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Alvarez G, Rodriguez-Homs L, Al-Rohil RN, Kheterpal M, Fresco A. Sequential primary cutaneous follicle center lymphoma and marginal zone B-cell lymphoma arising in the same patient. JAAD Case Rep 2023; 40:30-33. [PMID: 37701886 PMCID: PMC10494308 DOI: 10.1016/j.jdcr.2023.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Affiliation(s)
| | | | - Rami N. Al-Rohil
- Department of Dermatology, Duke University, Durham, North Carolina
- Department of Pathology, Duke University Hospital, Durham, North Carolina
| | - Meenal Kheterpal
- Department of Dermatology, Duke University, Durham, North Carolina
| | - Amber Fresco
- Department of Dermatology, Duke University, Durham, North Carolina
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Wei Y, Liu L, Bu L, Zhan X, Xu H, Wang S. Diffuse Large B-cell Lymphoma (Leg Type) Originating in the Skin of the Right Cheek Region: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231202192. [PMID: 37776289 DOI: 10.1177/01455613231202192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023] Open
Abstract
Primary diffuse cutaneous large B-cell lymphoma, leg type (PCDLBCL-LT), usually affecting one or both lower legs, with a 5-year disease-free survival rate of less than 60%. Solitary facial lesions are extremely rare. Our report is about a 93-year-old woman whose clinical examination revealed a 4 cm × 5 cm × 3 cm mass with a soft texture and smooth margins on the right side of her cheek. Immunohistochemical analyses were consistent with a diagnosis of PCDLBCL-LT. The surgical method for this patient was: extensive resection of the tumor and repair of the defect with an adjacent flap. Neither local recurrence nor systemic invasion was observed during postoperative follow-up (8 months). The clinician must be very careful when making a correct diagnosis based on the clinical and immunohistochemical findings of PCDLBCL-LT. For this type of PCDLBCL-LT isolated in 1 site without invasion of the rest of the body, extensive surgical resection may result in a favorable prognosis.
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Affiliation(s)
- Yubo Wei
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Liyan Liu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Lingxue Bu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Xiaohong Zhan
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Haoyue Xu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Shuangyi Wang
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
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3
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Huang SF, Liu WC. A rare case of primary cutaneous diffuse large B-cell lymphoma, leg type, presenting as cellulitis: a case report. J Surg Case Rep 2021; 2021:rjab227. [PMID: 34104408 PMCID: PMC8177962 DOI: 10.1093/jscr/rjab227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/11/2021] [Indexed: 02/05/2023] Open
Abstract
Primary cutaneous diffuse large B-cell lymphoma, leg type, accounts for only 4% of all cutaneous lymphomas and bears a worse prognosis than other cutaneous B-cell lymphomas. Diagnosis at an early stage may be difficult due to its nonspecific manifestations. We report an 88-year-old female who was brought to our emergency department due to two rapidly growing painful skin lesions with local redness and swelling on her right lower leg. We performed incisional biopsy of the two right lower leg skin lesions and sent the specimens for histopathological examination. The pathological examination was compatible with diffuse large B-cell lymphoma. Primary cutaneous diffuse large B-cell lymphoma, leg type, is a rare condition that can present as skin cellulitis, thereby misleading clinicians and resulting in delayed treatment. This diagnosis should be considered when assessing skin lesions.
