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Martínez-Banaclocha N, Martínez-Madueño F, Caballé B, Badia J, Blanes M, Bujanda DA, Calvo V, Gómez Codina J, Blanco CQ, Espinosa P, Lavernia J, Arroyo FRG, Risueño MG, Llorca C, Cumeras R, Pulla MP, Gumà J. A Descriptive Study of 103 Primary Cutaneous B-Cell Lymphomas: Clinical and Pathological Characteristics and Treatment from the Spanish Lymphoma Oncology Group (GOTEL). Cancers (Basel) 2024; 16:1034. [PMID: 38473391 DOI: 10.3390/cancers16051034] [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: 02/12/2024] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) are B-cell lymphomas that can occur in the skin without evidence of extracutaneous involvement. The 2005 WHO/EORTC classification of cutaneous lymphomas and its 2018 update have distinguished three main categories based on clinicopathological, immunohistochemical, and genetic characteristics: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). PCMZL and PCFCL are clinically indolent, while PCDLBCL-LT is an aggressive lymphoma. Due to its low incidence and lack of prospective studies, it is difficult to establish a standard treatment for each subgroup. The objective of our study was to describe the clinical and pathological characteristics of 103 patients with cutaneous B-cell lymphoma from 12 centres belonging to the Spanish Lymphoma Oncology Group. The median age was 53 years (40-65). According to skin extension, 62% had single-site lymphoma, 17% had regional lymphoma, and 20% had multifocal lymphoma. Histology: 66% had PCMZL, 26% had PCFCL, and 8% had PCDLBCL-LT. Twenty-three percent of the patients were treated exclusively with surgery, 26% with radiotherapy only, 21% with surgery plus radiotherapy, 10% with polychemotherapy, and 5% with rituximab monotherapy. Overall, 96% of patients achieved a complete response, and 44% subsequently relapsed, most of them relapsing either locally or regionally. The 10-year OS was 94.5% for the entire cohort, 98% for the PCMZL cohort, 95% for the PCFCL cohort, and 85.7% for the PCDLBCL-LT cohort. Our data are comparable to those of other published series, except for the high frequency of PCMZL. The expected heterogeneity in therapeutic management has been observed.
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Affiliation(s)
- Natividad Martínez-Banaclocha
- Medical Oncology Department, Hospital General Universitario Dr. Balmis, Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Francisca Martínez-Madueño
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Berta Caballé
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Joan Badia
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Mar Blanes
- Dermatology Department, Hospital General Universitario Dr. Balmis, Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - David Aguiar Bujanda
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrin, 35010 Las Palmas de Gran Canaria, Spain
| | - Virginia Calvo
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain
| | - Jose Gómez Codina
- Medical Oncology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Cristina Quero Blanco
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain
| | - Pablo Espinosa
- Dermatology Department, Hospital Infanta Cristina, 28981 Parla, Spain
| | - Javier Lavernia
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología (I.V.O.), 46009 Valencia, Spain
| | | | - María Guirado Risueño
- Medical Oncology Department, Hospital General Universitario de Elche, 03203 Alicante, Spain
| | - Cristina Llorca
- Medical Oncology Department, Hospital General Universitario de Elda, 03600 Alicante, Spain
| | - Raquel Cumeras
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
| | - Mariano Provencio Pulla
- Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain
| | - Josep Gumà
- Southern Catalonia Institute of Oncology, Hospital Universitari Sant Joan de Reus, IISPV-URV-CERCA, 43204 Reus, Spain
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2
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Stephan C, Barone P, Kim J, Ma L. Primary cutaneous marginal zone lymphoproliferative disorder following COVID-19 vaccination. J Cutan Pathol 2024; 51:193-197. [PMID: 38018231 DOI: 10.1111/cup.14550] [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: 05/12/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 11/30/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 vaccines were administered worldwide. A number of skin reactions, including primary cutaneous T-cell lymphoproliferative disorders (LPDs) were reported following COVID-19 vaccination. We report a case of primary cutaneous marginal zone lymphoproliferative disorder (PCMZLPD) secondary to COVID-19 vaccination. A 57-year-old man presented with an erythematous nodule on his left arm at the site of vaccine inoculation following his first dose of the Moderna (mRNA-1273) vaccine a few weeks prior. The nodule continued to progress in size after the second dose. A skin biopsy specimen of the nodule showed a diffuse dermal infiltrate of small to medium-sized lymphocytes with plasma cells and histiocytes. The infiltrate was composed of CD3+ T cells with CD20+ and CD79a+ B cells. The neoplastic B cells reacted with BCL-2 and were negative for BCL-6 and CD10. Kappa light chain restriction was identified by in situ hybridization. Gene rearrangement studies revealed kappa light chain monoclonality, confirming the diagnosis of PCMZLPD. The temporal association with the Moderna vaccination and the occurrence of the lesion at the inoculation site indicate a COVID-19 vaccination-induced PCMZLPD. This is one of the rare cases of PCMZLPD following COVID-19 vaccination.
