatoid papulosis. J Cutan Pathol 2016; 43:963-973. [DOI: 10.1111/cup.12779] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/07/2016] [Accepted: 07/22/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Márta Marschalkó
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Nóra Gyöngyösi
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Noll
- Department of Dermatology; Heim Pál Childrens Hospital; Budapest Hungary
| | | | - Norbert Wikonkál
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Hársing
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Enikő Kuroli
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Judit Csomor
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - András Matolcsy
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
| | - Kárpáti Sarolta
- Department of Dermatology Venereology and Dermatooncology; Semmelweis University; Budapest Hungary
| | - Ágota Szepesi
- 1st Department of Pathology and Experimental Cancer Research Institute; Semmelweis University; Budapest Hungary
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10
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A Primary Cutaneous CD30-Positive T-Cell Lymphoproliferative Disorder Arising in a Patient With Multiple Myeloma and Cutaneous Amyloidosis. Am J Dermatopathol 2016; 38:388-92. [PMID: 26981738 DOI: 10.1097/dad.0000000000000534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
CD30-positive cutaneous lymphoproliferative disorders, a group of T-cell neoplasms, including lymphomatoid papulosis (LyP) and cutaneous anaplastic large cell lymphoma, require careful clinicopathologic correlation for diagnosis. An association between LyP and the development of a second hematolymphoid malignancy has been established in the literature. LyP has also been reported with systemic amyloidosis, but no such reports have documented coexisting cutaneous amyloid deposition with LyP to our knowledge. A 66-year-old woman with cutaneous amyloidosis, secondary to multiple myeloma, in remission, presented with erythematous and dark-brown papules involving the right arm, scalp, and torso. Punch biopsy of the arm showed a dermal infiltrate of intermediate-sized lymphocytes, some of which displayed a plasmacytoid morphology and prominent nodular subepidermal amyloid deposition. Punch biopsy of the scalp similarly showed a nonepidermotropic dense dermal infiltrate of intermediate-sized plasmacytoid lymphocytes and multifocal amyloid deposition. Both infiltrates were immunophenotypically CD30-positive, anaplastic lymphoma kinase-negative T-cell lymphoproliferative processes. Subsequent studies showed no systemic involvement, and clinical correlation suggested a final diagnosis of LyP. We present this case of LyP, which histologically mimics a B-cell proliferation with a plasmacytoid morphology arising in association with cutaneous amyloidosis to highlight the importance of clinicopathologic correlation, a thorough battery of immunohistochemical studies, and consideration for a second hematologic malignancy arising in the setting of LyP.
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11
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Cordel N, Tressières B, D'Incan M, Machet L, Grange F, Estève É, Dalac S, Ingen-Housz-Oro S, Bagot M, Beylot-Barry M, Joly P. Frequency and Risk Factors for Associated Lymphomas in Patients With Lymphomatoid Papulosis. Oncologist 2015; 21:76-83. [PMID: 26668250 DOI: 10.1634/theoncologist.2015-0242] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is classified as an indolent cutaneous lymphoma, but outcome dramatically worsens if LyP is associated with lymphoma. The frequency of this association remains unclear in the literature. Here, we assess the frequency and risk factors of association between LyP and another lymphoma in an 11-year retrospective study conducted in 8 dermatology departments belonging to the French Study Group on Cutaneous Lymphoma (FSGCL). PATIENTS AND METHODS Patients with LyP were identified and data extracted from the FSGCL registry between 1991 and 2006. Patients were followed up to January 2014. Age, sex, number of skin lesions, histologic subtype, and genotype were recorded at baseline. Risk factors were determined using univariate and multivariate analysis. Cumulative probability of association was calculated using the Kaplan-Meier method. RESULTS We observed 52 cases of lymphomas (cutaneous, n = 38; systemic, n = 14) in 44 of 106 patients (41%). Lymphoma diagnosis was concomitant with or prior to LyP diagnosis in 31 cases and occurred during the course of LyP in 21 cases (cutaneous, n = 14; systemic, n = 7; median delay: 5 years; interquartile range: 1.5-7 years). In multivariate analysis, main prognostic factors for association between LyP and another lymphoma were older age (odds ratio [OR]: 1.05 per year; 95% confidence interval [CI]: 1.01-1.08; p = .011) and presence of a T-cell clone in LyP lesions (OR: 7.55; 95% CI: 2.18-26.18; p = .001). CONCLUSION Older age and presence of a T-cell clone in LyP lesions are risk factors for associated lymphomas in patients with LyP. These findings should help to identify patients who require close management in clinical practice. IMPLICATIONS FOR PRACTICE The management of lymphomatoid papulosis (LyP) is that of an indolent cutaneous lymphoma, based on its excellent prognosis. However, this good prognosis is altered if LyP is associated with lymphoma. Furthermore, risk factors for and frequency of this association remain unclear in the literature. The results presented here demonstrate a high rate of association between LyP and other lymphomas (41%) as well as a long median delay of occurrence (5 years), which emphasizes the need for prolonged follow-up of patients with LyP. Moreover, two main risk factors (i.e., older age and presence of a T-cell clone in LyP lesions) are highlighted, which should help clinical practitioners to identify patients who require close management.
