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Puccio J, Huang Y, Viveiros MD, Reneau JC, Chung C, Spaccarelli N, Dulmage B. Observation of lymphadenopathy, systemic symptoms, and treatment in suspected indolent cutaneous B-cell lymphomas. Arch Dermatol Res 2024; 316:199. [PMID: 38775835 DOI: 10.1007/s00403-024-02902-8] [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: 09/17/2023] [Revised: 04/15/2024] [Accepted: 04/25/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Following the initial diagnosis of a marginal zone or follicle center lymphoma on skin biopsy, patients undergo staging to determine the extent of disease. OBJECTIVE We sought to characterize the frequency that these patients were found to have a systemic nodal disease upon work-up as well as the impact of imaging on disease management. METHODS We conducted a retrospective chart review of patients presenting with a working diagnosis of PCMZL or PCFCL treated at The Ohio State University from 1990 to 2022. Data collected included: patient history, progress notes, virtual encounters, laboratory results, presentation features, imaging, and pathology. Biomarkers included ANA, SSA/SSB, BCL6 and H. Pylori labs, bone marrow biopsies, positive imaging, and need of systemic medication and mortality. RESULTS 71 patients with suspected PCMZL and PCFCL were identified. 66 of 71 patients underwent imaging. Of this group, 12 patients (9 with suspected PCFCL and 3 with suspected PCMZL) demonstrated lymphadenopathy on imaging. Of these 12 patients, 5 underwent biopsy of suspected lymph nodes, and 3 had biopsy-proven nodal involvement and received systemic therapy. Of the remaining 7 patients with evidence of lymphadenopathy on imaging, 4 were thought to have reactive lymph nodes, and 3 were treated empirically with systemic chemotherapy due to the extent or progression of their disease. Of patients with imaging negative for lymphadenopathy, 3 of 52 (5.8%) patients with received systemic treatment, while 49 of 52 patients (94.2%) received localized treatment. LIMITATIONS Most of the relationships between this data were correlational and patients selected for this study were limited to a single institution. CONCLUSION Prospective study of the role of imaging without subsequent lymph biopsy to direct treatment decisions is warranted.
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MESH Headings
- Humans
- Male
- Retrospective Studies
- Female
- Middle Aged
- Lymphadenopathy/diagnosis
- Lymphadenopathy/pathology
- Aged
- Skin Neoplasms/diagnosis
- Skin Neoplasms/therapy
- Skin Neoplasms/pathology
- Biopsy
- Adult
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymph Nodes/pathology
- Skin/pathology
- Aged, 80 and over
- Lymphoma, Follicular/diagnosis
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Follicular/drug therapy
- Neoplasm Staging
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Affiliation(s)
- Jordyn Puccio
- Medical Student Research Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ying Huang
- Division of Hematology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Matthew D Viveiros
- Medical Student Research Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - John C Reneau
- Division of Hematology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Catherine Chung
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Division of Hematology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Pathology, The Ohio State University Wexner Medical Center, 540 Officenter Pl Suite 240, 43230, Columbus, OH, USA
| | - Natalie Spaccarelli
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Bai SJ, Geng Y, Gao YN, Zhang CX, Mi Q, Zhang C, Yang JL, He SJ, Yan ZY, He JX. Marginal zone lymphoma with severe rashes: A case report. World J Clin Cases 2024; 12:565-574. [PMID: 38322474 PMCID: PMC10841955 DOI: 10.12998/wjcc.v12.i3.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/22/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Marginal zone lymphoma (MZL) is an indolent subtype of non-Hodgkin lymphoma (NHL), which is rare clinically with severe rashes as the initial symptom. CASE SUMMARY This study reports a case of MZL with generalized skin rashes accompanied by pruritus and purulent discharge. First-line treatment with rituximab combined with zanubrutinib had poor effects. However, after switching to obinutuzumab combined with zanubrutinib, the case was alleviated, and the rashes disappeared. CONCLUSION For patients with advanced stage MZL not benefiting from type I anti-CD20 monoclonal antibody (mAb) combination therapy, switching to a type II anti-CD20 mAb combination regimen may be considered. This approach may provide a new perspective in the treatment of MZL.
