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Rolim R, Maia T, Ionita A, Cravo M, Cabeçadas J. Aggressive Form of Mycosis Fungoides With Bilateral Testicular Involvement and Salivary Gland Mass, Exhibiting Phenotypic Switch. Am J Dermatopathol 2024; 46:690-692. [PMID: 39008461 DOI: 10.1097/dad.0000000000002794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
ABSTRACT We report the case of a 72-year-old man with bilateral testicular involvement by mycosis fungoides (MF). The patient was diagnosed with MF 6 months prior, and testicular involvement was found upon staging. The rare behavior of MF, with early visceral involvement and no hematolymphoid organs affected, had a poor prognosis with patient death 14 months after the original diagnosis despite surgery and chemotherapy. The neoplastic cells showed a phenotypic switch from a CD4 + /CD8 - profile in the skin to a CD4 - /CD8 - in the testis and the same clone, confirmed with T-cell receptor gene rearrangement studies, making this the third reported case of MF affecting the testis and the first with clonality studies to confirm it. The clinical evolution may be related to its distinctive biology showcased in the neoplastic cell's switch to a more aggressive CD4 - /CD8 - profile and the early extension of the disease to an uncommon visceral site.
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Affiliation(s)
- Ricardo Rolim
- Pathology Department, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal
| | - Tiago Maia
- Pathology Department, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal
| | - Alina Ionita
- Haematology Department, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal
| | - Mariana Cravo
- Dermatology Department, Instituto Português de Oncologia de Lisboa, Francisco Gentil, Lisboa, Portugal; and
| | - José Cabeçadas
- Portuguese Institute of Anatomical Pathology, Lisboa, Portugal
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Motamedi M, Xiao MZX, Deschenes J, Hardin J, Sterrett R, Street L, Taparia M, Mahe E, Ferrara G, Barrie JR, Gniadecki R. Early Organ Metastasis in Granulomatous Mycosis Fungoides: A Systematic Review. Dermatology 2024; 240:468-473. [PMID: 38422999 DOI: 10.1159/000537893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/05/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Granulomatous mycosis fungoides (GMF) is a rare form of cutaneous T-cell lymphoma characterized by a granulomatous inflammatory infiltrate. OBJECTIVE The impact of granulomatous inflammation on the prognosis of the disease remains controversial as there have been both favorable and unfavorable outcomes documented. METHODS We performed a systematic review of 116 GMF cases previously described in the literature. RESULTS In contrast to the classic Alibert-Bazin type of mycosis fungoides (MF), cutaneous lesions in GMF tend to involve distal extremities (lower legs, feet, hands) early in the disease course. In the literature, 30% of GMF patients developed organ metastasis, most frequently to the lung. The median time to stage progression was 25 months. CONCLUSION GMF is an aggressive form of MF. Therefore, screening for distant metastases should be considered at presentation and repeated during follow-up.
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Affiliation(s)
- Melika Motamedi
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada,
| | - Maggie Z X Xiao
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Jean Deschenes
- Cross Cancer Institute, Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jori Hardin
- Department of Medicine, Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Russell Sterrett
- Cross Cancer Institute, Faculty of Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Lesley Street
- Department of Medicine, Section of Hematology and Hematologic Malignancies, University of Calgary, Calgary, Alberta, Canada
| | - Minakshi Taparia
- Department of Medicine, Division of Hematology, University of Alberta, Edmonton, Alberta, Canada
| | - Etienne Mahe
- Departments of Pathology and Laboratory Medicine, and Medicine, Division of Hematology and Hematological Malignancies, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Giovanni Ferrara
- Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - James R Barrie
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Robert Gniadecki
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
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Patil K, Sher G, Kuttikrishnan S, Moton S, Alam M, Buddenkotte J, Ahmad A, Steinhoff M, Uddin S. The cross-talk between miRNAs and JAK/STAT pathway in cutaneous T cell lymphoma: Emphasis on therapeutic opportunities. Semin Cell Dev Biol 2024; 154:239-249. [PMID: 36216715 DOI: 10.1016/j.semcdb.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 02/25/2023]
Abstract
Mycosis Fungoides (MF) and Sézary Syndrome (SS) belong to a wide spectrum of T cell lymphoproliferative disorders collectively termed cutaneous T cell lymphomas (CTCL). CTCLs represent an archetype of heterogeneous and dynamically variable lymphoproliferative neoplasms typified by distinct clinical, histological, immunophenotypic, and genetic features. Owing to its complex dynamics, the pathogenesis of CTCL remains elusive. However, in recent years, progress in CTCL classification combined with next-generation sequencing analyses has broadened the genetic and epigenetic spectrum of clearly defined CTCL entities such as MF and SS. Several large-scale genome studies have identified the polygenic nature of CTCL and unveiled an idiosyncratic mutational landscape involving genetic aberrations, epigenetic alterations, cell cycle dysregulation, apoptosis, and the constitutive activation of T cell/NF-κB/JAK-STAT signaling pathways. In this review, we summarize the evolving insights on how the intrinsic epigenetic events driven by dysregulated miRNAs, including the oncogenic and tumor-suppressive miRNAs, influence the pathogenesis of MF and SS. We also focus on the interplay between the JAK/STAT pathway and miRNAs in CTCL as well as the significance of the miRNA/STAT axis as a relevant pathogenetic mechanism underlying CTCL initiation and progression. Based on these biologic insights, the current status and recent progress on novel therapies with a strong biological rationale, including miRNA-targeted molecules and JAK/STAT-targeted therapy for CTCL management, are discussed.