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Affiliation(s)
- Nadège Cordel
- Unit of Dermatology and Internal Medicine, Guadeloupe University Hospital and EA 4546, Antilles University, Pointe-à-Pitre, Guadeloupe
| | - Benoît Tressières
- Centre d'investigation clinique Antilles-Guyane, INSERM CIC 1424, Pointe-à-Pitre, Guadeloupe
| | - Michel D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, University of Auvergne, Clermond-Ferrand, France
| | - Laurent Machet
- Department of Dermatology, Tours University Hospital and François Rabelais University, Tours, France
| | - Florent Grange
- Department of Dermatology, Robert Debré Hospital and EA 7319, University of Reims Champagne-Ardennes, Reims, France
| | - Éric Estève
- Department of Dermatology, Orléans Regional Hospital, Orléans, France
| | - Sophie Dalac
- Department of Dermatology, Dijon University Hospital, Dijon, France
| | | | - Martine Bagot
- Department of Dermatology, Paris University Hospitals-St Louis and INSERM U 976, Denis Diderot University, Sorbonne Paris Cité, Paris, France
| | - Marie Beylot-Barry
- Department of Dermatology, Bordeaux University Hospital and EA 2406, University of Bordeaux, Bordeaux, France
| | - Pascal Joly
- Department of Dermatology, Rouen University Hospital and INSERM U 519, Institute for Research and Innovation in Biomedicine, Rouen University, Rouen, Normandy, France
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12
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Samaraweera APR, Cohen SN, Akay EM, Evangelou N. Lymphomatoid papulosis: A cutaneous lymphoproliferative disorder in a patient on fingolimod for multiple sclerosis. Mult Scler 2015. [PMID: 26219664 DOI: 10.1177/1352458515597568] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fingolimod was the first oral disease-modifying treatment for relapsing-remitting multiple sclerosis. It has previously been associated with the development of lymphoma. OBJECTIVE To describe a case of lymphomatoid papulosis, a CD30+ cutaneous lymphoproliferative disorder, in a patient taking fingolimod. METHODS Case study. RESULTS Our patient developed lymphomatoid papulosis 2 months after starting fingolimod. Histology confirmed the diagnosis. The drug was withdrawn. Resolution began only 2 days later. CONCLUSIONS Lymphomatoid papulosis is a benign subtype of cutaneous T-cell lymphoma, but up to 20% of cases can transform to a malignant course. Patients on fingolimod and physicians caring for them should be mindful of the need to monitor the skin.
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Affiliation(s)
- Amal P R Samaraweera
- Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, UK
| | | | - Ela M Akay
- Nottingham University Hospitals NHS Trust, UK
| | - Nikos Evangelou
- Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, UK/Nottingham University Hospitals NHS Trust, UK
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13
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Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 cases. Plast Reconstr Surg 2015; 135:695-705. [PMID: 25490535 DOI: 10.1097/prs.0000000000001033] [Citation(s) in RCA: 235] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The first silicone breast implant was inserted in 1962. In 1997, the first case of anaplastic large cell lymphoma (ALCL) in association with a silicone breast implant was reported. The authors reviewed 37 articles in the world literature reporting on 79 patients and collected another 94 unreported cases as of the date of submission. METHODS The world literature was reviewed. Missing clinical and laboratory information was solicited from the authors and treating physicians. As several different specialties were involved, information was not in one place. Many (but not all) authors and treating physicians were responsive, resulting in incomplete data. RESULTS ALCL lesions first presented as late peri-implant seromas, a mass attached to the capsule, tumor erosion through the skin, in a regional node, or discovered during revision surgery. The clinical course varied widely from a single positive cytology result followed by apparent spontaneous resolution, to disseminated treatment-resistant tumor and death. There was no preference for saline or silicone fill or for cosmetic or reconstructive indications. Where implant history was known, the patient had received at least one textured-surface device. Extracapsular dissemination occurred in 18 cases; nine of those were fatal. Histochemical markers were primarily CD-30 and Alk-1. Other markers occurred at a lower frequency. Risk estimates ranged from one in 500,000 to one in 3 million women with implants. CONCLUSION Breast implant-associated ALCL is a novel manifestation of site- and material-specific lymphoma originating in a specific scar location, presenting a wide array of diverse characteristics and suggesting a multifactorial cause.
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14
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Fauconneau A, Pham-Ledard A, Cappellen D, Frison E, Prochazkova-Carlotti M, Parrens M, Dalle S, Joly P, Viraben R, Franck F, Ingen-Housz-Oro S, Giacchero D, Jullié ML, Vergier B, Merlio JP, Beylot-Barry M. Assessment of diagnostic criteria between primary cutaneous anaplastic large-cell lymphoma and CD30-rich transformed mycosis fungoides; a study of 66 cases. Br J Dermatol 2015; 172:1547-1554. [DOI: 10.1111/bjd.13690] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- A. Fauconneau
- Department of Dermatology; Hôpital Haut Lévêque; Avenue de Magellan; 33604 PESSAC France
| | - A. Pham-Ledard
- Department of Dermatology; Hôpital Haut Lévêque; Avenue de Magellan; 33604 PESSAC France
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
| | - D. Cappellen
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
| | - E. Frison
- Pole de Sante Publique; Service d'information Médicale; CHU Bordeaux; Bordeaux France
| | | | - M. Parrens
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
- Department of Pathology; CHU Bordeaux; Bordeaux France
| | - S. Dalle
- Centre de Recherche en Cancérologie de Lyon; Université Claude Bernard Lyon 1; Hospices Civils de Lyon; Lyon France
| | - P. Joly
- Department of Dermatology; CHU Rouen; Rouen France
| | - R. Viraben
- Department of Dermatology; CHU Toulouse; Toulouse France
| | - F. Franck
- Department of Pathology; CHU Clermont-Ferrand; Université d'Auvergne; Clermont-Ferrand France
| | | | - D. Giacchero
- Department of Dermatology; CHU Nice; Nice France
| | - M.-L. Jullié
- Department of Pathology; CHU Bordeaux; Bordeaux France
| | - B. Vergier
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
- Department of Pathology; CHU Bordeaux; Bordeaux France
| | - J.-P. Merlio
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
- Tumor Bank and Department of Tumor Biology; CHU Bordeaux; Bordeaux France
| | - M. Beylot-Barry
- Department of Dermatology; Hôpital Haut Lévêque; Avenue de Magellan; 33604 PESSAC France
- EA2406 Histology and Molecular Pathology of Tumors; Université de Bordeaux; Bordeaux France
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15
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Nikolaou V, Papadavid E, Ekonomidi A, Dalamaga M, Marinos L, Stratigos A, Papadaki T, Antoniou C. Association of clinicopathological characteristics with secondary neoplastic lymphoproliferative disorders in patients with lymphomatoid papulosis. Leuk Lymphoma 2014; 56:1303-7. [PMID: 25242096 DOI: 10.3109/10428194.2014.958821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Lymphomatoid papulosis (LyP) refers to an indolent cutaneous lymphoma. The association of prognostic clinicopathological risk factors with a second hematologic malignancy has not yet been determined. We investigated the prognostic effect of clinicopathological characteristics on the occurrence of a second lymphoma, as well as the first-line treatment, in 24 patients diagnosed with LyP using logistic regression models. We showed that lymphoma occurrence was associated with a lower mean age at onset of LyP symptoms, histological types B and C, head-located LyP lesions and a higher frequency of LyP recurrences. In multivariate analyses, histologic type A was associated with a lower risk of second lymphoma (odds ratio [OR] = 0.12, 95% confidence interval [CI] 0.014-0.98; p = 0.045) adjusting for age of LyP first symptomatology, and an important increased lymphoma-free survival rate (long-rank test; p = 0.06). Clinicopathological characteristics are important in defining the clearance or persistence of LyP lesions and may predict the occurrence of a second lymphoma.