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Affiliation(s)
- Si-Jun Bai
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Ye Geng
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Yi-Nan Gao
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Cai-Xia Zhang
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Qian Mi
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Chen Zhang
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Jia-Ling Yang
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Si-Jie He
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Zhen-Ying Yan
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
| | - Jian-Xia He
- Department of Hematology, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
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3
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Quaglino P, Pimpinelli N, Zinzani PL, Paulli M, Pileri S, Berti E, Cerroni L, Guitart J, Kim YH, Rupoli S, Santucci M, Simontacchi G, Vermeer M, Hoppe R, Pro B, Swerdlow SH, Barosi G. Identifying and addressing unmet clinical needs in primary cutaneous B-cell lymphoma: A consensus-based paper from an ad-hoc international panel. Hematol Oncol 2024; 42:e3215. [PMID: 37649350 DOI: 10.1002/hon.3215] [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: 06/03/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) are lymphoproliferative disorders that appear on the skin without evidence of extracutaneous manifestations at the time of diagnosis. There is a lack of evidence-based guidelines for their clinical management due to the availability of very few large scale studies and controlled clinical trials. Here we present and discuss a series of major unmet clinical needs (UCNs) in the management of PCBCLs by a panel of 16 experts involved in research and clinical practice of PCBCL. The Panel produced recommendations on the appropriateness of the clinical decisions concerning the identified clinical needs and proposed research for improving the knowledge needed to solve them. Recommendations and proposals were achieved by multiple-step formalized procedures to reach a consensus after a comprehensive analysis of the scientific literature. Recommendations and proposals lay in the domain of classification uncertainties of PCBCL, optimization of diagnosis, optimization of prognosis, optimization of staging and critical issues on therapeutic strategies with particular focus on new treatments. These recommendations are intended for use not only by experts but above all by dermatologists and hematologists with limited experience in the field of PCBCLs as well as general practitioners.
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Affiliation(s)
- Pietro Quaglino
- Department of Medical Sciences, Section of Dermatology, University of Turin, Torino, Italy
| | - Nicola Pimpinelli
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna. Istituto di Ematologia "Seràgnoli", Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale. Università di Bologna, Bologna, Italy
- Istituto di Ematologia "Seràgnoli", Azienda Ospedaliero-Universitaria di Bologna - IRCCS, Bologna, Italy
| | - Marco Paulli
- Pathology Section, Department of Molecular Medicine, University of Pavia and Fondazione I.R.C.C.S. Policlinico "S.Matteo", Pavia, Italy
| | - Stefano Pileri
- IEO - European Institute of Oncology IRCCS (Milan) & Bologna University School of Medicine, Milano, Italy
| | - Emilio Berti
- Dermatology Unit, La Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Lorenzo Cerroni
- Department of Dermatology, Research Unit Dermatopathology, Medical University of Graz, Graz, Austria
| | - Joan Guitart
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Youn H Kim
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Serena Rupoli
- Clinica di Ematologia, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Marco Santucci
- Pathology Unit, Careggi University Hospital, Florence, Italy
- Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - Gabriele Simontacchi
- Radiation Oncology Unit - Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Maarten Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Richard Hoppe
- Department of Radiation Oncology, Stanford University, Stanford, California, USA
| | - Barbara Pro
- Northwestern University, Chicago, Illinois, USA
| | - Steven H Swerdlow
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Giovanni Barosi
- Center for the Study of Myelofibrosis, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
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4
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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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5
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Di Napoli A, Rogges E, Noccioli N, Gazzola A, Lopez G, Persechino S, Mancini R, Sabattini E. Deep Sequencing of Immunoglobulin Genes Identifies a Very Low Percentage of Monoclonal B Cells in Primary Cutaneous Marginal Zone Lymphomas with CD30-Positive Hodgkin/Reed–Sternberg-like Cells. Diagnostics (Basel) 2022; 12:diagnostics12020290. [PMID: 35204381 PMCID: PMC8870847 DOI: 10.3390/diagnostics12020290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/31/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
The spectrum of cutaneous CD30-positive lymphoproliferative disorders encompasses both inflammatory and neoplastic conditions. CD30+ Hodgkin and Reed–Sternberg-like cells have been occasionally reported in primary cutaneous marginal zone lymphoma, where they are thought to represent a side neoplastic component within a dominant background of lymphomatous small B cells. Herein, we describe the histological and molecular findings of three cases of primary cutaneous marginal zone lymphomas with CD30+ H/RS cells, in which next-generation sequencing analysis revealed the clonal population to consist in less than 5% of the cutaneous B-cell infiltrate, providing a thought-provoking focus on a possible main role for CD30+ cells in primary cutaneous marginal zone lymphoproliferations.