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Affiliation(s)
- Shih-Feng Huang
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Chung Liu
- Correspondence address. No. 386, Ta-Chung 1st Rd., Kaohsiung, Taiwan. Tel: +886-7-3422121-3000; Fax: +886-7-3422288; E-mail:
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Mantovani A, Perrone F, Stoico V, Pichiri I, Salvotelli L, Teobaldi I, Bruti M, Conti M, Cima L, Eccher A, Bonora E. Primary cutaneous B-cell lymphoma and chronic leg ulcers in a patient with type 2 diabetes. Endocrinol Diabetes Metab Case Rep 2017; 2017:EDM170032. [PMID: 28567289 PMCID: PMC5445424 DOI: 10.1530/edm-17-0032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 11/16/2022] Open
Abstract
The incidences of type 2 diabetes mellitus and many cancers are rapidly increasing worldwide. Diabetes is a strong risk factor for some cancers (including lymphomas) and is also associated with adverse cancer outcomes. After gastrointestinal tract, the skin is the second most frequent extranodal site involved by non-Hodgkin lymphomas and the cutaneous B-cell lymphomas (CBCLs) range from 25% to 30% of all primary cutaneous lymphomas. The primary cutaneous diffuse large B-cell lymphoma (PCDLBCL) is an aggressive lymphoma with a poor prognosis, representing roughly 20% of all primary CBCLs. Classically, the cutaneous manifestation of this lymphoma is a red or violaceous tumors arising on a leg. To date, despite the large body of evidence suggesting that diabetes is strongly associated with an increased risk of some cancers, very little information is available regarding a possible association between type 2 diabetes and primary cutaneous diffuse large B-cell lymphoma. In this report, we will present the case of a white adult patient with type 2 diabetes with chronic leg ulcers complicated by a primary cutaneous diffuse large B-cell lymphoma.
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Affiliation(s)
| | - Fabrizia Perrone
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
| | - Vincenzo Stoico
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
| | - Isabella Pichiri
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
| | - Laura Salvotelli
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
| | - Ilaria Teobaldi
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
| | | | - Michela Conti
- Division of Infectious DiseaseDepartment of Medicine and
| | - Luca Cima
- Division of Pathology UnitDepartment of Diagnostics and Public Health, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Albino Eccher
- Division of Pathology UnitDepartment of Diagnostics and Public Health, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Enzo Bonora
- Division of EndocrinologyDiabetes and Metabolism, Department of Medicine
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5
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Lima M. Cutaneous primary B-cell lymphomas: from diagnosis to treatment. An Bras Dermatol 2016; 90:687-706. [PMID: 26560215 PMCID: PMC4631235 DOI: 10.1590/abd1806-4841.20153638] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Accepted: 06/05/2014] [Indexed: 12/19/2022] Open
Abstract
Primary cutaneous B-cell lymphomas are a heterogeneous group of mature B-cells neoplasms with tropism for the skin, whose biology and clinical course differ significantly from the equivalent nodal lymphomas. The most indolent forms comprise the primary cutaneous marginal zone and follicle center B-cell lymphomas that despite the excellent prognosis have cutaneous recurrences very commonly. The most aggressive forms include the primary cutaneous large B-cell lymphomas, consisting in two major groups: the leg type, with poor prognosis, and others, the latter representing a heterogeneous group of lymphomas from which specific entities are supposed to be individualized over time, such as intravascular large B-cell lymphomas. Treatment may include surgical excision, radiotherapy, antibiotics, corticosteroids, interferon, monoclonal antibodies and chemotherapy, depending on the type of lymphoma and on the type and location of the skin lesions. In subtypes with good prognosis is contraindicated overtreatment and in those associated with a worse prognosis the recommended therapy relies on CHOP-like regimens associated with rituximab, assisted or not with local radiotherapy. We review the primary cutaneous B-cell lymphomas, remembering the diagnostic criteria, differential diagnosis, classification, and prognostic factors and presenting the available therapies.
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Affiliation(s)
- Margarida Lima
- Centro Hospitalar do Porto, Hospital de Santo António, Porto, Portugal
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6
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Subramaniyam S, Magro CM, Gogineni S, Tam W, Mathew S. Primary cutaneous follicle center lymphoma associated with an extracutaneous dissemination: a cytogenetic finding of potential prognostic value. Am J Clin Pathol 2015; 144:805-10. [PMID: 26486746 DOI: 10.1309/ajcpv3f9befctaoq] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Cytogenetic studies on cutaneous lymphomas are rare, and very little is known about their prognostic value. We present a rare case of primary cutaneous follicle center lymphoma (PCFCL) with a complex translocation presenting with cutaneous and extracutaneous dissemination in the lymph node. METHODS Morphologic, immunohistochemical, conventional cytogenetic, and fluorescence in situ hybridization (FISH) studies were performed on this patient. RESULTS A combination of cytogenetic and FISH analysis identified a complex novel four-way t(2;14;9;3) (p11.2;q32;p13;q27) translocation involving rearrangements of BCL6, immunoglobulin light and heavy chain genes, and an unknown gene on 9p. CONCLUSIONS Our report elaborates the morphologic and immunohistochemical features in combination with cytogenetic and molecular cytogenetic analysis of PCFCL, which provide additional insight into the clinical and biologic behavior of this lesion.