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Affiliation(s)
- Kalyani Patil
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar
| | - Gulab Sher
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar
| | - Shilpa Kuttikrishnan
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar
| | - Safwan Moton
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33200, USA
| | - Majid Alam
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
| | - Joerg Buddenkotte
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
| | - Aamir Ahmad
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar
| | - Martin Steinhoff
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar; Weill Cornell Medicine-Qatar, Medical School, Doha 24144, Qatar; Dept. of Dermatology, Weill Cornell Medicine-New York 10065, New York, USA.
| | - Shahab Uddin
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar; Laboratory Animal Research Center, Qatar University, Doha 2713, Qatar.
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Miyashiro D, Sanches JA. Mycosis fungoides and Sézary syndrome: clinical presentation, diagnosis, staging, and therapeutic management. Front Oncol 2023; 13:1141108. [PMID: 37124514 PMCID: PMC10140754 DOI: 10.3389/fonc.2023.1141108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are cutaneous T-cell lymphomas. MF is the most common cutaneous lymphoma, and it is classified into classic Alibert-Bazin MF, folliculotropic MF, pagetoid reticulosis, and granulomatous slack skin, each with characteristic clinical presentation, histopathological findings, and distinct clinical behaviors. SS is an aggressive leukemic variant of cutaneous lymphoma, and it is characterized by erythroderma, lymphadenopathy, and peripheral blood involvement by malignant cells. There is a wide range of dermatological manifestations of MF/SS, and prompt recognition is essential for early diagnosis. Skin biopsy for histopathology and immunohistochemical analysis is imperative to confirm the diagnosis of MF/SS. Histopathology may also provide information that may influence prognosis and treatment. Staging follows the TNMB system. Besides advanced stage, other factors associated with poorer prognosis are advanced age, male gender, folliculotropism in histopathology of patients with infiltrated plaques and tumors in the head and neck region, large cell transformation, and elevated lactate dehydrogenase. Treatment is divided into skin-directed therapies (topical treatments, phototherapy, radiotherapy), and systemic therapies (biological response modifiers, targeted therapies, chemotherapy). Allogeneic bone marrow transplantation and extracorporeal photopheresis are other treatment modalities used in selected cases. This review discusses the main clinical characteristics, the histopathological/immunohistochemical findings, the staging system, and the therapeutic management of MF/SS.
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Molecular pathogenesis of Cutaneous T cell Lymphoma: Role of chemokines, cytokines, and dysregulated signaling pathways. Semin Cancer Biol 2022; 86:382-399. [PMID: 34906723 DOI: 10.1016/j.semcancer.2021.12.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/08/2021] [Indexed: 01/27/2023]
Abstract
Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphoproliferative neoplasms that exhibit a wide spectrum of immune-phenotypical, clinical, and histopathological features. The biology of CTCL is complex and remains elusive. In recent years, the application of next-generation sequencing (NGS) has evolved our understanding of the pathogenetic mechanisms, including genetic aberrations and epigenetic abnormalities that shape the mutational landscape of CTCL and represent one of the important pro-tumorigenic principles in CTCL initiation and progression. Still, identification of the major pathophysiological pathways including genetic and epigenetic components that mediate malignant clonal T cell expansion has not been achieved. This is of prime importance given the role of malignant T cell clones in fostering T helper 2 (Th2)-bias tumor microenvironment and fueling progressive immune dysregulation and tumor cell growth in CTCL patients, manifested by the secretion of Th2-associated cytokines and chemokines. Alterations in malignant cytokine and chemokine expression patterns orchestrate the inflammatory milieu and influence the migration dynamics of malignant clonal T cells. Here, we highlight recent insights about the molecular mechanisms of CTCL pathogenesis, emphasizing the role of cytokines, chemokines, and associated downstream signaling networks in driving immune defects, malignant transformation, and disease progression. In-depth characterization of the CTCL immunophenotype and tumoral microenvironment offers a facile opportunity to expand the therapeutic armamentarium of CTCL, an intractable malignant skin disease with poor prognosis and in dire need of curative treatment approaches.