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Affiliation(s)
- Carla Stephan
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, New York, USA
| | - Paul Barone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine/New York-Presbyterian, New York, New York, USA
| | - Jeanyoung Kim
- Department of Dermatology, Weill Cornell Medicine/New York-Presbyterian, New York, New York, USA
| | - Linglei Ma
- Department of Pathology-Laboratory Medicine, University of Virginia, Charlottesville, VA, USA
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3
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Lee JH, Jo UH, Kim TM, Suh DH. Primary Cutaneous Marginal Zone Lymphoma following Repeated Inflammation Caused by Hair Dyeing. Case Rep Dermatol 2023; 15:152-155. [PMID: 37899942 PMCID: PMC10601760 DOI: 10.1159/000533516] [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: 11/18/2022] [Accepted: 07/19/2023] [Indexed: 10/31/2023] Open
Abstract
Primary cutaneous marginal zone lymphoma (PCMZL) is a rare form of B-cell lymphoma that primarily affects the skin. Chronic antigen stimulation has been implicated in its development, with cases associated with various triggers. We present a case of PCMZL following chronic inflammation caused by long-term hair dyeing. A 75-year-old woman with a history of repeated inflammation and itching after hair dyeing for 30 years presented with persistent red-to-violaceous patches and plaques on her scalp. Despite receiving topical corticosteroid treatment for 10 years, the lesions remained. Pathological examinations confirmed the diagnosis of PCMZL. The patient achieved complete remission after radiotherapy. This case underscores the potential link between chronic inflammation and the development of PCMZL.
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Affiliation(s)
- Jun Hyo Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, South Korea
| | - Ui Hyeon Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
- Acne, Rosacea, Seborrheic Dermatitis and Hidradenitis Suppurativa Research Laboratory, Seoul National University Hospital, Seoul, South Korea
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4
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Eens S, Van Hecke M, Favere K, Tousseyn T, Guns PJ, Roskams T, Heidbuchel H. B-cell lymphoblastic lymphoma following intravenous BNT162b2 mRNA booster in a BALB/c mouse: A case report. Front Oncol 2023; 13:1158124. [PMID: 37197431 PMCID: PMC10183601 DOI: 10.3389/fonc.2023.1158124] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Unprecedented immunization campaigns have been rolled out worldwide in an attempt to contain the ongoing COVID-19 pandemic. Multiple vaccines were brought to the market, among two utilizing novel messenger ribonucleic acid technology. Despite their undisputed success in decreasing COVID-19-associated hospitalizations and mortality, various adverse events have been reported. The emergence of malignant lymphoma is one of such rare adverse events that has raised concern, although an understanding of the mechanisms potentially involved remains lacking. Herein, we present the first case of B-cell lymphoblastic lymphoma following intravenous high-dose mRNA COVID-19 vaccination (BNT162b2) in a BALB/c mouse. Two days following booster vaccination (i.e., 16 days after prime), at only 14 weeks of age, our animal suffered spontaneous death with marked organomegaly and diffuse malignant infiltration of multiple extranodal organs (heart, lung, liver, kidney, spleen) by lymphoid neoplasm. Immunohistochemical examination revealed organ sections positive for CD19, terminal deoxynucleotidyl transferase, and c-MYC, compatible with a B-cell lymphoblastic lymphoma immunophenotype. Our murine case adds to previous clinical reports on malignant lymphoma development following novel mRNA COVID-19 vaccination, although a demonstration of direct causality remains difficult. Extra vigilance is required, with conscientious reporting of similar cases and a further investigation of the mechanisms of action explaining the aforementioned association.
