1
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Thellman JC, Fang MM, Neff T, Thomas G, Frerich C, Press R, Dhossche JM, White KP, Chang BH, Raess PW. Clonally related benign cephalic histiocytosis, histiocytic sarcoma, and T-cell acute lymphoblastic leukemia: Expanding the spectrum of histiocytic transdifferentiation. Pediatr Blood Cancer 2024; 71:e31100. [PMID: 39031548 DOI: 10.1002/pbc.31100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/09/2024] [Accepted: 05/12/2024] [Indexed: 07/22/2024]
Affiliation(s)
- J Connor Thellman
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Milie M Fang
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Tanaya Neff
- Knight Diagnostic Laboratories, Oregon Health & Science University, Portland, Oregon, USA
| | - George Thomas
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
- Knight Diagnostic Laboratories, Oregon Health & Science University, Portland, Oregon, USA
| | - Candace Frerich
- Knight Diagnostic Laboratories, Oregon Health & Science University, Portland, Oregon, USA
| | - Richard Press
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
- Knight Diagnostic Laboratories, Oregon Health & Science University, Portland, Oregon, USA
| | - Julie M Dhossche
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Kevin P White
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Bill H Chang
- Division of Pediatric Hematology and Oncology, Oregon Health & Science University, Portland, Oregon, USA
| | - Philipp W Raess
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
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2
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Cheng J, Svoronos N, Pan M, Smith S, Vatsayan A, Jacobsohn D, Wistinghausen B. Philadelphia chromosome-like B-acute lymphoblastic leukemia and disseminated juvenile xanthogranulomatosis with shared KRAS mutation. Pediatr Blood Cancer 2024; 71:e30963. [PMID: 38523244 DOI: 10.1002/pbc.30963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Jinjun Cheng
- Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, District of Columbia, USA
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Nikolaos Svoronos
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Center for Cancer and Blood Disorder, Children's National Hospital, Washington, District of Columbia, USA
| | - Miao Pan
- Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Shelby Smith
- Center for Cancer and Blood Disorder, Children's National Hospital, Washington, District of Columbia, USA
| | - Anant Vatsayan
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Center for Cancer and Blood Disorder, Children's National Hospital, Washington, District of Columbia, USA
| | - David Jacobsohn
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Center for Cancer and Blood Disorder, Children's National Hospital, Washington, District of Columbia, USA
| | - Birte Wistinghausen
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, District of Columbia, USA
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Center for Cancer and Blood Disorder, Children's National Hospital, Washington, District of Columbia, USA
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3
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Elborai Y, Alkhayat N, Elyamany G, Alshahrani M, Ibrahim W, Othman M, Hamzi H, Binhassan A, Aljabry MS, Alqawahmed R, Alrusayni Y, Abdulhaleem K, Alsuhaibani O, Alsharif O. Rare tumors in pediatric age group: Single center experience from Saudi Arabia. Rare Tumors 2021; 13:2036361321997331. [PMID: 33708364 PMCID: PMC7907711 DOI: 10.1177/2036361321997331] [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: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 11/17/2022] Open
Abstract
Rare pediatric tumors are heterogeneous group containing a variety of histopathological diseases, they represent approximately 10% of all childhood cancers. These rare tumors had a diversity of histology and clinical behaviors that pose different challenges to the investigators. Exploring different pediatric rare tumors. The data were reviewed, retrospectively, through the medical records of seven rare pediatric diseases between 2012 and 2019. Giant cell fibroblastoma (GCF) presented as painless swelling in the trunk, positive for CD34 with PTEN gene mutation. Neuroglial heterotopic tissue presented in 7 days old girl with facial asymmetry and bulging in the oral cavity, maximal de-bulking was done, histopathology was positive for GFAP and S100p. Left side neck mass, surgically excised revealed non-metastatic salivary grand mucoepidermoid carcinoma. Follow up without any chemotherapy or radiotherapy for 5 years with complete remission. Mesenchymal chondrosarcoma (MCS) presented in maxillofacial bones by persistent nasal bleeding, HEY1-NCOA2 fusion gene confirmed the diagnosis. Extra-osseous Ewing sarcoma (EES) presented as rubbery painless swelling in the scalp with fusion transcript involving EWSR1-FL11. Juvenile xanthogranuloma (JXG) presented by butter fly like skin patch in the face with foamy histiocytes in upper dermis with few Touton giant cells, extensive systemic involvement of lung and bone marrow. Metastatic ovarian choriocarcinoma with choriocarcinoma syndrome received induction two different lines of chemotherapy and consolidated with autologous stem cell transplant. Seven pediatric rare tumors, with different aspects of challenges in diagnosis and management, despite the absence of formal protocols and rarity of other center experiences.