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Bayramgürler D, Kazan D, Eruyar T, Demirkesen C, Demirbaş A. The oral cavity and gastric involvement in mycosis fungoides while on systemic bexarotene therapy: A rare case report. Dermatol Ther 2022; 35:e15349. [PMID: 35103368 DOI: 10.1111/dth.15349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/28/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Dilek Bayramgürler
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Didem Kazan
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Tuğrul Eruyar
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Cüyan Demirkesen
- Department of Pathology, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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Miyashiro D, Sanches JA. Characteristics and outcomes of 727 patients with mycosis fungoides and Sézary syndrome from a Brazilian cohort. Int J Dermatol 2021; 61:442-454. [PMID: 34435672 DOI: 10.1111/ijd.15865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mycosis fungoides (MF) and Sézary syndrome (SS) are the most prevalent cutaneous lymphomas. They were not described in a large Brazilian cohort yet. We aimed, with this single-center, retrospective cohort analysis, to describe the characteristics and outcomes of MF/SS in a tertiary public health service in Brazil. METHODS MF/SS patients evaluated at the University of São Paulo Medical School between 1989 and 2018 were included. Data were collected at diagnosis. Demographic, clinical, histopathological, immunopathological, molecular, laboratory, and follow-up data were analyzed. RESULTS Among 727 patients, 92.6% (673) were diagnosed with MF, 7.4% (54) with SS. There were 51.2% (372) of males, 48.8% (355) of females. The median age was 51.8 years; it was higher in erythrodermic MF (60.2) and SS (60.9). Among MF, 41.8% (281) had classic MF, 4.9% (33) folliculotropic MF, 1.8% (12) granulomatous slack skin, and 0.3% (2) pagetoid reticulosis. Common subtypes included erythrodermic (14.1%, 95), hypopigmented (10.8%, 73), and poikilodermatous MF (10.8%, 73). Extracutaneous involvement was rare. Five, 10, 20, and 30-year overall survival rates were 97.3%, 92.4%, 82.6%, and 82.6% for early-stage, and 58.6%, 42.7%, 20.8%, and 15.4% for advanced-stage disease, respectively. After multivariate analysis, SS diagnosis, folliculotropic MF, erythrodermic MF, clinical stage, age (≥60 years), increased lactate dehydrogenase, and large cell transformation conferred poorer prognosis. CONCLUSIONS We observed a higher percentage of hypopigmented MF compared to the literature, and demographic (older age) and prognostic (poorer prognosis) similarities between erythrodermic MF and SS, suggesting a possible relationship between these erythrodermic lymphomas. Factors associated with a poorer prognosis were compatible with the literature.
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Affiliation(s)
- Denis Miyashiro
- Division of Clinical Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - José A Sanches
- Division of Clinical Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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Mycosis Fungoides and Sézary Syndrome: An Integrative Review of the Pathophysiology, Molecular Drivers, and Targeted Therapy. Cancers (Basel) 2021; 13:cancers13081931. [PMID: 33923722 PMCID: PMC8074086 DOI: 10.3390/cancers13081931] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary In the last few years, the field of cutaneous T-cell lymphomas has experienced major advances. In the context of an active translational and clinical research field, next-generation sequencing data have boosted our understanding of the main molecular mechanisms that govern the biology of these entities, thus enabling the development of novel tools for diagnosis and specific therapy. Here, we focus on mycosis fungoides and Sézary syndrome; we review essential aspects of their pathophysiology, provide a rational mechanistic interpretation of the genomic data, and discuss the current and upcoming therapies, including the potential crosstalk between genomic alterations and the microenvironment, offering opportunities for targeted therapies. Abstract Primary cutaneous T-cell lymphomas (CTCLs) constitute a heterogeneous group of diseases that affect the skin. Mycosis fungoides (MF) and Sézary syndrome (SS) account for the majority of these lesions and have recently been the focus of extensive translational research. This review describes and discusses the main pathobiological manifestations of MF/SS, the molecular and clinical features currently used for diagnosis and staging, and the different therapies already approved or under development. Furthermore, we highlight and discuss the main findings illuminating key molecular mechanisms that can act as drivers for the development and progression of MF/SS. These seem to make up an orchestrated constellation of genomic and environmental alterations generated around deregulated T-cell receptor (TCR)/phospholipase C, gamma 1, (PLCG1) and Janus kinase/ signal transducer and activator of transcription (JAK/STAT) activities that do indeed provide us with novel opportunities for diagnosis and therapy.