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Affiliation(s)
- Sander Eens
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- *Correspondence: Sander Eens,
| | - Manon Van Hecke
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Kasper Favere
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Thomas Tousseyn
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Pieter-Jan Guns
- Laboratory of Physiopharmacology, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
| | - Tania Roskams
- Laboratory of Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium
| | - Hein Heidbuchel
- Research Group Cardiovascular Diseases, Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton (GENCOR), University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
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5
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Bresler SC, Menge TD, Tejasvi T, Carty SA, Hristov AC. Two cases of challenging cutaneous lymphoid infiltrates presenting in the context of COVID-19 vaccination: A reactive lymphomatoid papulosis-like eruption and a bona fide lymphoma. J Cutan Pathol 2022; 50:213-219. [PMID: 36437812 PMCID: PMC9878077 DOI: 10.1111/cup.14371] [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: 06/23/2022] [Revised: 08/24/2022] [Accepted: 11/26/2022] [Indexed: 11/29/2022]
Abstract
COVID-19 infection and vaccination may be associated with a wide variety of cutaneous and immune manifestations. Here, we describe two patients who presented with monoclonal cutaneous T-cell infiltrates that showed cytologic and immunophenotypic features concerning for lymphoma shortly following COVID-19 vaccination. In one case, the eruption completely resolved. The second patient showed initial resolution, but her disease recurred and progressed following a breakthrough SARS-CoV-2 infection. These cases suggest that immune stimulation following exposure to SARS-Cov-2 protein(s) in vaccine or infection may facilitate the development of a lymphoma or lymphoproliferative disorder in susceptible individuals. Moreover, they show that separating these cases from pseudolymphomatous reactive conditions is often challenging and requires close clinical correlation.
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Affiliation(s)
- Scott C. Bresler
- Department of Pathology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA,Department of Dermatology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Tyler D. Menge
- Department of Dermatology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Trilokraj Tejasvi
- Department of Dermatology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA
| | - Shannon A. Carty
- Division of Hematology/OncologyMichigan Medicine, University of MichiganAnn ArborMichiganUSA,Department of Internal MedicineMichigan Medicine, University of MichiganAnn ArborMichiganUSA
| | - Alexandra C. Hristov
- Department of Pathology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA,Department of Dermatology, Michigan MedicineUniversity of MichiganAnn ArborMichiganUSA
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6
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Sekizawa A, Hashimoto K, Kobayashi S, Kozono S, Kobayashi T, Kawamura Y, Kimata M, Fujita N, Ono Y, Obuchi Y, Tanaka Y. Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report. Front Med (Lausanne) 2022; 9:963393. [PMID: 35979213 PMCID: PMC9377515 DOI: 10.3389/fmed.2022.963393] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
B-cell lymphomas are neoplastic diseases occasionally associated with chronic inflammation. mRNA vaccines for coronavirus disease 2019 (COVID-19) induce inflammatory responses, which often lead to fever and lymphadenopathies indistinguishable from lymphomas. Although both lymphadenopathies and lymphomas can be influential, the correlation between them is unclear. Herein, we present the first case of marginal zone B-cell lymphoma following mRNA COVID-19 vaccination. An 80-year-old Japanese woman presented with a right temporal mass that appeared the morning after she was administered her first mRNA COVID-19 vaccination (BNT162b2). The mass gradually decreased in size but persisted over 6 weeks after her first vaccination (3 weeks after her second vaccination). At her first visit to our hospital, ultrasound revealed the size of the mass to be 28.5 × 5.7 mm, and computed tomography revealed multiple lymphadenopathies in the right parotid, submandibular, jugular, and supraclavicular regions. Initially, we suspected head-and-neck benign lymphadenopathy as a side effect of vaccination. Nine weeks later, the number of swollen submandibular and parotid glands increased, and the lymph nodes further enlarged. Finally, the right temporal mass was diagnosed as marginal zone B-cell lymphoma based on immunohistochemical and flow cytometry findings of biopsy specimens. Our findings suggest that although 4–6 weeks of observation for lymph node inflammation after the second vaccination is recommended, malignancy should also be considered in the differential diagnosis of lymphadenopathy following vaccination.
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Affiliation(s)
- Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
- *Correspondence: Kenichi Hashimoto
| | - Shinichi Kobayashi
- Department of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Sawako Kozono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
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7
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Krenitsky A, Klager S, Hatch L, Sarriera-Lazaro C, Chen PL, Seminario-Vidal L. Update in Diagnosis and Management of Primary Cutaneous B-Cell Lymphomas. Am J Clin Dermatol 2022; 23:689-706. [PMID: 35854102 DOI: 10.1007/s40257-022-00704-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
Primary cutaneous lymphomas are a rare group of diseases, with an estimated incidence of 0.5-1 case per 100,000 people per year. Primary cutaneous B-cell lymphomas (pCBCLs) represent 25-30% of all primary cutaneous lymphomas. There are three main subtypes of pCBCL: primary cutaneous marginal zone lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous B-cell lymphomas have a broad spectrum of clinical presentations, which makes diagnostic and therapeutic strategies challenging. To date, treatment recommendations for cutaneous B-cell lymphomas have been largely based on small retrospective studies and institutional experience. Recently, the pharmacotherapeutic landscape has expanded to include drugs that may modify the underlying disease pathology of pCBCLs, representing new therapeutic modalities for this rare group of diseases. Novel therapies used for other systemic B-cell lymphomas show promise for the treatment of pCBCLs and are being increasingly considered. These new therapies are divided into five main groups: monoclonal antibodies, immune checkpoint inhibitors, small-molecule inhibitors, bispecific T-cell engaging, and chimeric antigen receptor T cell. In this review, we discuss the clinical, histopathological, molecular, and cytogenetic features of the most common pCBCL subtypes with a focus on current and innovative therapeutic developments in their management. These emerging treatment strategies for B-cell lymphomas and cutaneous B-cell lymphomas may represent novel first-line options for the management of these rare diseases.