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Affiliation(s)
- Yasser Elborai
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Nawaf Alkhayat
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghaleb Elyamany
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad Alshahrani
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Walid Ibrahim
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohamed Othman
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hasna Hamzi
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Amal Binhassan
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mansour S Aljabry
- Pathology department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Raniah Alqawahmed
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yasir Alrusayni
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khadijah Abdulhaleem
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Alsuhaibani
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Alsharif
- Division of Pediatric Hematology/Oncology, Pediatric Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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4
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Bátai B, Krizsán S, Gángó A, Hegyi L, Csóka M, Erdélyi DJ, Csomor J, Kállay K, Bödör C. Juvenile myelomonocytic leukaemia presentation after preceding juvenile xanthogranuloma harbouring an identical somatic PTPN11 mutation. Pediatr Blood Cancer 2020; 67:e28368. [PMID: 32558336 DOI: 10.1002/pbc.28368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Bence Bátai
- First Department of Pathology and Experimental Cancer Research, Hungarian Academy of Sciences-Semmelweis University Momentum Molecular Oncohematology Research Group, Semmelweis University, Budapest, Hungary
| | - Szilvia Krizsán
- First Department of Pathology and Experimental Cancer Research, Hungarian Academy of Sciences-Semmelweis University Momentum Molecular Oncohematology Research Group, Semmelweis University, Budapest, Hungary
| | - Ambrus Gángó
- First Department of Pathology and Experimental Cancer Research, Hungarian Academy of Sciences-Semmelweis University Momentum Molecular Oncohematology Research Group, Semmelweis University, Budapest, Hungary
| | - Lajos Hegyi
- First Department of Pathology and Experimental Cancer Research, Hungarian Academy of Sciences-Semmelweis University Momentum Molecular Oncohematology Research Group, Semmelweis University, Budapest, Hungary
| | - Monika Csóka
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | | | - Judit Csomor
- First Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Krisztián Kállay
- Department of Pediatric Hematology and Stem Cell Transplantation, Central Hospital of Southern Pest, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Csaba Bödör
- First Department of Pathology and Experimental Cancer Research, Hungarian Academy of Sciences-Semmelweis University Momentum Molecular Oncohematology Research Group, Semmelweis University, Budapest, Hungary
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5
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Pawińska-Wa Sikowska K, Cwiklinska M, Wyrobek E, Balwierz W, Bukowska-Strakova K, Dluzniewska A, Gozdzik J, Drabik G, Rygielska M, Stepien K, Skoczen S. Disseminated Juvenile Xanthogranuloma and Hemophagocytic Lymphohistiocytosis Developed During Treatment of Acute Lymphoblastic Leukemia: Case Report. Front Oncol 2020; 10:921. [PMID: 32719740 PMCID: PMC7350519 DOI: 10.3389/fonc.2020.00921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/11/2020] [Indexed: 12/02/2022] Open
Abstract
The association between acute lymphoblastic leukemia (ALL), non-Langerhans cell histiocytosis (non-LCH), and hemophagocytic lymphohistiocytosis (HLH), to the best of our knowledge, has not been published to date. Juvenile xanthogranuloma (JXG), as a type of non-LCH, is usually a benign disease limited to the skin. Systemic involvement is rarely reported. The present case report describes a 15-year-old boy diagnosed with disseminated JXG involving skin and bone marrow concurrent with severe symptoms of HLH during ALL therapy. Examination of immunoglobulin heavy chain genes in B-cell precursor leukemic blasts and histiocytes in the skin and bone marrow revealed identical rearrangements, confirming clonal relationship between both diseases. Implementation of corticosteroids, vinblastine, etoposide, cyclosporine, and tocilizumab resulted in partial skin lesion resolution with no improvement of bone marrow function; therefore, hematopoietic stem cell transplantation (HSCT) was eventually performed. The patient's hematological and general status has improved gradually; however, remarkable recovery of skin lesions was observed after empirical antitubercular therapy. Mycobacterium spp. infection should be considered as a possible secondary HLH trigger. Triple association of ALL, non-LCH, and HLH highlights heterogeneity of histiocytic disorders and possible common origin of dendritic and lymphoid cells.