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Affiliation(s)
- Vassiliki Nikolaou
- Dermatology Department, Andreas Syggros Hospital, Athens University Medical School , Athens , Greece
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16
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Meena M, Martin PA, Abouseif C, Bullpitt P. Lymphomatoid papulosis type C of the eyelid in a young girl: a case report and review of literature. Orbit 2014; 33:395-398. [PMID: 24911471 DOI: 10.3109/01676830.2014.907813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To report an unusual presentation of a case of Lymphomatoid papulosis(LyP) in a young girl. MATERIAL AND METHODS A 14-year-old female presented with a history of swelling of the left upper eyelid of two weeks duration. There was a history of trivial trauma prior to the swelling. The patient was diagnosed as having pre-septal cellulitis elsewhere and was put on oral antibiotics. The lesion was non-responsive to oral antibiotics. The patient was then referred to our hospital. Ocular examination revealed an elevated lesion measuring 15 mm × 10 mm on the left upper eyelid, associated with pre-septal swelling and induration. Ocular movements were normal. The anterior and posterior segment examination was normal. Incision biopsy was done from the eyelid lesion. Multiple cutaneous lesions were also biopsied. RESULTS The histopathology examination confirmed the diagnosis of lymphomatoid papulosis type C. Dermatological and systemic evaluation ruled out the other aggressive forms of CD30(+) lymphoid proliferation. CONCLUSION We report an unusual presentation of lymphomatoid papulosis(LyP) type C in a young girl. Complete systemic work up and histopathological evaluation is mandatory in cases of suspicious lesions, not responding to conservative treatment.
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Affiliation(s)
- Manju Meena
- Oculoplastic Unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital , Macquarie Street, Sydney, NSW , Australia and
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17
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Huang CH, Hsu CK, Lee JYY. Lymphomatoid papulosis in association with mycosis fungoides: A clinical and histopathologic review of five Taiwanese cases. DERMATOL SIN 2014. [DOI: 10.1016/j.dsi.2013.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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18
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McQuitty E, Curry JL, Tetzlaff MT, Prieto VG, Duvic M, Torres-Cabala C. The differential diagnosis of CD8-positive (“type D”) lymphomatoid papulosis. J Cutan Pathol 2013; 41:88-100. [DOI: 10.1111/cup.12243] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 05/12/2013] [Accepted: 06/09/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth McQuitty
- Department of Pathology and Immunology; Baylor College of Medicine; Houston TX USA
| | - Jonathan L. Curry
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | | | - Victor G. Prieto
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | - Madeleine Duvic
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
| | - Carlos Torres-Cabala
- Department of Pathology; MD Anderson Cancer Center; Houston TX USA
- Department of Dermatology; MD Anderson Cancer Center; Houston TX USA
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19
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Taskinen M, Jeskanen L, Karjalainen-Lindsberg ML, Mäkitie A, Mäkitie O, Ranki A. Combating cancer predisposition in association with idiopathic immune deficiency: a recurrent nodal and cutaneous T-cell lymphoproliferative disease in a patient with cartilage-hair hypoplasia. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2012; 13:73-6. [PMID: 22999941 DOI: 10.1016/j.clml.2012.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 06/09/2012] [Accepted: 06/15/2012] [Indexed: 10/27/2022]
Affiliation(s)
- Mervi Taskinen
- Department of Pediatrics, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
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21
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Lymphomatoid Papulosis Followed by Pityriasis Lichenoides: A Common Pathogenesis? Am J Dermatopathol 2011; 33:835-40. [DOI: 10.1097/dad.0b013e3181f4d8c3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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22
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Lin JW, Shiau WJ, Lu CI, Tsai CY, Wong WR, Hui RCY. Lymphomatoid papulosis: a clinical and histopathologic review and follow-up study of 34 cases in Taiwan. DERMATOL SIN 2011. [DOI: 10.1016/j.dsi.2011.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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23
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Sim JH, Kim YC. CD8+ Lymphomatoid Papulosis. Ann Dermatol 2011; 23:104-7. [PMID: 21738377 DOI: 10.5021/ad.2011.23.1.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 04/09/2010] [Accepted: 05/09/2010] [Indexed: 11/08/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is defined as a histologically malignant, but clinically benign condition. It can appear as erythematous pink to purple papules or nodules. Immunophenotyping studies of the lymphomatoid papulosis lesions have shown a predominance of a CD4 expression and negativity for CD8. However, a positive CD8 expression has rarely been reported for LyP. Herein we report on a case of CD8 positive lymphomatoid papulosis in a 43-year-old man. The patient presented with erythematous, asymptomatic papules on the left axilla and thigh. Histopathologically, there was a wedge-shaped infiltrate composed of a mixture of various cell types, including lymphocytes, histiocytes, neutrophils and large atypical lymphoid cells. Immunophenotyping revealed the neoplastic cells were positive for CD3, CD8 and CD30 and they were negative for CD4, CD20 and CD56.