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Affiliation(s)
- Amanda Krenitsky
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA.
| | - Skylar Klager
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
| | - Leigh Hatch
- Department of Dermatology and Cutaneous Surgery, University of South Florida, 13320 USF Laurel Drive, Tampa, FL, 33612, USA
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | | | - Pei Ling Chen
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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8
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Collinson AC, Moore L, Cheung A, Gold MS, Goh DW. Subcutaneous nodules following vaccination. J Paediatr Child Health 2022; 58:388-391. [PMID: 35137488 DOI: 10.1111/jpc.15900] [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: 02/08/2021] [Revised: 10/26/2021] [Accepted: 01/04/2022] [Indexed: 11/26/2022]
Abstract
Five patients presented to surgical clinics at our institution with subcutaneous nodules of the upper arm or thigh present for 6-18 months. Excisional or fine-needle biopsy was performed due to diagnostic uncertainty and parental concern. Histopathological examination revealed these to be cutaneous lymphoid hyperplasia in reaction to vaccine components. Nodular reactions with this histopathological pattern are well recognised within vaccine-related literature, but less commonly recognised in patients presenting to general paediatric or surgical clinics. This article reviews literature on delayed-onset nodule formation after vaccination and recommends observation and reassurance as mainstays of management of this largely benign entity.
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Affiliation(s)
- Anne C Collinson
- Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Lynette Moore
- Department of Anatomical Pathology, SA Pathology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Abigail Cheung
- Department of Allergy and Clinical Immunology, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Michael S Gold
- Department of Allergy and Clinical Immunology, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Day Way Goh
- Department of Paediatric Surgery, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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9
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Nakatsuka SI, Kadowaki M, Kaneko H. Cutaneous marginal zone lymphoma of the nose arising after rhinoplasty with filler injection. J Hematop 2021. [DOI: 10.1007/s12308-021-00441-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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10
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González Pérez AM, Nájera Botello L, Suarez Massa D, Roustan Gullón G, Alfageme Roldán F. Sonography of subcutaneous nodules following immunization with histopathological correlation: a three-case series. J Ultrasound 2021; 25:355-360. [PMID: 33400252 DOI: 10.1007/s40477-020-00554-8] [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: 10/12/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022] Open
Abstract
Subcutaneous nodules are a rare adverse event following immunization frequently associated with suboptimal injection procedures and aluminium-containing vaccines. We present three cases of subcutaneous nodules following immunization describing their clinical signs, histopathological features and ultrasound findings and demonstrating the use of sonography as an aid to the diagnosis of this entity.
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Affiliation(s)
- Ana María González Pérez
- Department of Dermatology, Hospital Clínico Universitario de Salamanca, Paseo de San Vicente 182, 37007, Salamanca, Spain
| | - Laura Nájera Botello
- Pathology Department, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Dolores Suarez Massa
- Pathology Department, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Gastón Roustan Gullón
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain
| | - Fernando Alfageme Roldán
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla 2, 29022, Majadahonda, Madrid, Spain.
- Department of Dermatology, Autonomous University of Madrid, Calle Joaquín Rodrigo, 1, 28222, Majadahonda, Madrid, Spain.