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Affiliation(s)
- Katarzyna Pawińska-Wa Sikowska
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.,Department of Oncology and Hematology, University Children's Hospital of Krakow, Krakow, Poland
| | - Magdalena Cwiklinska
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.,Department of Oncology and Hematology, University Children's Hospital of Krakow, Krakow, Poland
| | - Elzbieta Wyrobek
- Department of Oncology and Hematology, University Children's Hospital of Krakow, Krakow, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.,Department of Oncology and Hematology, University Children's Hospital of Krakow, Krakow, Poland
| | - Karolina Bukowska-Strakova
- Department of Clinical Immunology and Transplantation, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Dluzniewska
- Department of Clinical Immunology and Transplantology, Stem Cell Transplant Center, University Children's Hospital of Krakow, Jagiellonian University Medical College, Krakow, Poland
| | - Jolanta Gozdzik
- Department of Clinical Immunology and Transplantology, Stem Cell Transplant Center, University Children's Hospital of Krakow, Jagiellonian University Medical College, Krakow, Poland
| | - Grazyna Drabik
- Department of Pathology, University Children's Hospital of Krakow, Krakow, Poland
| | - Monika Rygielska
- Department of Biochemistry, University Children's Hospital of Krakow, Krakow, Poland
| | - Konrad Stepien
- Student Scientific Group of Pediatric Oncology and Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.,Department of Oncology and Hematology, University Children's Hospital of Krakow, Krakow, Poland
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6
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So N, Liu R, Hogeling M. Juvenile xanthogranulomas: Examining single, multiple, and extracutaneous presentations. Pediatr Dermatol 2020; 37:637-644. [PMID: 32468628 DOI: 10.1111/pde.14174] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis characterized by yellowish papules in the skin. JXGs most often occur in infancy or early childhood and are typically solitary and asymptomatic, often regressing after several years. While JXGs predominantly occur on the skin, extracutaneous JXGs also exist. AIMS In this paper, we review the literature on single, multiple, and visceral JXGs and provide recommendations on monitoring and work-up. MATERIALS & METHODS A literature review was conducted with the PubMed database using selective search terms for single, multiple, ocular, and visceral lesions as well as NF1/JMML. RESULTS / DISCUSSION JXG is typically a self-limited disorder if lesions are cutaneous and singular. While rare, JXGs may manifest as multiple and extracutaneous lesions. Further screening and referral to specialists may be warranted in these cases based on age and extent of involvement. CONCLUSION Our review demonstrates common presentations of single, multiple, and extracutaneous lesions in addition to those that occur with NF1 and JMML. We suggest patients be evaluated on a case-by-case basis by a dermatologist and referred to specialists as appropriate.
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Affiliation(s)
- Naomi So
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Regina Liu
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Marcia Hogeling
- Division of Dermatology, UCLA Department of Medicine, Los Angeles, California
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7
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Al Mugairi A, Al Turki S, Salama H, Al Ahmadi K, Abuelgasim KA, Damlaj M. Isolated Bone Marrow Non-Langerhans Cell Histiocytosis Preceding RUNX1-Mutated Acute Myeloid Leukemia: Case Report and Literature Review. Am J Clin Pathol 2019; 151:638-646. [PMID: 30989185 DOI: 10.1093/ajcp/aqz018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/09/2019] [Accepted: 02/12/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The prevalence of concomitant myeloid neoplasms was recently reported to be unexpectedly high among adults without non-Langerhans cell histiocytosis (non-LCH); however, the coexistence of non-LCH with RUNX1 genetic aberration has not been reported previously. METHODS Herein, we report a 23-year-old woman with severe pancytopenia diagnosed with non-LCH following presentation with pancytopenia and marrow examination showing histiocytosis positive for CD45, CD68, CD136, and lysozyme but negative for CD1a, langerin, and S100. RESULTS Whole-exome sequencing showed RUNX1 mutation and NF1 mutation. In the ensuing 6 months, she developed hepatosplenomegaly, and repeat bone marrow evaluation was diagnostic of acute myeloid leukemia (AML). Repeat mutational analysis showed again presence of RUNX1 mutation. She underwent induction therapy but died of septic shock. CONCLUSIONS The demonstration of RUNX1 mutation in both non-LCH and AML bone marrow specimens at differing time points is suggestive of a biologic association of both distinct disease entities.