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Affiliation(s)
- Ji Hyun Sim
- Department of Dermatology, Ajou University School of Medicine, Suwon, Korea
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24
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Min JA, Oh ST, Kim JE, Cho BK, Chung NG, Park HJ. Lymphomatoid papulosis followed by anaplastic large cell lymphoma in a pediatric patient. Ann Dermatol 2010; 22:447-51. [PMID: 21165218 DOI: 10.5021/ad.2010.22.4.447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2009] [Revised: 12/04/2009] [Accepted: 01/25/2010] [Indexed: 11/08/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is a benign, self-healing, papular eruption that can wax and wane over time. Transformation to T-cell lymphoma has been well documented in 10% to 20% of adults with LyP. However, this transformation rarely occurs in patients younger than 20 years of age. Here, we present the first known pediatric patient in Korea, a 12-year-old boy who developed a subcutaneous nodule on the scrotum 13 months after papulonecrotic lesions of LyP were identified on both lower extremities and face. Histological and immunohistochemical examination of the subcutaneous nodule revealed anaplastic large cell lymphoma (ALCL). A T-cell receptor gene rearrangement analysis demonstrated an identical rearranged pattern in the two specimens, indicating that a common T-cell clone had proliferated over time in both the LyP and ALCL lesions.
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Affiliation(s)
- Jung Ah Min
- Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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25
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Kunishige JH, McDonald H, Alvarez G, Johnson M, Prieto V, Duvic M. Lymphomatoid papulosis and associated lymphomas: a retrospective case series of 84 patients. Clin Exp Dermatol 2009; 34:576-81. [DOI: 10.1111/j.1365-2230.2008.03024.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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26
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Treatment of Primary Cutaneous CD30+ Anaplastic Large-Cell Lymphoma With Radiation Therapy. Int J Radiat Oncol Biol Phys 2008; 70:1542-5. [DOI: 10.1016/j.ijrobp.2007.08.077] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Revised: 08/22/2007] [Accepted: 08/24/2007] [Indexed: 11/22/2022]
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27
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Allabert C, Estève E, Joly P, Troussard X, Comoz F, Courville P, Morice A, Verneuil L, Leroy D, Dompmartin A. Atteinte muqueuse dans la papulose lymphomatoïde : quatre cas. Ann Dermatol Venereol 2008; 135:273-8. [DOI: 10.1016/j.annder.2007.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 11/23/2007] [Indexed: 11/26/2022]
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28
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Yu JB, Blitzblau RC, Decker RH, Housman DM, Wilson LD. Analysis of Primary CD30+ Cutaneous Lymphoproliferative Disease and Survival From the Surveillance, Epidemiology, and End Results Database. J Clin Oncol 2008; 26:1483-8. [DOI: 10.1200/jco.2007.14.1374] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Primary CD30+ cutaneous lymphoproliferative disease (PCLPD) is a spectrum of indolent cutaneous T-cell lymphomas. The primary intention of the analysis of the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database was to report epidemiologic information and overall survival of patients with PCLPD. Methods We investigated the SEER database from 1973 to 2004 and performed univariable and multivariable survival analysis. Results A total of 268 cases of PCLPD were recorded from 1973 to 2004. Median age at diagnosis was 61 years (range, 5 to 98 years). Among cases, 58% were male, and 42% female. Race distribution was 87% white, 7% black, and 4% Asian/Pacific Islander. A total of 157 patients had primary, localized PCLPD. For the total population (N = 268), overall survival at 3 years was 81% (95% CI, 74% to 87%). Population-matched relative survival at 3 years was 87% (SE, 3.6%). Disease-specific survival at 5 years was 92% (95% CI, 86% to 95%). Head and neck skin site predicted for inferior overall survival in patients with primary, localized PCLPD on univariable analysis (hazard ratio [HR] = 4.4; P = .008; 95% CI, 1.5 to 13.2), and was suggestive of decreased overall survival on multivariate analysis (HR = 3.0; P = .06; 95% CI, 0.95 to 9.7). Conclusion Localized PCLPDs are rare diseases with an excellent overall survival and occur more frequently in whites and in men. Head and neck skin primary site may be associated with poorer survival. Conclusions regarding subsets demonstrating association with survival should be taken with caution, given the small number of deaths analyzed.
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Affiliation(s)
- James B. Yu
- From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; and the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Rachel C. Blitzblau
- From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; and the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Roy H. Decker
- From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; and the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Douglas M. Housman
- From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; and the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Lynn D. Wilson
- From the Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT; and the Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
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29
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Seifert G, Tautz C, Seeger K, Henze G, Laengler A. Therapeutic use of mistletoe for CD30+ cutaneous lymphoproliferative disorder/lymphomatoid papulosis. J Eur Acad Dermatol Venereol 2007; 21:558-60. [PMID: 17374000 DOI: 10.1111/j.1468-3083.2006.01958.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kinney MC, Jones D. Cutaneous T-cell and NK-cell lymphomas: the WHO-EORTC classification and the increasing recognition of specialized tumor types. Am J Clin Pathol 2007; 127:670-86. [PMID: 17439828 DOI: 10.1309/mttm86ut1xfql7rv] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Cases drawn from Session 5 of the 2005 Society for Hematopathology/European Association for Haematopathology Workshop on progress in T-cell and natural killer (NK)-cell malignancies are used as a framework to review the current classification of T-cell and NK-cell malignancies in skin. In comparison with the typical pattern and course of mycosis fungoides (MF), selected variants of MF that can be difficult to diagnose are discussed. Cutaneous CD30+ lymphoproliferative disorders are also presented in detail. Particular focus is placed on the recognition of rare but clinically more aggressive cytotoxic lymphomas in the skin. Overall, diagnostic pitfalls and new information regarding disease pathogenesis brought up by the Workshop cases are provided. In addition, a general approach to the diagnosis of cutaneous T-cell lymphomas is discussed.