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Affiliation(s)
- Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy; (E.R.); (N.N.); (G.L.); (R.M.)
- Correspondence: ; Tel.: +39-06-33775463
| | - Evelina Rogges
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy; (E.R.); (N.N.); (G.L.); (R.M.)
| | - Niccolò Noccioli
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy; (E.R.); (N.N.); (G.L.); (R.M.)
| | - Anna Gazzola
- Haematopathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (E.S.)
| | - Gianluca Lopez
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy; (E.R.); (N.N.); (G.L.); (R.M.)
| | - Severino Persechino
- NESMOS Department, Dermatology Unit, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy;
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University, 00189 Rome, Italy; (E.R.); (N.N.); (G.L.); (R.M.)
| | - Elena Sabattini
- Haematopathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (E.S.)
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6
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Dobos G, Miladi M, Michel L, Ram-Wolff C, Battistella M, Bagot M, de Masson A. Recent advances on cutaneous lymphoma epidemiology. Presse Med 2022; 51:104108. [PMID: 35026392 DOI: 10.1016/j.lpm.2022.104108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/26/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Primary cutaneous lymphomas are a group of T- (CTCL) and B-cell (CBCL) malignancies. These diseases have different clinical presentations and prognosis. Our knowledge on their epidemiology is limited. Aim of this review was to summarise recent findings on the incidence of CTCL and CBCL, how they change over time, and to describe possible causes and consequences. We found that although there are important differences in the epidemiology of cutaneous lymphomas in different countries, the relative frequency of certain, especially rare lymphomas remains stable. Several studies described growing incidences of both CTCL and CBCL. The emergence of new diagnostic criteria, a more precise definition of the entities and new biomarkers enable a better classification of cases.
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Affiliation(s)
- G Dobos
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France; Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Germany
| | - M Miladi
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - L Michel
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France
| | - C Ram-Wolff
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - M Battistella
- INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France; Pathology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - M Bagot
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France.
| | - A de Masson
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France; INSERM U976 Human Immunology, Pathophysiology and Immune Therapies, Paris, France; Université de Paris, Paris, France
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Jiang ZZ, Zheng YY, Hou CL, Liu XT. Primary mucosal-associated lymphoid tissue extranodal marginal zone lymphoma of the bladder from an imaging perspective: A case report. World J Clin Cases 2021; 9:10024-10032. [PMID: 34877346 PMCID: PMC8610910 DOI: 10.12998/wjcc.v9.i32.10024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/10/2021] [Accepted: 09/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mucosal-associated lymphoid tissue extranodal marginal zone (MALT) lymphoma is a low-grade tumor that rarely occurs in the urinary bladder. There is currently no consensus on the common imaging findings or most appropriate treatment in MALT lymphoma in the urinary bladder due to the limited number of reports.
CASE SUMMARY A 48-year-old woman was admitted to the hospital with a 1-year history of macroscopic hematuria. Imaging showed a large homogeneous mass with an unclear boundary and an irregular morphology in the bladder. The mass had an abundant blood supply. For further diagnosis, transurethral cystoscopic biopsy and bone marrow biopsy was performed, and the patient was finally diagnosed with primary MALT lymphoma of the bladder. R-CHOP chemotherapy was carried out. After three cycles of chemotherapy, the mass disappeared and the bladder wall thickness was only 4 mm, which indicated excellent therapeutic response to the chemotherapy. To date, the patient remains asymptomatic and she visits our hospital regularly for the completion of the remaining chemotherapy cycles.