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Affiliation(s)
- Areej Al Mugairi
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, King Abdul Aziz Medical City, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Saeed Al Turki
- Division of Molecular Pathology, Department of Pathology and Laboratory Medicine, King Abdul Aziz Medical City, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Hind Salama
- Division of Hematology and HSCT, Department of Oncology, King Abdul Aziz Medical City, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Khlood Al Ahmadi
- Division of Hematopathology, Department of Pathology and Laboratory Medicine, King Abdul Aziz Medical City, Riyadh, KSA
| | - Khadeja A Abuelgasim
- Division of Hematology and HSCT, Department of Oncology, King Abdul Aziz Medical City, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
| | - Moussab Damlaj
- Division of Hematology and HSCT, Department of Oncology, King Abdul Aziz Medical City, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
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8
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Cheon E, Yang S, Han JH, Lee KC, Park JE. Systemic Juvenile Xanthogranuloma Involving the Bone Marrow, Multiple Bones, and the Skin That Developed During Treatment of Acute Lymphoblastic Leukemia in Remission State. Pediatr Dev Pathol 2018; 21:489-493. [PMID: 28836893 DOI: 10.1177/1093526617721775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Juvenile xanthogranuloma (JXG) is a rare benign disorder classified as non-Langerhans cell histiocytosis, with unclear etiology and pathogenesis. JXG is generally characterized by solitary or multiple cutaneous nodules that resolve spontaneously over a few years. JXG rarely presents as extracutaneous lesions that progress to a symptomatic systemic disorder through multiple organ involvement. We encountered a systemic JXG case involving the bone marrow, multiple bones, and the skin during acute lymphoblastic leukemia (ALL) treatment. A 16-year-old boy undergoing ALL treatment experienced unexplained prolonged fever and scalp, hip joint, and right knee joint pain for 2 weeks during interim maintenance chemotherapy. Bone marrow pathologic findings revealed no evidence of leukemia relapse but showed diffuse infiltration of histiocytes with several Touton-type giant cells; the stains were positive for CD68 and negative for CD1a and S100 protein. Bone and skin biopsies confirmed the findings. Symptoms have resolved since maintenance chemotherapy, which included vincristine, dexamethasone, 6-mercaptopurine, and methotrexate. Bone marrow involvement of JXG is very rare, occurring only in patients less than 1 year of age; however, this case was reported in an adolescent during ALL treatment.
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Affiliation(s)
- Eunjae Cheon
- 1 Department of Pediatrics, School of Medicine, Ajou University, Suwon, Korea
| | - Saemi Yang
- 1 Department of Pediatrics, School of Medicine, Ajou University, Suwon, Korea
| | - Jae Ho Han
- 1 Department of Pediatrics, School of Medicine, Ajou University, Suwon, Korea
| | - Kwang Chul Lee
- 2 Department of Pediatrics, College of Medicine, Korea University, Korea
| | - Jun Eun Park
- 1 Department of Pediatrics, School of Medicine, Ajou University, Suwon, Korea
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9
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Paulus S, Koronowska S, Fölster-Holst R. Association Between Juvenile Myelomonocytic Leukemia, Juvenile Xanthogranulomas and Neurofibromatosis Type 1: Case Report and Review of the Literature. Pediatr Dermatol 2017; 34:114-118. [PMID: 28111791 DOI: 10.1111/pde.13064] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The occurrence of juvenile myelomonocytic leukemia (JMML), juvenile xanthogranuloma (JXG), and neurofibromatosis type 1 (NF1) together is relatively rare. Approximately only 20 cases have been reported in the literature. It is debated whether children with NF1 and JXG are at higher risk of developing JMML than children with NF1 alone. We present the case of a boy primarily diagnosed with NF1 with coexisting JXG who developed JMML at the age of 22 months. The clinical course from initial presentation to final diagnosis is detailed and the genetic features and hematologic characteristics are discussed. We report this case to underscore the importance of close monitoring of blood count and strict clinical follow-up in children presenting with concurrent NF1 and JXG and provide a possible explanation for this association.
