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Plumptre IR, Said JT, Sun T, Larocca C, Virgen CA, Kupper TS, Fisher DC, Devlin PM, Elco CP, Song JS, LeBoeuf NR. Clinical features and treatment outcomes for primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder: a retrospective cohort study from the Dana-Farber Cancer Institute and updated literature review. Leuk Lymphoma 2022; 63:2832-2846. [PMID: 35862569 DOI: 10.1080/10428194.2022.2098287] [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: 12/14/2022]
Abstract
Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (PCSM-TCLPD) was reclassified in 2016 as a rare benign entity with an excellent prognosis, yet its clinical features and best treatments remain poorly defined. We collected clinical data, treatments, and treatment-responses from our institution's patients with PCSM-TCLPD through September 2018 and an identical PubMed review through June 2021. Among 36 cases (median-age 54 years; 58.3% head/neck), diagnostic biopsy resulted in sustained complete remission (CR) in 13/33 punch/shave biopsies and 3/3 excisional biopsies. The remaining 20 patients further required topical corticosteroids (n = 5); intralesional corticosteroids (n = 1); surgical-excision (n = 5); electron-beam-radiation (n = 6); or brachytherapy (n = 3). All patients ultimately achieved CR, excluding one patient continuing treatment at end-of-study. 57/59 (96.6%) of institutional and literature-reported radiation-treated patients experienced CR. No institutional cases progressed beyond skin; 5/209 (2.4%) literature-reported cases progressed to systemic/extracutaneous involvement, all pre-reclassification. PCSM-TCLPD responds well to local-directed therapy including radiation, and only rarely if ever progresses.
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Affiliation(s)
| | - Jordan T Said
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Tiffany Sun
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cecilia Larocca
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cesar A Virgen
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Thomas S Kupper
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David C Fisher
- Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Philip M Devlin
- Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher P Elco
- Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Johanna Sheu Song
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Center for Cutaneous Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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2
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Peeters M, Geusens J, Van der Cruyssen F, Michaux L, de Leval L, Tousseyn T, Vandenberghe P, Politis C. Case Report: Spontaneous Remission of an Infraorbital Follicular B-Cell Lymphoma: Case Report and Review of the Literature. Pathol Oncol Res 2021; 27:642433. [PMID: 34257608 PMCID: PMC8262163 DOI: 10.3389/pore.2021.642433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/01/2021] [Indexed: 11/21/2022]
Abstract
Non-Hodgkin lymphomas comprise a heterogeneous group of malignancies, with a wide scope of clinical, radiological and histological presentations. In this paper, a case is presented of a 59-year-old white male with an infraorbital follicular B-cell lymphoma, which appeared as a painless mass in the left cheek. The lymphoma achieved spontaneous remission five and a half months after his diagnostic incision biopsy. The literature is reviewed, focusing on this rare site of presentation and spontaneous remission. In literature, only four cases have been reported with a follicular B-cell lymphoma of the cheek or infraorbital region, and only 26 cases of spontaneous remission of an extracranial non-Hodgkin lymphoma in the head and neck region have been described. To the authors’ best knowledge, this is the first time spontaneous remission of an infraorbital follicular lymphoma could be observed. The nature of the processes inducing spontaneous remission remains obscure. It is important to recognize this phenomenon as this might prevent unnecessary treatment.
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Affiliation(s)
- Maxime Peeters
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Joris Geusens
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Fréderic Van der Cruyssen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium
| | - Lucienne Michaux
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Laurence de Leval
- Department of Pathology, Lausanne University Hospital (CHUV) and Lausanne University, Lausanne, Switzerland
| | - Thomas Tousseyn
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - Constantinus Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, Catholic University Leuven, Leuven, Belgium
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Koper M, Putała‐Pośpiech M, Biernat W, Woźniacka A, Robak E. Primary cutaneous CD4+ small-/medium-sized T-cell lymphoproliferative disorder: A case report. Clin Case Rep 2019; 7:703-706. [PMID: 30997068 PMCID: PMC6452474 DOI: 10.1002/ccr3.2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/19/2018] [Accepted: 01/05/2019] [Indexed: 01/06/2023] Open
Abstract
Primary cutaneous CD4+ small-/medium-sized T-cell lymphoproliferative disorder is usually characterized by nodules and plaques affecting the upper part of the body. The present case presented with a large, single tumor located on a lower extremity. The patient did not respond to surgical therapy but responded to cyclophosphamide, methotrexate, and radiotherapy.
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Affiliation(s)
- Monika Koper
- Department of Dermatology and VenereologyMedical University of LodzLodzPoland
| | | | | | - Anna Woźniacka
- Department of Dermatology and VenereologyMedical University of LodzLodzPoland
| | - Ewa Robak
- Department of Dermatology and VenereologyMedical University of LodzLodzPoland
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Maurelli M, Colato C, Gisondi P, Girolomoni G. Primary Cutaneous CD4+ Small/Medium Pleomorphic T-Cell Lymphoproliferative Disorder: A Case Series. J Cutan Med Surg 2017; 21:502-506. [DOI: 10.1177/1203475417715209] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (CD4+ PCSM-LPD) is defined by a predominance of small- to medium-sized CD4+ pleomorphic T cells and a favorable clinical course. Objective: We performed a retrospective analysis of 6 patients with CD4+ PCSM-LPD and reviewed the literature to address questions about its diagnosis, treatment, and prognosis. Methods: Patients were 3 men and 3 women with a median age of 50 years. All patients presented with a single erythematous nodule, localised on the head in 4 patients and the upper trunk in 2 cases. No patients showed extracutaneous disease at any evaluation. Histopathologic features were characterised by nodular, diffuse, or, in 1 case, a superficial dense infiltrate of small/medium-sized pleomorphic CD4+/PD1+ T lymphocytes. T-cell receptor clonality was demonstrated in 5 cases. Treatment was surgical excision in 5 cases and radiotherapy in 1 case. Results: All patients achieved complete resolution without relapses, during a median follow-up of 3 years. A review of the literature confirmed that CD4+ PCSM-LPD presents predominantly with a solitary nodular lesion on the face, neck, or upper trunk in adult patients. Surgical excision is the preferred treatment. Spontaneous resolution after biopsy may occur. Conclusions: CD4+ PCSM-LPD is a rare disorder with a favorable course.
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Affiliation(s)
- Martina Maurelli
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Chiara Colato
- Section of Pathology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
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Rodríguez-Lomba E, Molina-López I, Pulido-Pérez A, Ciudad-Blanco C. Ultrasound Appearance of Primary Cutaneous CD4+ Small/Medium-Sized T-Cell Lymphoproliferative Disorder. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:792-794. [PMID: 28388988 DOI: 10.1016/j.ad.2016.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 11/15/2016] [Accepted: 11/29/2016] [Indexed: 02/02/2023] Open
Affiliation(s)
- E Rodríguez-Lomba
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - I Molina-López
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - A Pulido-Pérez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - C Ciudad-Blanco
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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