CONCLUSION Primary MALT lymphoma of the bladder is rare, and there are certain characteristics in the ultrasonographic findings. Imaging findings play an important role in evaluating the therapeutic efficacy and are critical during long-term follow-up after therapy.
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Affiliation(s)
- Zhen-Zhen Jiang
- Department of Ultrasound, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
| | - Yuan-Yuan Zheng
- Department of Ultrasound, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
| | - Chuan-Ling Hou
- Department of Pathology, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
| | - Xia-Tian Liu
- Department of Ultrasound, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing 312000, Zhejiang Province, China
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8
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Olszewska-Szopa M, Sobas M, Laribi K, Bao Perez L, Drozd-Sokołowska J, Subocz E, Joks M, Zduniak K, Gajewska M, de Nalecz AK, Romejko-Jarosińska J, Kumiega B, Waszczuk-Gajda A, Wróbel T, Czyz A. Primary cutaneous indolent B-cell lymphomas - a retrospective multicenter analysis and a review of literature. Acta Oncol 2021; 60:1361-1368. [PMID: 34346830 DOI: 10.1080/0284186x.2021.1956689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Primary cutaneous indolent B-cell lymphomas (PCBCLs) are not well characterized due to their rarity and indolent character.Methods: We retrospectively reviewed the data from 52 patients with primary cutaneous follicular lymphoma (PCFL) (n = 26), marginal zone lymphoma (PCMZL) (n = 25) or undefined PCBCL (n = 1) treated in 10 hematology centers in 1999-2019.Results: Patients characteristics and diagnostic approach: In almost half of the patients, pruritus or pain were present at diagnosis. The lesions were predominantly located on the head and trunk. The disease was present in a form of solitary infiltration or disseminated lesions with a similar frequency.Treatment details and outcomes: Surgery, radiotherapy, rituximab alone or combined with chemotherapy were applied as first-line treatment in 33%, 25%, 21% and 21% of patients, with complete response (CR) achieved by 94%, 83%, 50% and 70% of patients, respectively (p = 0.28). The median duration of response (DoR) was 65 months (95%CI 35-155).Survival: After the median follow-up time of 46 months (range: 3-225), the estimated 5-year overall survival (OS) and progression-free survival (PFS) were 93% and 54%, respectively.Discussion: Clinical presentation was largely consistent with the literature data, however, we observed some differences, including higher predilection to affect upper extremities (25%) and more frequent multifocal appearance in PCFCL (64%) and unifocal in PCMZL (70%).A high proportion of patients with indolent PCBCL achieved CR after the first-line therapy (77%), regardless of treatment mode. We did not find any impact of clinical features on treatment outcomes.Conclusions: All treatment modalities resulted in a high overall response rate. Surgery and/or radiotherapy are the optimal therapeutic options for patients with localized disease. The decision to treat systemically should rather be limited to the generalized form of the disease. High response rate, long duration of remission and excellent long-term survival confirm the truly indolent character of PCFCL and PCMZL.