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Affiliation(s)
- Samuel Paulus
- Department of Dermatology, University of Kiel, Kiel, Germany
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10
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11
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Ferguson SD, Waguespack SG, Langford LA, Ater JL, McCutcheon IE. Fatal juvenile xanthogranuloma presenting as a sellar lesion: case report and literature review. Childs Nerv Syst 2015; 31:777-84. [PMID: 25503249 DOI: 10.1007/s00381-014-2604-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Juvenile xanthogranuloma (JXG) is a histiocytic condition in the spectrum of non-Langerhans histiocytosis that preferentially affects children. Rarely this condition can involve the central nervous system (CNS) with devastating consequences. METHODS The authors report the unique case of an 11-year-old child who initially presented with a sellar lesion without evidence of the cutaneous stigmata typical of JXG. She was later discovered to have JXG following initial diagnosis of granulomatous hypophysitis, with development of widespread intracranial disease and subsequent neurological deterioration. She underwent subtotal resection of her sellar lesion followed by whole brain radiation and systemic chemotherapy; however, she succumbed to her disseminated disease within 1 month of the JXG diagnosis. CONCLUSIONS This is a rare case of fatal disseminated intracranial JXG without cutaneous manifestations. Additionally, the initial presentation as a sellar lesion is particularly unusual and seldom described in the literature.
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Affiliation(s)
- Sherise D Ferguson
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, 1400, Holcombe Blvd., Unit 442, Houston, TX, 77030, USA,
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12
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Disseminated Juvenile Xanthogranuloma Associated With Follicular Lymphoma in an Adult: Successful Treatment With Chemotherapy and Rituximab. A Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.adengl.2012.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Aggressive histiocytic lesions are uncommon in the pediatric population. These neoplasms occur in isolation or after therapy for other types of hematopoietic malignancy such as T-cell acute lymphoblastic leukemia. The etiology of these lesions is poorly understood, and no definitive standard of care has been established for patients with these diagnoses. Here, we report the success of thalidomide treatment for 2 subtypes of histiocytic proliferation--metastatic histiocytic sarcoma and extracutaneous juvenile xanthogranuloma--in pediatric patients. Our findings highlight the importance of considering thalidomide therapy in this unique and difficult to treat patient population.
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14
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Narváez-Moreno B, Pulpillo-Ruiz Á, De Zulueta-Dorado T, Conejo-Mir J. Disseminated juvenile xanthogranuloma associated with follicular lymphoma in an adult: successful treatment with chemotherapy and rituximab. A review of the literature. ACTAS DERMO-SIFILIOGRAFICAS 2012; 104:242-6. [PMID: 22681714 DOI: 10.1016/j.ad.2012.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2011] [Revised: 02/01/2012] [Accepted: 02/10/2012] [Indexed: 11/25/2022] Open
Abstract
Juvenile xanthogranuloma is a non-Langerhans cell histiocytosis that typically affects children, but several cases have been reported in adults, some in connection with hematologic malignancies. We present the case of a 61-year-old woman with multiple xanthogranulomas who developed a follicular lymphoma after 4 years of follow-up. After 6 months of treatment with chemotherapy and rituximab, the cutaneous lesions disappeared and the patient achieved remission from lymphoma. We highlight this case because xanthogranuloma is a rare disorder that is difficult to diagnose in adults and also because this is the first report of an association between xanthogranuloma and follicular lymphoma. Excellent response was achieved with chemotherapy and rituximab. Finally, given the possible association between xanthogranulomas and hematologic diseases, these lesions may be a cutaneous manifestation of an occult malignancy.
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Affiliation(s)
- B Narváez-Moreno
- Servicio de Gestión Clínica Dermatología, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
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