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Padilla O, Tam W, Geyer JT. T-cell neoplasms in the spleen. Semin Diagn Pathol 2020; 38:135-143. [PMID: 33199090 DOI: 10.1053/j.semdp.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/11/2022]
Abstract
Hematopoietic neoplasms involving the spleen are uncommon, but T cell neoplasms involving the spleen are extremely rare. The rarity of splenic involvement by T cell neoplasms has resulted in a limited body of literature describing their splenic characteristics. As a result, our purpose in this review article is to provide and summarize some of the characteristics seen by different T cell neoplasms that may involve the spleen.
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Affiliation(s)
- Osvaldo Padilla
- Texas Tech University Health Sciences Center, PL Foster School of Medicine, Department of Pathology, 4625 Alberta Ave., El Paso, TX 79905, United States.
| | - Wayne Tam
- Weill Cornell Medicine, Department of Pathology and Laboratory Medicine, 525 E 68th Street, Starr Pavilion 715, New York, NY 10065, United States
| | - Julia T Geyer
- Weill Cornell Medicine, Department of Pathology and Laboratory Medicine, 525 E 68th Street, Starr Pavilion 715, New York, NY 10065, United States
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Scali E, Presta I, Donato A, Schipani G, Dastoli S, Rossi M, Mignogna C, Malara N, Nisticò SP, Donato G. Mycosis fungoides and gastric T-cell lymphoma: A case report. Mol Clin Oncol 2020; 13:15. [PMID: 32754329 PMCID: PMC7391825 DOI: 10.3892/mco.2020.2085] [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: 12/22/2019] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
Mycosis fungoides (MF) is a cutaneous malignant lymphoma with an extended clinical course. MF presents in series of dermatological manifestations, beginning with patches and plaques of the skin, and eventually evolving into tumours. Often MF can occur for extended periods without worsening of external symptoms, while the disease advances internally in organs such as lymph nodes, liver, spleen, lung, bone marrow, gastrointestinal tract, pancreas and kidney. The present report presents a clinical case in which gastrointestinal symptomatology occurred a decade after the first dermatological manifestation. Immunohistochemical analysis of the skin, along with small bowel biopsies revealed evidence of gastric T-cell lymphoma. To the best of our knowledge, the present study is the first to describe such a case in the literature.
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Affiliation(s)
- Elisabetta Scali
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Ivan Presta
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Annalidia Donato
- Department of Medical and Surgical Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giusy Schipani
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Stefano Dastoli
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Marco Rossi
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Chiara Mignogna
- Department of Interdipartimental Services Center (CIS), University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Natalia Malara
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Steven Paul Nisticò
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giuseppe Donato
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
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Kohn M, Karras A, Zaidan M, Bénière C, de Fréminville JB, Laribi K, Perrin MC, Malphettes M, Le Calloch R, Anglaret B, Martiniuc J, Bailly S, Chevret S, Molina T, Thervet E, Thieblemont C. Lymphomas with kidney involvement: the French multicenter retrospective LyKID study. Leuk Lymphoma 2020; 61:887-895. [PMID: 32037948 DOI: 10.1080/10428194.2019.1697811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The LyKID study is a nationwide survey in France of lymphoma patients with renal involvement based on biopsy and/or imaging, to evaluate its impact on disease outcome and renal function. A total of 87 adult cases of B or T-cell lymphomas were retrospectively analyzed. Interstitial topography was observed in most of the kidney biopsies (54/66; 80%). Kidney failure (glomerular filtration rate <60 mL/min/1.73 m2) was present in 47% of patients and was associated with non-significantly different outcome. After lymphoma treatment, 44% of patients had persistent chronic kidney failure (CKF); kidney failure at diagnosis was the only parameter associated with CKF in multivariate analysis. DLBCL (diffuse large B-cell lymphomas) represented half of the series, with noticeably CNS (central neurological system) relapse in 17% patients, while fewer than one of two patients had received CNS prophylaxis. To our knowledge, the LyKID study represents the largest published non-autopsy lymphoma series with renal involvement.