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11
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Chandler JB, Waldman R, Sloan SB, Rose MG, Wong EY. Cutaneous marginal zone lymphoma following anthrax vaccination. Ann Hematol 2020; 100:3079-3080. [PMID: 33200274 DOI: 10.1007/s00277-020-04336-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Jocelyn B Chandler
- Veterans Affairs Connecticut Healthcare System, Department of Pathology and Cancer Center, West Haven, CT, 06516, USA. .,Departments of Pathology and Internal Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
| | - Reid Waldman
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Steven B Sloan
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Michal G Rose
- Veterans Affairs Connecticut Healthcare System, Department of Pathology and Cancer Center, West Haven, CT, 06516, USA.,Departments of Pathology and Internal Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
| | - Ellice Y Wong
- Veterans Affairs Connecticut Healthcare System, Department of Pathology and Cancer Center, West Haven, CT, 06516, USA.,Departments of Pathology and Internal Medicine, Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA
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12
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Gibson SE, Swerdlow SH. How I Diagnose Primary Cutaneous Marginal Zone Lymphoma. Am J Clin Pathol 2020; 154:428-449. [PMID: 32808967 DOI: 10.1093/ajcp/aqaa116] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Primary cutaneous marginal zone lymphoma (PCMZL) is 1 of the 3 major subtypes of primary cutaneous B-cell lymphoma. The diagnosis of PCMZL may be challenging, as the differential diagnosis includes benign cutaneous lymphoproliferations as well as other primary or secondary cutaneous B-cell or T-cell lymphomas. This review describes our approach to the diagnosis of PCMZL. METHODS Two cases are presented that illustrate how we diagnose each of the 2 subtypes of PCMZL. The clinicopathologic features of PCMZL and the ways in which these cases can be distinguished from both benign and other neoplastic entities are emphasized. RESULTS A definitive diagnosis of PCMZL requires the incorporation of histologic and immunophenotypic features, molecular genetic studies in some cases, and just as importantly, clinical findings. Emerging data suggest that the heavy chain class-switched cases may be more like a clonal chronic lymphoproliferative disorder. CONCLUSIONS The 2 subtypes of PCMZL create different diagnostic challenges and require the use of a multiparameter approach. Although very indolent, it is important to distinguish PCMZLs from reactive proliferations, because they frequently recur and may require antineoplastic therapies. It is also critical to distinguish PCMZLs from other B- or T-cell lymphomas so that patients are properly evaluated and not overtreated.
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13
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Dumont M, Battistella M, Ram-Wolff C, Bagot M, de Masson A. Diagnosis and Treatment of Primary Cutaneous B-Cell Lymphomas: State of the Art and Perspectives. Cancers (Basel) 2020; 12:cancers12061497. [PMID: 32521744 PMCID: PMC7352758 DOI: 10.3390/cancers12061497] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022] Open
Abstract
Primary cutaneous B-cell lymphomas are rare entities that develop primarily in the skin. They constitute a heterogeneous group that represents around a quarter of primary cutaneous lymphomas. The 2018 update of the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification differentiates primary cutaneous marginal zone lymphoma and primary cutaneous follicle center lymphoma with an indolent course from primary cutaneous diffuse large B-cell lymphoma, leg type with an aggressive behavior. The broad spectrum of clinical presentations and the disease course marked by frequent relapses are diagnostic and therapeutic challenges. The classification of these diseases has been refined in recent years, which allows to better define their immunopathogenesis and specific management. In the present article, we review the main clinico-biological characteristics and the current therapeutic options of these three main subsets. Based on the recent therapeutic advances in nodal B-cell lymphomas, we focus on the development of novel treatment options applicable to primary cutaneous B-cell lymphomas, including targeted therapies, combination treatments and immunotherapeutic approaches, and cover basic, translational and clinical aspects aiming to improve the treatment of cutaneous B-cell lymphomas.
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Affiliation(s)
- Maëlle Dumont
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
| | - Maxime Battistella
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Pathology, APHP, Saint-Louis Hospital, F-75010 Paris, France
| | - Caroline Ram-Wolff
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
| | - Martine Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
- Correspondence: ; Tel.: +33-1-53-72-20-93; Fax: +33-1-42-49-40-38
| | - Adèle de Masson
- Department of Dermatology, APHP, Saint-Louis Hospital, F-75010 Paris, France; (M.D.); (C.R.-W.); (A.d.M.)
- INSERM U976, Human Immunology, Pathophysiology and Immunotherapy, Institut de Recherche Saint-Louis, F-75010 Paris, France;
- Faculty of Medicine, Université de Paris (Paris University), F-75010 Paris, France
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14
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Hellmich L. [31/f with livid erythematous papules and nodules : Preparation for the specialist examination: part 6]. Hautarzt 2018; 69:100-104. [PMID: 30374538 DOI: 10.1007/s00105-018-4240-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Luisa Hellmich
- Klinik und Poliklinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Olisova O, Grabovskaya O, Teplyuk N, Tertychnyy A, Varshavsky V, Grekova E. Cutaneous pseudolymphoma caused by Poly Implant Prothèse breast implants. J Eur Acad Dermatol Venereol 2018. [DOI: 10.1111/jdv.14934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- O.Y. Olisova
- Department of Dermatology and Venereology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
| | - O.V. Grabovskaya
- Department of Dermatology and Venereology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
| | - N.P. Teplyuk
- Department of Dermatology and Venereology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
| | - A.S. Tertychnyy
- A.I. Strukov, Department of Pathomorphology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
| | - V.A. Varshavsky
- A.I. Strukov, Department of Pathomorphology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
| | - E.V. Grekova
- Department of Dermatology and Venereology; I.M. Sechenov First Moscow State Medical University; Moscow Russian Federation
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Kheterpal M, Mehta-Shah N, Virmani P, Myskowski PL, Moskowitz A, Horwitz SM. Managing Patients with Cutaneous B-Cell and T-Cell Lymphomas Other Than Mycosis Fungoides. Curr Hematol Malig Rep 2017; 11:224-33. [PMID: 27101016 DOI: 10.1007/s11899-016-0322-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cutaneous lymphomas (CL) are a heterogeneous group of neoplasms characterized with clinical and histopathological variation, as well as overlap with benign dermatoses. Diagnosis and treatment of CLs is challenging and often requires a multidisciplinary approach. However, prognostic knowledge of these conditions and awareness of treatment options can help optimize appropriate use of available regimens, thereby improving care for patients. Here, we review the most recent literature and outline treatment themes for managing patients with cutaneous B-cell and T-cell lymphomas other than mycosis fungoides.