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Nudelmann LM, Bonamigo RR. Primary cutaneous lymphoma in southern Brazil: a 12-year single-center experience. Int J Dermatol 2015; 54:e512-20. [PMID: 26496535 DOI: 10.1111/ijd.12970] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/08/2014] [Accepted: 01/13/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Primary cutaneous lymphomas (PCL) are a group of extranodal non-Hodgkin lymphomas presenting with no evidence of extracutaneous disease at the time of diagnosis. Few longitudinal studies of PCL have been conducted, particularly in South American populations. Our objective was to describe the behavior of PCL and evaluate patient survival in a cohort of patients from southern Brazil. METHODS We conducted a retrospective cohort study of all patients with a histopathological diagnosis of PCL receiving care at a tertiary referral center in southern Brazil from 2000 to 2012. Clinical, laboratory, and histopathological data, treatment variables, and survival curves were analyzed. RESULTS Eighty-nine patients with PCL were included, with a mean age at diagnosis of 58.9 years. Cutaneous T-cell and natural killer (NK) cell lymphomas (CTCL/NKCL) accounted for 78.4% of cases and cutaneous B-cell lymphomas (CBCL) for 21.6%; 57.4% of patients with CTCL/NKCL and 50% of patients with CBCL were male. Half of all cases were mycosis fungoides (MF). The 5-year survival rate was 74.8% for MF, 61% for Sézary syndrome, 87.5% for primary cutaneous CD30+ lymphoproliferative disorders, and 88.9% for primary cutaneous follicle center lymphoma. CONCLUSIONS In this cohort of patients with PCL from southern Brazil, CTCL/NKCL was more prevalent than CBCL, and the MF subtype was predominant. Survival curves were similar to those reported in the literature, except for Sézary syndrome, which had a better prognosis in this sample.
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Affiliation(s)
- Lisia M Nudelmann
- Department of Dermatology, Universidade Luterana do Brasil, Canoas, Brazil.,Department of Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Renan R Bonamigo
- Department of Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Department of Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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8
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Haverkos B, Tyler K, Gru AA, Winardi FK, Frederickson J, Hastings J, Elkins C, Zhang X, Xu-Welliver M, Wong HK, Porcu P. Primary Cutaneous B-Cell Lymphoma: Management and Patterns of Recurrence at the Multimodality Cutaneous Lymphoma Clinic of The Ohio State University. Oncologist 2015; 20:1161-6. [PMID: 26306900 DOI: 10.1634/theoncologist.2015-0175] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/07/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The increasing incidence of primary cutaneous B-cell lymphomas (PCBCLs) presents new challenges for clinicians. Despite advances in the clinical and pathologic characterization of PCBCL, the significance of the current staging approach as a risk profiling tool and the effect of various treatments on outcome remain unclear. MATERIALS AND METHODS We retrospectively reviewed patients who presented with a diagnosis of PCBCL seen at The Ohio State University between 1998 and 2012. We reviewed the initial presentation and treatment modality. We then assessed whether the treatment modality (conservative skin-directed vs. definitive radiation with or without systemic therapy), stage (T1 or ≥T2), or histologic subtype (primary cutaneous follicle center lymphoma [PCFCL] vs. primary cutaneous marginal zone B-cell lymphoma [PCMZL]) affected the risk of recurrence. RESULTS We identified 67 patients referred with an initial diagnosis of PCBCL. After imaging, 12 did not meet the criteria for PCBCL and were classified as having systemic B-cell lymphoma with cutaneous involvement. The remaining 55 patients included 25 with PCMZL, 24 with PCFCL, 2 with primary cutaneous large B-cell lymphoma leg type, and 4 with unclassifiable disease. According to the International Society of Cutaneous Lymphoma-European Organization for Research and Treatment of Cancer staging, 30 cases were T1 (55%), 14 T2 (25%), and 11 T3 (20%). Comparing the time to first recurrence (TFR) by indolent PCBCL subtypes, we found no difference in the recurrence risk for either stage (T1, p = .51 vs. T2/T3, p = .30). Comparing TFR by treatment modality, we found no difference in TFR within T1 patients (p = .34) or T2/T3 patients (p = .44). CONCLUSION Our limited analysis highlights the importance of complete staging at diagnosis and suggests that the treatment modality does not affect the risk of recurrence in T1 indolent PCBCL.