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Affiliation(s)
- Marsha C Kinney
- Department of Pathology, Division of Hematopathology, The University of Texas Health Science Center, San Antonio 78229, USA
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Mata Vázquez MI, Fernández Canedo I, Fúnez Liébana R, Poveda Gómez F. [Elevated levels of IgE and lymphomatoid papulosis (subtype B) as background of well-differentiated lymphocyte B cell lymphoma]. Rev Clin Esp 2007; 207:148-9. [PMID: 17397641 DOI: 10.1016/s0014-2565(07)73341-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hallermann C, Kaune KM, Kaune MK, Tiemann M, Kunze E, Griesinger F, Mitteldorf C, Bertsch HP, Neumann C. High frequency of primary cutaneous lymphomas associated with lymphoproliferative disorders of different lineage. Ann Hematol 2007; 86:509-15. [PMID: 17340135 DOI: 10.1007/s00277-007-0276-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Accepted: 02/15/2007] [Indexed: 12/13/2022]
Abstract
In patients suffering from primary cutaneous lymphomas, secondary malignancies of various origin may develop. However, the frequency of a second neoplasm deriving from another lymphoid lineage is still unclear and may be underestimated. We screened all our patients with primary cutaneous lymphomas from a 4-year recruitment period for a coexisting secondary lymphoproliferative disorder. The cohort comprised of a total of 82 patients with primary cutaneous lymphomas, 62 with primary cutaneous T-cell lymphoma (CTCL), 18 with primary cutaneous B-cell lymphomas, and two with CD4+/CD56+ hematodermic neoplasm/blastic lymphomas. Seven patients (8.5%) were identified with a coexisting lymphoma of a different lymphoid lineage. Four patients with Sézary syndrome (SS) suffered from systemic B-cell lymphoma. Two of these developed SS after chemotherapy of their B-cell lymphoma. The other three patients with various types of skin lymphomas (SS, Mycosis fungoides [MF], primary cutaneous marginal zone lymphoma) developed Hodgkin's disease (hairy cell leukemia). Our data indicate that patients with primary cutaneous lymphomas have an elevated risk for the development of a secondary lymphoproliferative disorder even without previous chemotherapy. Possible explanations for this association include a genetic predisposition, alterations in early progenitor cells, underlying viral infections, and/or stimulation of a B-cell clone by the malignant helper T cells of the primary CTCL and vice versa.
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Bowers S, Warshaw EM. Pityriasis lichenoides and its subtypes. J Am Acad Dermatol 2006; 55:557-72; quiz 573-6. [PMID: 17010734 DOI: 10.1016/j.jaad.2005.07.058] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Revised: 07/05/2005] [Accepted: 07/23/2005] [Indexed: 11/18/2022]
Abstract
Pityriasis lichenoides represents a unique group of inflammatory skin disorders that include pityriasis lichenoides et varioliformis acuta (PLEVA), febrile ulceronecrotic Mucha-Habermann disease (a subtype of PLEVA), and pityriasis lichenoides chronica. The history, epidemiology, clinical features, pathophysiology, and treatment of this group of conditions are reviewed in this manuscript.
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Sàbat Santandreu M, Luelmo Aguilar J, Sáez Artacho A. Papulosis linfomatoide pustulosa. An Pediatr (Barc) 2006; 65:391-2. [PMID: 17020740 DOI: 10.1157/13092502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Franchina M, Kadin ME, Abraham LJ. Polymorphism of the CD30 promoter microsatellite repressive element is associated with development of primary cutaneous lymphoproliferative disorders. Cancer Epidemiol Biomarkers Prev 2005; 14:1322-5. [PMID: 15894695 DOI: 10.1158/1055-9965.epi-04-0826] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lymphomatoid papulosis is a preneoplastic cutaneous lymphoproliferative disorder characterized by overexpression of CD30, a member of the tumor necrosis factor receptor superfamily. CD30 signaling is known to have an effect on the growth and survival of lymphoid cells. Therefore, we hypothesized that the development of lymphomatoid papulosis and progression to an associated neoplasm such as cutaneous and systemic anaplastic large cell lymphoma may reflect an underlying genetic defect. In this study, we determined that two allelic forms of the CD30 promoter microsatellite repressive element, designated 30M377 and 30M362, are associated with the development of lymphomatoid papulosis and CD30+ lymphomas in lymphomatoid papulosis patients, respectively. These findings suggest that allele-specific differences in the control of CD30 transcription may determine the pathogenesis of the spectrum of CD30+ cutaneous lymphoproliferative disorders.
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Affiliation(s)
- Maria Franchina
- The Western Australian Institute for Medical Research and Centre for Medical Research, The University of Western Australia, Level 6, MRF Building, 50 Rear Murray Street, Perth, Western Australia, Australia
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Ribeiro-Silva A, Chang D, Arruda D, Félix PR. Lymphomatoid papulosis in a patient with Waldenström's macroglobulinemia. J Dermatol 2005; 32:132-6. [PMID: 15906545 DOI: 10.1111/j.1346-8138.2005.tb00731.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lymphomatoid papulosis (LyP) is a rare skin disease with a benign course but a malignant histologic appearance based on atypical lymphocytes. Waldenström's macroglobulinemia (WM) is a diffuse infiltration of the bone marrow by cells that synthesize IgM immunoglobulins. A 46-year-old female presented with a two year history of weakness, fatigue, anemia, and recurring multiple erythematous papules and nodules in the skin. The skin biopsy showed pleomorphic lymphoid cells with atypical mitoses permeated by a diffuse dermal infiltrate of normal appearing lymphocytes. The neoplastic cells were positive for CD30, CD3, and CD5 but negative for CD20 and EMA. The bone marrow was hypercellular due to a diffuse infiltration by lymphocytes, plasma cells, and plasmacytoid lymphocytes. LyP is a lymphoproliferative disorder of CD30-positive T cells that may be associated with other lymphoid malignancies, particularly Hodgkin's disease, mycosis fungoides, and anaplastic T cell lymphomas. To our knowledge, this is the first report of a LyP appearing in a patient with WM.