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Affiliation(s)
- Meenal Kheterpal
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, 500 Westchester Ave, West Harrison, NY, 10604, USA
| | - Neha Mehta-Shah
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, 1233 York Avenue, New York, NY, 10065, USA
| | - Pooja Virmani
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 16 E60th Street, New York, NY, 10022, USA
| | - Patricia L Myskowski
- Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 16 E60th Street, New York, NY, 10022, USA
| | - Alison Moskowitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,, 1275 York Avenue, New York, NY, 10065, USA
| | - Steven M Horwitz
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Memorial Sloan Kettering Cancer Center, 1233 York Avenue, New York, NY, 10065, USA.
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Lack of evidence for post-vaccine onset of autoimmune/lymphoproliferative disorders, during a nine-month follow-up in multiply vaccinated Italian military personnel. Clin Immunol 2017. [PMID: 28625884 DOI: 10.1016/j.clim.2017.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Anecdotal case reports, amplified by mass media and internet-based opinion groups, have recently indicated vaccinations as possibly responsible for autoimmunity/lymphoproliferation development. Multiply vaccinated Italian military personnel (group 1, operating in Italy, group 2, operating in Lebanon) were followed-up for nine months to monitor possible post-vaccine autoimmunity/lymphoproliferation onset. No serious adverse event was noticed in both groups. Multivariate analysis of intergroup differences only showed a significant association between lymphocyte increase and tetanus/diphtheria vaccine administration. A significant post-vaccine decrease in autoantibody positivity was observed. Autoantibodies were also studied by microarray analysis of self-proteins in subjects exposed to ≥4 concurrent vaccinations, without observing significant difference among baseline and one and nine months post-vaccine. Moreover, HLA-A2 subjects have been analyzed for the possible CD8T-cell response to apoptotic self-epitopes, without observing significant difference between baseline and one month post-vaccine. Multiple vaccinations in young adults are safe and not associated to autoimmunity/lymphoproliferation onset during a nine-month-long follow-up.
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Abstract
Primary cutaneous marginal zone lymphoma (CMZL) is one of the major primary B-cell lymphomas of skin. Two types are recognized: a more common class-chain switched CMZL, and a much less common IgM+ CMZL. The extremely indolent course, together with other features distinct from most other MALT lymphomas, has led some to question whether at least the class-switched cases should be considered an overt lymphoma.
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Affiliation(s)
- Steven H Swerdlow
- Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, UPMC-Presbyterian, G-335, 200 Lothrop Street, Pittsburgh, PA 15213.
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Romero-Pérez D, Blanes Martínez M, Encabo-Durán B. Cutaneous Pseudolymphomas. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:640-51. [PMID: 27289134 DOI: 10.1016/j.ad.2016.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/16/2016] [Accepted: 05/01/2016] [Indexed: 11/19/2022] Open
Abstract
The term cutaneous pseudolymphoma refers to benign reactive lymphoid proliferations in the skin that simulate cutaneous lymphomas. It is a purely descriptive term that encompasses various reactive conditions with a varied etiology, pathogenesis, clinical presentation, histology, and behavior. We present a review of the different types of cutaneous pseudolymphoma. To reach a correct diagnosis, it is necessary to contrast clinical, histologic, immunophenotypic, and molecular findings. Even with these data, in some cases only the clinical course will confirm the diagnosis, making follow-up essential.