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Affiliation(s)
- Brad Haverkos
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Kelly Tyler
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Alejandro A Gru
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Francisca Kartono Winardi
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Julie Frederickson
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Justin Hastings
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Camille Elkins
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Xiaoli Zhang
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Meng Xu-Welliver
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Henry K Wong
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
| | - Pierluigi Porcu
- Comprehensive Cancer Center, Department of Pathology, Division of Hematology, Department of Medicine, Division of Dermatology, Department of Medicine, Center for Biostatistics, and Department of Radiation Oncology, The Ohio State University, Columbus, Ohio, USA; Department of Dermatology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas, USA
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Taghavi M, Zhang Y, Lindfors K, Aminololama-Shakeri S. Breast cancer mimic: cutaneous B-cell lymphoma presenting as an isolated breast mass. Case Rep Oncol 2014; 7:685-91. [PMID: 25473394 PMCID: PMC4241639 DOI: 10.1159/000368043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary cutaneous B-cell lymphoma typically localizes to the skin, and dissemination to internal organs is rare. Lymphomatous involvement of the breasts is also rare. We describe the clinical and radiological findings of an unusual case of primary cutaneous B-cell lymphoma presenting as an isolated breast mass without associated skin changes. CASE PRESENTATION The patient was a 55-year-old Caucasian female who initially presented with cutaneous B-cell lymphoma around her eyes and forehead with recurrence involving the skin between her breasts. Three years after terminating treatment due to a lack of symptoms, she presented for an annual screening mammogram that found a new mass in her upper inner right breast without imaging signs of cutaneous extension. On physical examination, there were no corresponding skin findings. Due to the suspicious imaging features of the mass that caused concern for primary breast malignancy, she underwent a core biopsy which revealed cutaneous B-cell lymphoma. CONCLUSION When evaluating patients with a systemic disease who present with findings atypical for that process, it is important to still consider the systemic disease as a potential etiology, particularly with lymphoma given its reputation as a great mimicker.
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Affiliation(s)
- Margaret Taghavi
- Department of Radiology, UC San Francisco Medical Center, San Francisco, Calif., USA
| | - Yanhong Zhang
- Department of Pathology, UC Davis Medical Center, Sacramento, Calif., USA
| | - Karen Lindfors
- Department of Radiology, UC Davis Medical Center, Sacramento, Calif., USA
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Sebastiani M, Anelli MG, Atzeni F, Bazzani C, Farina I, Fedele AL, Favalli EG, Fineschi I, Cino N, Dal Forno I, Gasparini S, Cassarà E, Giardina R, Bruschi E, Addimanda O, Cassone G, Lopriore S, Sarzi-Puttini P, Filippini M, Pignatti F, Gremese E, Biggioggero M, Manganelli S, Amato G, Caimmi C, Salaffi F, Iannone F, Ferri C, Sandri G, Lapadula G, Gorla R, Govoni M, Ferraccioli G, Marchesoni A, Galeazzi M, Foti R, Carletto A, Cantini F, Triolo G, Epis OM, Salvarani C. Efficacy and safety of rituximab with and without methotrexate in the treatment of rheumatoid arthritis patients: Results from the GISEA register. Joint Bone Spine 2014; 81:508-12. [DOI: 10.1016/j.jbspin.2014.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 06/24/2014] [Indexed: 01/23/2023]
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12
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Malignant Skin and Subcutaneous Neoplasms in Adults: Multimodality Imaging With CT, MRI, and18F-FDG PET/CT. AJR Am J Roentgenol 2014; 202:W422-38. [DOI: 10.2214/ajr.13.11424] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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13