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Affiliation(s)
- Alfredo Ribeiro-Silva
- Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Clarke LE, Bayerl MG, Bruggeman RD, Mauger D, Ioffreda MD, Abou-Elella A, Helm KF. Death Receptor Apoptosis Signaling Mediated by FADD in CD30-Positive Lymphoproliferative Disorders Involving the Skin. Am J Surg Pathol 2005; 29:452-9. [PMID: 15767797 DOI: 10.1097/01.pas.0000155154.46434.93] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The CD30-positive lymphoproliferative disorders lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (C-ALCL), and systemic anaplastic large cell lymphoma (S-ALCL) are lesions that overlap clinically, histopathologically, and immunophenotypically. Their biologic behaviors, however, vary considerably. In particular, lesions of LyP regress spontaneously while those of S-ALCL persist and often progress. Apoptosis has been suggested as the mechanism by which the lesions of LyP regress, but the underlying signaling pathways remain unclear. In this study, we used newly developed activation state-specific antibodies to demonstrate apoptosis signaling through the death receptor-mediated pathway regulated by FADD and caspase 3. METHODS Dual immunohistochemistry for CD30 and activated forms of FADD and caspase 3 was performed on cutaneous biopsy specimens from 27 patients with CD30-positive lymphoproliferative disorders involving the skin. The patients included 18 with primary cutaneous CD30-positive LPDs (15 with LyP and 3 with C-ALCL) and 9 with S-ALCL. RESULTS The proportion of CD30-positive cells expressing activated FADD was significantly different between primary cutaneous CD30-positive lymphoproliferative disorders and S-ALCL (36.4% vs. 14.5%, P = 0.0083). Expression of cleaved caspase 3 was also significantly different between primary cutaneous lesions and S-ALCL (9.2% vs. 1.9%, P = 0.048). CONCLUSIONS Although a larger number of cases should be studied to validate these results, these data provide evidence that differences in signaling through the death-receptor apoptosis pathway mediated by FADD may be responsible for the varying biologic behaviors of CD30-positive lymphoproliferative disorders involving the skin.
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Affiliation(s)
- Loren E Clarke
- Departments of Pathology, Penn State University College of Medicine/Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
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Perna AG, Jones DM, Duvic M. Lymphomatoid papulosis from childhood with anaplastic large-cell lymphoma of the small bowel. ACTA ACUST UNITED AC 2005; 5:190-3. [PMID: 15636695 DOI: 10.3816/clm.2004.n.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lymphomatoid papulosis (LyP) is a lymphoproliferative disorder that exists on a spectrum of diseases with cutaneous CD30+ anaplastic large-cell lymphoma (ALCL). Multiple treatment options are available, although none are curative. The typical age of onset for LyP is in the third and fourth decades, but it has been seen occasionally in children. Lymphomatoid papulosis is associated with primary cutaneous ALCL and other lymphoproliferative malignancies, but is rarely associated with extranodal systemic ALCL. A 43-year-old man developed lymphomatoid papulosis lesions at 3 years of age, which persisted into adulthood, and he later developed ALCL of the duodenum. Treatment with standard CHOP (cyclophosphamide/doxorubicin/vincristine/prednisolone) chemotherapy resulted in complete remission of his gastrointestinal lymphoma and temporary improvement of his skin lesions. However, the LyP relapsed and proved refractory to psoralen plus ultraviolet-A phototherapy, and was only temporarily and partially responsive to bexarotene and denileukin diftitox.
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Affiliation(s)
- Ashley G Perna
- Department of Pathology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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Pujol RM, Muret MPG, Bergua P, Bordes R, Alomar A. Oral Involvement in Lymphomatoid Papulosis. Dermatology 2005; 210:53-7. [PMID: 15604547 DOI: 10.1159/000081485] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 05/28/2004] [Indexed: 11/19/2022] Open
Abstract
Oral involvement in cutaneous CD30+ T-cell lymphoid proliferations is rare and has received little attention in the dermatologic literature. The authors report 2 patients with self-healing, recurrent papulonodular eruptions with the classic clinical, histopathological and immunophenotypic features of lymphomatoid papulosis, which developed two ulcerated papules and an ulcerative nodule on the dorsum of the tongue, respectively. The lesions appeared coincident with a new cutaneous relapse of the disease. Histopathological and immunophenotypic features were similar to those of the cutaneous lesions. All lesions regressed spontaneously after several weeks. Since then, and after follow-up periods of 3 and 7 years, respectively, no evidence of extracutaneous involvement has been detected. Oral involvement in lymphomatoid papulosis is an uncommon event, probably without prognostic significance. Previously reported cases are reviewed. The differential diagnosis of atypical T-cell lymphoid infiltrates observed in the oral mucosa is discussed.
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Affiliation(s)
- Ramon M Pujol
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain.
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40
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Aguilar-Bernier M, Bassas-Vila J, Bordel-Gomez MT, Morales-Callaghan A, Tejerina-Garcia JA, Miranda-Romero A. Lymphomatoid papulosis associated with parathyroid nodular hyperplasia: report of a case. J Eur Acad Dermatol Venereol 2004; 18:693-6. [PMID: 15482298 DOI: 10.1111/j.1468-3083.2004.01033.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The association of cutaneous lymphoproliferative diseases and primary hyperparathyroidism (PHP) is infrequent, with only three cases reported to date. We present a patient with lymphomatoid papulosis (LyP) who developed hypercalcaemia secondary to parathyroid nodular hyperplasia. A review of the literature has revealed no similar cases; we therefore believe this to be the first description of the association between LyP and PHP.
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Affiliation(s)
- M Aguilar-Bernier
- Department of Dermatology, Hospital Universitario, Avda.Ramon y Cajal, 3. 47005 Valladolid, Spain.