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Affiliation(s)
- Magdalena Olszewska-Szopa
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Marta Sobas
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Kamel Laribi
- Service d'Hématologie, Centre Hospitalier Le Mans, Le Mans, France
| | - Laura Bao Perez
- Division of Hematology, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS – SERGAS), Santiago de Compostela, Spain
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland
| | - Edyta Subocz
- Department of Haematology, Military Institute of Medicine, Warsaw, Poland
| | - Monika Joks
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Zduniak
- Department of Pathology, Wrocław Medical University, Wrocław, Poland
| | | | | | - Joanna Romejko-Jarosińska
- Cytogenetic Department, Centre of Oncology, M. Skłodowska-Curie Memorial Institute, Warszawa, Poland
| | - Beata Kumiega
- Department of Hematology, Specialist District Hospital, Nowy Sacz, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland
| | - Tomasz Wróbel
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
| | - Anna Czyz
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wrocław Medical University, Wroclaw, Poland
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9
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Primary cutaneous epidermotropic marginal zone B-cell lymphoma treated with total skin electron beam therapy. JAAD Case Rep 2021; 15:15-18. [PMID: 34386563 PMCID: PMC8342534 DOI: 10.1016/j.jdcr.2021.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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10
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Dobos G, de Masson A, Ram-Wolff C, Beylot-Barry M, Pham-Ledard A, Ortonne N, Ingen-Housz-Oro S, Battistella M, d'Incan M, Rouanet J, Franck F, Vignon-Pennamen MD, Franck N, Carlotti A, Boulinguez S, Lamant L, Petrella T, Dalac S, Joly P, Courville P, Rivet J, Dereure O, Amatore F, Taix S, Grange F, Durlach A, Quéreux G, Josselin N, Moulonguet I, Mortier L, Dubois R, Maubec E, Laroche L, Michel L, Templier I, Barete S, Nardin C, Augereau O, Vergier B, Bagot M. Epidemiological changes in cutaneous lymphomas: an analysis of 8593 patients from the French Cutaneous Lymphoma Registry. Br J Dermatol 2020; 184:1059-1067. [PMID: 33131055 DOI: 10.1111/bjd.19644] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Primary cutaneous lymphomas (PCLs) are a heterogeneous group of T-cell (CTCL) and B-cell (CBCL) malignancies. Little is known about their epidemiology at initial presentation in Europe and about potential changes over time. OBJECTIVES The aim of this retrospective study was to analyse the frequency of PCLs in the French Cutaneous Lymphoma Registry (GFELC) and to describe the demography of patients. METHODS Patients with a centrally validated diagnosis of primary PCL, diagnosed between 2005 and 2019, were included. RESULTS The calculated incidence was unprecedently high at 1·06 per 100 000 person-years. The number of included patients increased yearly. Most PCL subtypes were more frequent in male patients, diagnosed at a median age of 60 years. The relative frequency of rare CTCL remained stable, the proportion of classical mycosis fungoides (MF) decreased, and the frequency of its variants (e.g. folliculotropic MF) increased. Similar patterns were observed for CBCL; for example, the proportion of marginal-zone CBCL increased over time. CONCLUSIONS Changes in PCL frequencies may be explained by the emergence of new diagnostic criteria and better description of the entities in the most recent PCL classification. Moreover, we propose that an algorithm should be developed to confirm the diagnosis of PCL by central validation of the cases.
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Affiliation(s)
- G Dobos
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France
| | - A de Masson
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France
| | - C Ram-Wolff
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France
| | - M Beylot-Barry
- Dermatology Department, Université de Bordeaux, Bordeaux, France
| | - A Pham-Ledard
- Dermatology Department, Université de Bordeaux, Bordeaux, France
| | - N Ortonne
- Pathology Department, Henri Mondor Hospital, INSERM U955, Université Paris Est, AP-HP, Paris, France
| | - S Ingen-Housz-Oro
- Dermatology Department, Henri Mondor Hospital, INSERM U955, Université Paris Est, AP-HP, Paris, France
| | - M Battistella
- INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France.,Pathology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - M d'Incan
- Dermatology and Cutaneous Oncology, Estaing University Hospital, Université de Clermont-Ferrand, Clermont-Ferrand, France
| | - J Rouanet
- Pathology Department, NHE Clermont et SIPATH UNILABS, Clermont-Ferrand, France