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Affiliation(s)
- D Romero-Pérez
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - M Blanes Martínez
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España.
| | - B Encabo-Durán
- Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, España
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Loidi Pascual L, Larrea García M, Agulló Pérez AD, Córdoba Iturriagagoitia A, Yanguas Bayona JI. Disseminated nodules after vaccines for hyposensitization for mites. Pseudolymphoma or lymphoma? J Eur Acad Dermatol Venereol 2016; 31:e5-e6. [PMID: 26861728 DOI: 10.1111/jdv.13581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- L Loidi Pascual
- Dermatology, Department of Complejo Hospitalario de Navarra, Navarra, Spain
| | - M Larrea García
- Dermatology, Department of Complejo Hospitalario de Navarra, Navarra, Spain
| | - A D Agulló Pérez
- Dermatology, Department of Complejo Hospitalario de Navarra, Navarra, Spain
| | | | - J I Yanguas Bayona
- Dermatology, Department of Complejo Hospitalario de Navarra, Navarra, Spain
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Primary cutaneous marginal zone lymphomas with plasmacytic differentiation show frequent IgG4 expression. Mod Pathol 2013; 26:1568-76. [PMID: 23765244 DOI: 10.1038/modpathol.2013.106] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 05/03/2013] [Accepted: 05/03/2013] [Indexed: 12/24/2022]
Abstract
The expression of IgG4 in malignant B-cell lymphomas has only partially been studied. Recent reports described single cases of marginal zone lymphomas arising in the ocular adnexae that express IgG4. Moreover, a subset of dura-associated marginal zone lymphomas appear to express IgG4 as well. We investigated IgG4 expression in a more systematic manner in a large cohort of marginal zone lymphoma specimens derived from the archive of our institute. Overall, we examined 169 marginal zone lymphomas of various primary sites that displayed a distinct plasmacytic differentiation and light chain restriction, allowing for a detailed investigation of the immunoglobulin heavy chain expression in these tumors by immunohistochemistry. Unexpectedly, primary cutaneous marginal zone lymphomas showed frequent IgG4 expression. Although only 1 out of 120 noncutaneous marginal zone lymphomas, located in the ocular adnexae, expressed IgG4, 19 of 49 (39%) primary cutaneous marginal zone lymphomas showed this feature, constituting the highest expression rate of IgG4 reported to date in any B-cell lymphoma. None of the IgG4-positive cutaneous marginal zone lymphomas with available clinical data showed evidence of a preexisting systemic IgG4-related disease, suggesting a localized immunologic IgG4-driven pathogenetic process at early stages of the disease. IgG4-positive and IgG4-negative primary cutaneous marginal zone lymphomas did not significantly differ in architectural features of the infiltrate or the composition of the reactive T-cell infiltrate as determined by analysis of T-cell content, CD4/CD8 ratio, and content of FOXP3- and PD1-positive T cells. Although the pathogenetic role of IgG4 expression in a significant subset of primary cutaneous marginal zone lymphomas with plasmacytic differentiation remains unclear at present, the demonstration of IgG4 expression in a marginal zone lymphoma involving the skin might be a helpful clue in the routine diagnostic setting, as these tumors will almost invariably be of primary cutaneous origin with an extremely low risk of spread to noncutaneous sites and an excellent prognosis.
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Edinger JT, Lorenzo CR, Breneman DL, Swerdlow SH. Primary cutaneous marginal zone lymphoma with subclinical cutaneous involvement and biclonality. J Cutan Pathol 2011; 38:724-30. [DOI: 10.1111/j.1600-0560.2011.01726.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Khamaysi Z, Weltfriend S, Khamaysi K, Bergman R. Contact hypersensitivity in patients with primary cutaneous lymphoproliferative disorders. Int J Dermatol 2011; 50:423-7. [DOI: 10.1111/j.1365-4632.2010.04763.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bachelez H. The Uncertain Status of Cutaneous Pseudolymphoma. ACTAS DERMO-SIFILIOGRAFICAS 2009; 100 Suppl 1:33-7. [DOI: 10.1016/s0001-7310(09)73166-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Monteagudo B, Cabanillas M, García-Rego J, Cacharrón J. Carcinoma de células de Merkel en el sitio de vacunación. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s0001-7310(09)70546-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Vellozzi C, Burwen DR, Dobardzic A, Ball R, Walton K, Haber P. Safety of trivalent inactivated influenza vaccines in adults: background for pandemic influenza vaccine safety monitoring. Vaccine 2009; 27:2114-20. [PMID: 19356614 DOI: 10.1016/j.vaccine.2009.01.125] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 01/22/2009] [Accepted: 01/29/2009] [Indexed: 11/16/2022]
Abstract
In preparation for pandemic vaccine safety monitoring, we assessed adverse events reported to the Vaccine Adverse Event Reporting System following receipt of trivalent inactivated influenza vaccines among adults from 1990 through 2005. We calculated reporting rates for nonserious, serious, and neurological adverse events. We reviewed reports of recurrent events and deaths, as well as reports identified through advanced signal detection. The most frequently reported events were local reactions and systemic symptoms. Guillain-Barré syndrome was the most frequently reported serious event (0.70 reports per million vaccinations). Adverse event reporting rates have been reasonably constant over time. No new safety concerns emerged after our review of 15 years of post-licensure surveillance data. These findings provide useful information if pandemic vaccine is rapidly distributed and pre-licensure data are limited.