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Yeung CK, Ma SY, Chan HHL, Trendell-Smith NJ, Au WY. Primary CD30+ve Cutaneous T-cell Lymphoma Associated with Chronic Burn Injury in a Patient with Longstanding Psoriasis. Am J Dermatopathol 2004; 26:394-6. [PMID: 15365372 DOI: 10.1097/00000372-200410000-00009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An increased incidence of lymphoma has been reported in psoriatic patients, but most cases are nodal B-cell lymphoma. We report a unique case of CD30-expressing cutaneous T-cell lymphoma arising from underlying psoriatic plaque after intractable caustic burns and cellulitis in the palm of a patient with generalized chronic plaque psoriasis. Molecular studies confirmed a localized clonal T-cell expansion, and the lesion responded dramatically to multiagent chemotherapy. The case highlighted the possible role of chronic systemic and local T-cell activation in the pathogenesis of primary CD30+ve cutaneous T-cell lymphoma, and the importance of histologic assessment in chronic nonhealing skin lesions.
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Affiliation(s)
- Chi-Keung Yeung
- Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China
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42
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Wu WM, Tsai HJ. Lymphomatoid Papulosis Histopathologically Simulating Angiocentric and Cytotoxic T-cell Lymphoma. Am J Dermatopathol 2004; 26:133-5. [PMID: 15024196 DOI: 10.1097/00000372-200404000-00009] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report a patient presenting with a 20-year history of recurrent papulonecrotic lesions in which skin biopsy shows extensive vascular destruction. Atypical lymphoid cells surrounding the dermal vessels had a CD3+, CD4-, CD5-, CD8+, CD20-, CD30+, CD56+, TIA-1+, and granzyme B immunophenotype implicating a natural killer/T origin. In situ hybridization was negative for Epstein-Barr virus transcripts. Analysis of T-cell receptor-gamma gene of 2 separate biopsy specimens detected an identical clone. The patient was treated with low-dose methotrexate and achieved complete resolution in a month. According to the clinical course, immunophenotype, clonality analysis and the excellent response to methotrexate, we conclude that this is an unusual case of lymphomatoid papulosis. We believe that this unusual presentation needs to be distinguished from other aggressive lymphomas, including the natural killer/T-cell and cytotoxic T-cell subsets.
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MESH Headings
- Adult
- Antimetabolites, Antineoplastic/therapeutic use
- Biomarkers, Tumor/metabolism
- Cell Nucleus/pathology
- Clone Cells
- DNA, Neoplasm/analysis
- Diagnosis, Differential
- Female
- Humans
- Immunophenotyping
- Lymphoma, T-Cell, Cutaneous/metabolism
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphomatoid Papulosis/drug therapy
- Lymphomatoid Papulosis/metabolism
- Lymphomatoid Papulosis/pathology
- Methotrexate/therapeutic use
- T-Lymphocytes, Cytotoxic/metabolism
- T-Lymphocytes, Cytotoxic/pathology
- Treatment Outcome
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Affiliation(s)
- Wei-Ming Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan.
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Gellrich S, Wernicke M, Wilks A, Lukowsky A, Muche JM, Jasch KC, Audring H, Mason D, Sterry W. The Cell Infiltrate in Lymphomatoid Papulosis Comprises a Mixture of Polyclonal Large Atypical Cells (CD30-Positive) and Smaller Monoclonal T cells (CD30-Negative). J Invest Dermatol 2004; 122:859-61. [PMID: 15086582 DOI: 10.1111/j.0022-202x.2004.22304.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Querfeld C, Rosen ST, Kuzel TM, Guitart J. Cutaneous T-cell lymphomas: a review with emphasis on new treatment approaches. ACTA ACUST UNITED AC 2003; 22:150-61. [PMID: 14649582 DOI: 10.1016/s1085-5629(03)00041-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Primary cutaneous T-cell lymphomas represent a wide variety of non-Hodgkin lymphomas that are characterized by a distinct clinical presentation. Advanced molecular and biological techniques have enhanced the recognition of cutaneous T-cell lymphomas. The most common subtypes of cutaneous T-cell lymphomas are the epidermotropic variants mycosis fungoides and Sézary syndrome. At present, a stage-adjusted therapy is the best concept available, since early aggressive treatment options did not improve the prognosis of patients with cutaneous T-cell lymphomas. Accurate diagnostic and clinical assessment as well as identification of prognostic factors provides a helpful basis for treatment strategies. Current medical literature on diagnosis, prognosis, and treatment is reviewed with emphasis on new biologic response-modifying treatment options.
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Affiliation(s)
- Christiane Querfeld
- Division of Hematology/Oncology, Department of Dermatology, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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45
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Gniadecki R, Lukowsky A, Rossen K, Madsen HO, Thomsen K, Wulf HC. Bone marrow precursor of extranodal T-cell lymphoma. Blood 2003; 102:3797-9. [PMID: 12842987 DOI: 10.1182/blood-2003-03-0899] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The development of extranodal lymphomas is thought to be initiated by the transformation event in peripheral organs. Lymphomatoid papulosis (LyP) is a low-grade cutaneous lymphoma and may progress into the cutaneous anaplastic lymphoma. We identified 2 patients who 3 and 4 years before the development of LyP were treated for an unrelated malignancy (Burkitt lymphoma and small-cell B-cell lymphoma). We analyzed the T-cell receptor (TCR) gene rearrangement pattern in their skin, blood, and bone marrow, including the archival bone marrow sampled years before the development of clinically evident LyP. In all samples we detected the unique monoclonal TCR rearrangements. This observation suggests that the initial malignant transformation in LyP occurred in bone marrow and not, as could be supposed, in the skin.
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MESH Headings
- Adult
- Bone Marrow/pathology
- Cell Transformation, Neoplastic
- Clone Cells
- Female
- Gene Rearrangement
- Genes, T-Cell Receptor
- Humans
- Ki-1 Antigen
- Lymphoma, Large-Cell, Anaplastic/etiology
- Lymphoma, Large-Cell, Anaplastic/pathology
- Lymphoma, T-Cell, Cutaneous/etiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphomatoid Papulosis/etiology
- Lymphomatoid Papulosis/pathology
- Male
- Middle Aged
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/pathology
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Affiliation(s)
- Robert Gniadecki
- Department of Dermatology, University of Copenhagen, Bispebjerg Hospital, Bldg D42, Bispebjerg bakke 23, DK-2400 Copenhagen, Denmark.