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Affiliation(s)
- Milena Kohn
- Hémato-Oncologie, APHP, Hôpital Saint-Louis, Paris, France
| | - Alexandre Karras
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | | | | | - Marion Malphettes
- Immuno-Pathologie Clinique, APHP, Hôpital Saint-Louis, Paris, France
| | - Ronan Le Calloch
- Service des Maladies du Sang, Médecine Interne, Maladies Infectieuses, CH de Quimper Cornouailles, Quimper, France
| | | | | | - Sarah Bailly
- Hématologie, Cliniques Universitaires Saint Luc Université catholique de Louvain, Bruxelles, Belgium
| | - Sylvie Chevret
- Biostatistiques, APHP, Hôpital Saint-Louis, Paris, France
| | | | - Eric Thervet
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
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Abstract
T-cell lymphoproliferative processes in the spleen are rare and it is important to study normal T cell subsets in the spleen to understand the splenic milieu in which they arise. True malignant T-cell processes including hepatosplenic T-cell lymphoma and T-cell large granular lymphocytic leukemia occur in the spleen, but other atypical reactive T-cell proliferations and those of uncertain significance also have been described. Proper distinction of florid T cell responses from malignant T-cell neoplasms has important therapeutic implications for the patient.
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Affiliation(s)
- Nadine S Aguilera
- Department of Pathology, University of Virginia Health System, Charlottesville VA 22908-0214, United States.
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Abstract
T-cell lymphoma, a collection of subtypes of Non-Hodgkin lymphoma, is a rare malignancy. The low prevalence of this disease has made it challenging to identify subtype-specific risk factors. Potential risk factors could enable us to identify high-risk patients and predict patient outcomes. Here, we report on the current epidemiologic and prognostic factors data associated with the individual subtypes both of peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) found in large cohort and case studies. Additionally, with recent findings, as well as updates in the new World Health Organization (WHO) classification of lymphoid neoplasms, we consider what this could do to change our approach to this group of diseases.
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Mycosis Fungoides of the Oral Cavity: Fungating Tumor Successfully Treated with Electron Beam Radiation and Maintenance Bexarotene. Case Rep Dermatol Med 2016; 2016:5857935. [PMID: 28074163 PMCID: PMC5198150 DOI: 10.1155/2016/5857935] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 10/26/2016] [Accepted: 11/06/2016] [Indexed: 11/17/2022] Open
Abstract
Oral involvement in mycosis fungoides is unusual and portends a poor prognosis. The clinical findings of three new cases are described along with a differential diagnosis and review of the literature. For brevity, only one patient is discussed in detail below whereas the other two cases are solely described in table form. The patient had a four-year history of mycosis fungoides before developing an exophytic tongue tumor. He was treated with local electron beam radiation and is disease-free to date while being on maintenance therapy with oral bexarotene. Analysis of the data collected from our review of the literature and the present cases reveal key insights.
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Tsankov N, Kazandjieva J, Darlenski R. The skin as a target organ in multisystemic diseases II. Clin Dermatol 2015; 33:509-11. [PMID: 26321395 DOI: 10.1016/j.clindermatol.2015.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Progress in medical science has given a new reading to the claim that the skin could be a mirror of the pathological changes found in the internal organs. The concept that we previously promoted is furthered in this issue; namely that the greatest part of skin diseases are systemic ones. In this issue we focus on another group of diseases with systemic involvement and skin manifestations. We review such inflammatory conditions as lichen planus, autoinflammatory syndromes, and pyoderma gangrenosum focusing on their systemic involvement. We have not missed such classic examples of systemic involvement as scleroderma. In this issue we have included two infectious diseases with multi-organ involvement: Lyme disease and Herpes simplex. In contrast to our previous work, we have also addressed neoplastic diseases - namely mycosis fungoides.
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Affiliation(s)
- Nikolai Tsankov
- Department of Dermatology and Venereology, Tokuda Hospital, Sofia, 51B Nikola Vaptsarov Blvd., 1407 Sofia, Bulgaria.
| | - Jana Kazandjieva
- Department of Dermatology and Venereology, Medical University, Sofia, 1 Saint Georgi Sofiiski Str., 1431 Sofia, Bulgaria
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Tokuda Hospital, Sofia, 51B Nikola Vaptsarov Blvd., 1407 Sofia, Bulgaria
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