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Fabbri A, Cencini E, Alterini R, Rubegni P, Rigacci L, Delfino C, Puccini B, Fimiani M, Bosi A, Bocchia M, Pimpinelli N. Rituximab plus liposomal pegylated doxorubicin in the treatment of primary cutaneous B-cell lymphomas. Eur J Haematol 2014; 93:129-36. [PMID: 24635751 DOI: 10.1111/ejh.12315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND In primary cutaneous B-cell lymphomas (PCBCL), radiotherapy - or surgery in a minority of cases - is the first-line treatment in follicle center lymphoma (PCFCL) and marginal zone B-cell lymphoma (PCMZL). Conversely, patients with multifocal skin involvement or relapsed/refractory disease deserve a systemic chemotherapy. In diffuse large B-cell lymphoma, leg type (PCLBCL-LT), due its poorer outcome, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like regimens are the most commonly used frontline, although hard to propose in elderly patients. In this regard, the association of rituximab (R) and pegylated liposomal doxorubicin (PLD) can be considered a promising, alternative approach. AIMS Based on the favorable results reported with R and PLD in several recent trials, we decided to test efficacy and safety of this combination. METHODS Twelve patients with PCBCL were treated with R plus PLD, and 7 had relapsed disease. Treatment plan consisted of 2 monthly cycles of R 375 mg/m(2) and PLD 20 mg/m(2) day 1;15, followed (in responders) by two cycles given only at day 1. All patients received prophylactic pyridoxine to prevent palmar-plantar erythrodysesthesia (PPE). RESULTS Ten of 12 patients had a response (eight complete; two partial), remarkably 2/3 with PCLBCL-LT. Two patients did not respond (one progressive disease, PD, and one stable disease). Three patients died after a median follow-up of 56 months, two patients due to PD, and 1 due to a second neoplasm. Two out of 10 responders relapsed after 31 and 32 months, respectively. Hematological toxicity was negligible (one case of grade 2 neutropenia), as well as extra-hematological toxicity (two cases of grade 2 PPE). CONCLUSIONS These preliminary data suggest that R-PLD is effective and well tolerated in all subsets of PCBCL and may be offered frontline in indolent cases unsuitable for radiotherapy or surgery as well as in more aggressive cases with contraindications to CHOP-like regimens.
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Affiliation(s)
- Alberto Fabbri
- Division of Haematology, University Hospital of Siena, Siena, Italy
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14
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Khan M, Scarisbrick JJ. Pediatric cutaneous lymphomas: rare diseases requiring expert diagnosis and management. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.2013.838041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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15
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Cockerell C, Mihm MC, Hall BJ, Chisholm C, Jessup C, Merola M. Cutaneous Lymphomas and Hematopathology. Dermatopathology (Basel) 2014. [DOI: 10.1007/978-1-4471-5448-8_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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16
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Jones JC, Chokshi S, Pistenmaa D, Naina HV. Primary cutaneous follicle center lymphoma arising adjacent to silicone breast implant. Clin Breast Cancer 2013; 14:e65-7. [PMID: 24321100 DOI: 10.1016/j.clbc.2013.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 10/07/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Jeremy C Jones
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Saurin Chokshi
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
| | - David Pistenmaa
- Professor, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Harris V Naina
- Assistant Professor, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
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17
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Moustafa MA, Seningen JL, Jouni H, Singh PP, el-Azhary RA, Witzig TE. A skin rash and what lies beneath: paraneoplastic pemphigus, an atypical presentation of follicular cell lymphoma. Am J Hematol 2013; 88:822-3. [PMID: 23658142 DOI: 10.1002/ajh.23471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 04/23/2013] [Accepted: 04/29/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Muhamad Alhaj Moustafa
- Division of Hematology and Oncology; Department of Internal Medicine; Mayo Clinic; Rochester; Minnesota
| | - Justin L. Seningen
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester; Minnesota
| | - Hayan Jouni
- Department of Internal Medicine; Mayo Clinic; Rochester; Minnesota
| | - Preet P. Singh
- Division of Hematology and Oncology; Department of Internal Medicine; Mayo Clinic; Rochester; Minnesota
| | | | - Thomas E. Witzig
- Division of Hematology and Oncology; Department of Internal Medicine; Mayo Clinic; Rochester; Minnesota
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