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Affiliation(s)
- Claudia Vellozzi
- Immunization Safety Office (ISO), Office of the Chief Science Officer (OCSO), Centers for Disease Control and Prevention, Atlanta, GA, United States.
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Monteagudo B, Cabanillas M, García-Rego J, Cacharrón J. Merkel Cell Carcinoma at a Site of Vaccination. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70056-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Laguna C, Martínez L, Sánchez JL, Alegre V. Squamous cell carcinoma at tetanus vaccination site. J Eur Acad Dermatol Venereol 2008; 22:1265-6. [PMID: 18331303 DOI: 10.1111/j.1468-3083.2008.02616.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Pseudolymphomas are a rare complication of vaccination, presenting with dense lymphoid infiltrates and prominent follicular pattern. We report our observations on 4 patients with vaccination-induced B-cell pseudolymphoma (all females; age range 19 to 60 years; median: 34.5 years). Clinically 3 patients presented with subcutaneous nodules and 1 presented with a large, indurated, erythematous plaque. Histology revealed in all cases dense lymphoid infiltrates in the subcutaneous fat with prominent follicular pattern. The follicles displayed features of reactive germinal centers (normal mantle zone, presence of tingible body macrophages, normal proliferation). Necrotic areas surrounded by palisaded histiocytes were seen in 3 biopsies from 2 patients. A mixed-cell infiltrate with eosinophils and plasma cells was present in all cases. In addition, histiocytes with granular basophilic cytoplasm could be observed around the focal area of necrosis or within the inflammatory infiltrate. Follow-up was available for 3 patients. One patient was alive with persistent disease 6 months after the first observation. Two patients were treated with local radiotherapy and are alive and free of disease after 12 and 72 months, respectively. One of these two patients had a second pseudolymphoma on the contralateral arm after a new injection of vaccine. Cutaneous pseudolymphoma after vaccination should be distinguished histopathologically from low-grade cutaneous B-cell lymphomas (follicle center cell lymphoma, marginal zone lymphoma) and from other B-cell pseudolymphomas with prominent follicular pattern requiring different treatment (eg, Borrelia burgdorferi-induced lymphocytoma cutis).
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Geissinger E, Adam P, Müller-Hermelink HK, Rüdiger T. [Cutaneous B-cell lymphoma. Classification and diagnostics]. DER PATHOLOGE 2006; 28:15-20. [PMID: 17195038 DOI: 10.1007/s00292-006-0881-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Primary cutaneous B-cell lymphomas include cutaneous follicle centre lymphoma (PCFCL), cutaneous marginal zone B-cell lymphoma (PCMZL) and cutaneous diffuse large B-cell lymphoma (PCLBCL) "leg type" which are the three main types in the new WHO-EORTC classification for cutaneous lymphomas. PCFCL and PCMZL are indolent lymphomas with an excellent prognosis while PCLBCL shows an aggressive clinical course. All three types must be distinguished from a secondary skin involvement by systemic lymphomas. Since histological and immunohistochemical findings are not decisive, making this distinction requires appropriate staging procedures. In contrast, the pathologist can make an important contribution to the differential diagnosis between neoplastic and reactive cutaneous lymphoproliferations.
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Abstract
PURPOSE OF REVIEW There has been confusion and debate regarding the definition, terminology, and optimal treatment of the different types of primary cutaneous B-cell lymphomas. This review presents the new World Health Organization-European Organization for the Research and Treatment of Cancer classification for cutaneous lymphomas; describes clinicopathologic, immunophenotypic, and genetic features of the different types of cutaneous B-cell lymphomas in this classification; and discusses current views on treatment of these lymphomas. RECENT FINDINGS The three main types of cutaneous B-cell lymphomas in this new classification are primary cutaneous marginal zone B-cell lymphoma, primary cutaneous follicle center lymphoma, and primary cutaneous large B-cell lymphoma (leg type). Primary cutaneous marginal zone B-cell and primary cutaneous follicle center lymphoma are indolent types with an excellent prognosis that should be treated primarily with nonaggressive therapies. Primary cutaneous large B-cell lymphoma (leg type) is an aggressive lymphoma that should be treated primarily with aggressive chemotherapy. SUMMARY The World Health Organization-European Organization for the Research and Treatment of Cancer classification will contribute to uniform diagnosis, management, and treatment of patients with cutaneous B-cell lymphoma and will prevent patients with indolent types of the disease from being treated inappropriately with systemic chemotherapy.
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Affiliation(s)
- Rein Willemze
- Leiden University Medical Center, Department of Dermatology, Leiden, The Netherlands.
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