| | - F Franck
- Pathology Department, NHE Clermont et SIPATH UNILABS, Clermont-Ferrand, France
| | | | - N Franck
- Dermatology Department, Cochin Hospital, AP-HP, Paris, France
| | - A Carlotti
- Pathology Department, Cochin Hospital, AP-HP, Paris, France
| | - S Boulinguez
- Dermatology Department, Cahors Hospital, Toulouse, France
| | - L Lamant
- Pathology and Cytopathology Department, Institut Universitaire du Cancer Toulouse, Toulouse, France
| | - T Petrella
- Pathology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - S Dalac
- Dermatology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - P Joly
- Dermatology Department, Rouen University Hospital, INSERM U1234, Rouen Institute for Research and Innovation in Biomedicine, Rouen, France
| | - P Courville
- Pathology Department, Rouen University Hospital, INSERM U1234, Rouen Institute for Research and Innovation in Biomedicine, Rouen, France
| | - J Rivet
- Dermatology Department, Université de Bordeaux, Bordeaux, France.,Pathology Department, Henri Mondor Hospital, INSERM U955, Université Paris Est, AP-HP, Paris, France
| | - O Dereure
- Dermatology Department, Montpellier University Hospital, Montpellier, France
| | - F Amatore
- Department of Dermatology and Oncodermatology, Aix-Marseille University, AP-HM, Timone Hospital, Marseille, France
| | - S Taix
- Department of Pathology, Aix-Marseille University, AP-HM, Timone Hospital, Marseille, France
| | - F Grange
- Dermatology Department, Robert Debré University Hospital, Reims, France
| | - A Durlach
- Pathology Department, Reims University Hospital, Reims, France
| | - G Quéreux
- Dermatology Department, Nantes University Hospital, Nantes, France
| | - N Josselin
- Pathology Department, Nantes University Hospital, Nantes, France
| | - I Moulonguet
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - L Mortier
- Dermatology Department, Claude Huriez University Hospital, INSERM U1189, Université de Lille, Lille, France
| | - R Dubois
- Pathology Department, Claude Huriez University Hospital, Lille, France
| | - E Maubec
- Dermatology Department, Avicenne Hospital, AP-HP, Paris, France
| | - L Laroche
- Dermatology Department, Avicenne Hospital, AP-HP, Paris, France
| | - L Michel
- INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France
| | - I Templier
- Dermatology Department, Grenoble University Hospital, Grenoble, France
| | - S Barete
- Dermatology Department, Pité-Salpêtrière Hospital, AP-HP, Paris, France
| | - C Nardin
- Dermatology Department, Minjoz Hospital, Besancon, France, INSERM U1098, University of Franche Comté, EFS Bourgogne Franche-Comté and Franche-Comté University, Besançon, France
| | - O Augereau
- Pathology Department, Saint-André Hospital, Bordeaux University Hospital, INSERM U1053 - UMR BaRITOn, Eq 3 Oncogenèse des Lymphomes Cutanés, Université de Bordeaux, Bordeaux, France
| | - B Vergier
- Pathology Department, Saint-André Hospital, Bordeaux University Hospital, INSERM U1053 - UMR BaRITOn, Eq 3 Oncogenèse des Lymphomes Cutanés, Université de Bordeaux, Bordeaux, France
| | - M Bagot
- Dermatology Department, Saint-Louis Hospital, AP-HP, Paris, France.,INSERM U976, Human Immunology Pathophysiology and Immune Therapies, Paris, France.,Université de Paris, Paris, France
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11
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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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12
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Agnihotri T, Adotama P, Kalowitz-Bieber A, Stokar E, Meehan SA, Latkowski JA. A case of primary cutaneous marginal zone lymphoma presenting with rosacea-like eruption. JAAD Case Rep 2020; 6:902-904. [PMID: 32875041 PMCID: PMC7452266 DOI: 10.1016/j.jdcr.2020.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Tanvir Agnihotri
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Prince Adotama
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Amy Kalowitz-Bieber
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Evan Stokar
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Shane A Meehan
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
| | - Jo-Ann Latkowski
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York
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13
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Tadiotto Cicogna G, Ferranti M, Alaibac M. Diagnostic Workup of Primary Cutaneous B Cell Lymphomas: A Clinician's Approach. Front Oncol 2020; 10:988. [PMID: 32656084 PMCID: PMC7324640 DOI: 10.3389/fonc.2020.00988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/19/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
| | | | - Mauro Alaibac
- Unit of Dermatology, University of Padua, Padua, Italy
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