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Querfeld C, Guitart J, Kuzel TM, Rosen ST. Primary cutaneous lymphomas: a review with current treatment options. Blood Rev 2003; 17:131-42. [PMID: 12818223 DOI: 10.1016/s0268-960x(03)00004-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Primary cutaneous T- and B-cell lymphomas are a heterogenous group of diseases with varied clinical presentations and prognosis. The use of new molecular, histological, and clinical criteria have enhanced the recognition of primary cutaneous T- and B-cell lymphomas. Compared to their nodal counterpart they have a different clinical behavior and therefore require a different treatment approach. Independent predictive factors identified clinically, histologically, and by immunopheno- and immunogenotyping are essential to assess the appropriate treatment for each subtype. The European Organization for Research and Treatment of Cancer (EORTC) Cutaneous Lymphoma Study Group provide a classification of cutaneous lymphomas taking into account of the histological and molecular features. Based on this classification we will provide a summary of the current medical literature in diagnosis, treatment, and prognosis for primary cutaneous lymphomas with emphasis on new treatment strategies.
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MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Cytokines/therapeutic use
- Europe
- Humans
- Immunotoxins/therapeutic use
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Mycosis Fungoides/drug therapy
- Mycosis Fungoides/pathology
- Retinoids/therapeutic use
- Sezary Syndrome/drug therapy
- Sezary Syndrome/pathology
- Skin Neoplasms/classification
- Skin Neoplasms/drug therapy
- Skin Neoplasms/pathology
- World Health Organization
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Affiliation(s)
- Christiane Querfeld
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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47
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Lendínez Molinos F, Vázquez López MA, Gómez Izquierdo L, López Muñoz J. [Lymphomatoid papulosis]. An Pediatr (Barc) 2003; 58:615-7. [PMID: 12781124 DOI: 10.1016/s1695-4033(03)78134-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
BACKGROUND CD134/OX40 and CD30 are transmembrane proteins from the tumour necrosis factor receptor (TNFR) family present selectively on activated T cells. TNFR-related proteins are crucially involved in the regulation of proliferation and survival of normal and malignant lymphohaematopoietic cells. CD30 has been used for the immunophenotyping and subclassification of cutaneous lymphomas; virtually nothing is known, however, about the expression pattern of CD134 in lymphoid skin malignancies. OBJECTIVES To determine CD134 expression in cutaneous lymphoma and benign inflammatory disorders. METHODS Biopsy material was obtained from patients with lymphomatoid papulosis (LyP, n = 42), mycosis fungoides (n = 21), Jessner's infiltrates (n = 10) and non-specific dermatitis (n = 14). The expression of CD134 and CD30 was scored after immunohistochemical staining with appropriate monoclonal antibodies. The proportion of G2 + S phase cells was determined by laser scanning cytometry from nuclei obtained from paraffin-embedded biopsies. RESULTS Few, single and scattered CD134+ cells (< 10%) were observed in the benign inflammatory infiltrations and in mycosis fungoides. A subset of 16 patients with LyP presented with clusters of CD30+ CD134+ cells. There was no correlation between the magnitude of CD134 expression and the histological type or the proportion of G2 + S cells in LyP. CD134 immunoreactivity was lower than expected in patients with LyP and another lymphoid malignancy (P < 0.001, Fisher's exact test). CONCLUSIONS CD134 is strongly expressed in a proportion (38%) of patients with LyP, but not in mycosis fungoides or benign lymphocytic infiltrations. Loss of CD134 expression in LyP may be a marker of an increased risk of second lymphoid malignancy.
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Affiliation(s)
- R Gniadecki
- Department of Dermatology D92, Bispebjerg Hospital, University of Copenhagen, Bispebjerg bakke 23, DK-2400 Copenhagen, Denmark.
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Ramaesh K, Monaghan H, Kemmett D, Gairns S, Dhillon B. Retinal vein occlusion in lymphomatoid papulosis. Eur J Ophthalmol 2002; 12:542-6. [PMID: 12510725 DOI: 10.1177/112067210201200616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe an unusual patient who presented with hemi-retinal vein occlusion and lymphomatoid papulosis (LyP). METHODS Clinicopathological case study. RESULTS A 42 year old female patient presented with blurring of vision in her left eye and a nodular eruption of the skin involving arms, face and torso. She also complained of a non-itchy, blotchy rash on the arms, face and torso lasting for period of three months. Ocular examination showed a left superior hemi-retinal vein occlusion. The nodules resolved spontaneously over a period of two-three weeks leaving a faint scar. Hematological and systemic evaluation for auto-immune disorders, hypercoagulability, systemic malignancy and lymphoma were negative. A biopsy of the skin nodule was performed which showed infiltration of lymphoid blast cells which were CD30 positive. Based on the clinicopathological features a diagnosis of lymphomatoid papulosis (LyP) was made. CONCLUSIONS Clinical and pathological features of this patient may suggest the retinal vein occlusion may be secondary to LyP.
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Affiliation(s)
- K Ramaesh
- Princess Alexandra Eye Pavilion, Edinburgh, UK
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50
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Deroo-Berger MC, Skowron F, Ronger S, Balme B, Berard F, Causeret AS, Perrot H, Thomas L. Lymphomatoid papulosis: a localized form with acral pustular involvement. Dermatology 2002; 205:60-2. [PMID: 12145437 DOI: 10.1159/000063132] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a localized form of lymphomatoid papulosis (LyP) presenting as pustular papules of the hands. The histopathology revealed a moderate inflammatory infiltrate composed of atypical pleomorphic large lymphocytes with atypical mitosis and large nuclei. Epidermotropism could be observed. These atypical cells expressed CD4 and CD30. Laboratory examinations and bone marrow explorations remained negative. The clinical presentation of this case of LyP is unusual. Only histopathological features allowed to diagnose LyP. The knowledge that LyP may be associated with neoplasia or lymphoma underlines the need for a long-term follow-up of these patients.
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