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Joffe D, Rohan TZ, Mandel J, Suriano J, Banner L, Valiga A, Porcu P, Gong JZ, Lee JB, Alpdogan O, Nikbakht N. The development of 2 clonally and histologically distinct subtypes of extranodal B-cell lymphomas in the brain and skin in 1 individual. JAAD Case Rep 2024; 49:51-54. [PMID: 38883181 PMCID: PMC11176604 DOI: 10.1016/j.jdcr.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Daniel Joffe
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Thomas Z Rohan
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jenna Mandel
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jayson Suriano
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lauren Banner
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Alexander Valiga
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Pierluigi Porcu
- Department of Hematology & Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jerald Z Gong
- Department of Pathology and Genomic Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason B Lee
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Onder Alpdogan
- Department of Hematology & Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Neda Nikbakht
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Preston JD, Jansen CS, Kosaraju S, Niyogusaba T, Zhuang TZ, Iwamoto SW, Hutto SK, Lechowicz MJ, Allen PB. Cutaneous T-cell lymphoma with CNS involvement: a case series and review of the literature. CNS Oncol 2023; 12:CNS105. [PMID: 37877303 PMCID: PMC10701703 DOI: 10.2217/cns-2023-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Cutaneous T-cell lymphoma (CTCL) is a rare hematologic malignancy that traditionally presents with cutaneous lesions, though metastases are not uncommon in progressive disease. We describe four cases of CTCL with central nervous system (CNS) involvement, detailing the history, pathological characteristics, treatment response, and progression. Median time from initial diagnosis to CNS metastasis was ∼5.4 years (range 3.4-15.5 years) and survival after metastasis was ∼160 days (range 19 days-4.4 years). No patients achieved long-term (>5 years) survival, though some displayed varying degrees of remission following CNS-directed therapy. We conclude that clinicians must be attentive to the development of CNS metastases in patients with CTCL. The growing body of literature on such cases will inform evolving therapeutic guidelines on this rare CTCL complication.
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Affiliation(s)
- Joshua D Preston
- Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA 30322, USA
- Nutrition & Health Sciences, Laney Graduate School, Emory University, Atlanta, GA 30322, USA
| | - Caroline S Jansen
- Medical Scientist Training Program, Emory University School of Medicine, Atlanta, GA 30322, USA
- Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Siddhartha Kosaraju
- Division of Neuroradiology, Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Tim Niyogusaba
- Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Tony Z Zhuang
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Sally W Iwamoto
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Spencer K Hutto
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mary Jo Lechowicz
- Department of Hematology & Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
| | - Pamela B Allen
- Department of Hematology & Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
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Ishikawa Y, Shimauchi T, Kageyama R, Tomita K, Hikoya A, Tokura Y, Yagi H, Honda T. CD8 + mycosis fungoides with optic nerve and central nervous system involvement. J Dermatol 2021; 48:e286-e287. [PMID: 33829518 DOI: 10.1111/1346-8138.15885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Yuto Ishikawa
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takatoshi Shimauchi
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Reiko Kageyama
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuki Tomita
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akiko Hikoya
- Department of Ophthalmology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiki Tokura
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroaki Yagi
- Department of Dermatology, Shizuoka General Hospital, Shizuoka, Japan
| | - Tetsuya Honda
- Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Bandini G, Bernardi P, Grandi V, Marchiani C, Gagliano M, Bellando Randone S, Moggi Pignone A. Mycosis fungoides: from early stages to fatal central nervous system involvement. Ital J Dermatol Venerol 2020; 156:724-726. [PMID: 33228331 DOI: 10.23736/s2784-8671.20.06537-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giulia Bandini
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Paolo Bernardi
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Vieri Grandi
- Unit of Skin Tumor, St John's Institute of Dermatology, Guy's and St Thomas NHS Foundation Trust, London, UK -
| | - Costanza Marchiani
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Manfredi Gagliano
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Silvia Bellando Randone
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
| | - Alberto Moggi Pignone
- Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy
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5
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Doerschner M, Pekar-Lukacs A, Messerli-Odermatt O, Dommann-Scherrer C, Rütti M, Müller AM, Nair G, Kamarachev J, Kerl K, Beer M, Messerli M, Frauenknecht K, Haralambieva E, Hoetzenecker W, French LE, Guenova E. Interferon alfa-2a maintenance after salvage autologous stem cell transplantation in atypical mycosis fungoides with central nervous system involvement. Br J Dermatol 2019; 181:1296-1302. [PMID: 30565216 DOI: 10.1111/bjd.17535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2018] [Indexed: 01/05/2023]
Abstract
Mycosis fungoides (MF) is a primary cutaneous T-cell lymphoma with unfavourable prognosis for patients with advanced stages of the disease. Refractory disease and advanced-stage disease require systemic therapy. We report on a rare case of an atypical predominantly CD8+ folliculotropic MF, a subtype of MF with poorer prognosis, in a 59-year-old woman. She was initially diagnosed with MF restricted to the skin, of T3N0M0B0/stage IIB according to the current World Health Organization-European Organisation for Research and Treatment of Cancer classification. First-line treatment with local percutaneous radiotherapy in combination with systemic interferon alfa-2a resulted in complete remission. However, 21 months later the disease progressed to T3N0M1B0/stage IVB with development of cerebral manifestation and thus very poor prognosis. Allogeneic stem cell transplantation (SCT) was not a therapeutic option due to the lack of a suitable donor. We initiated methotrexate and cytarabine chemotherapy, followed by high-dose chemotherapy with thiotepa and carmustine with autologous SCT. Despite rapid response and complete remission of the cerebral lesions, disease recurrence of the skin occurred soon after. Interestingly, readministration of interferon alfa-2a as a maintenance treatment after the salvage autologous SCT resulted in a durable complete remission during the follow-up period of currently 17 months after autologous SCT. What's already known about this topic? Mycosis fungoides is a primary cutaneous T-cell lymphoma with unfavourable prognosis for the advanced stages of the disease. A refractory course of disease requires systemic therapy. What does this study add? We report on an unusual case of a patient with mycosis fungoides with cerebral involvement, in which a durable complete remission was achieved upon autologous stem cell therapy and interferon alfa-2a maintenance therapy.
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Affiliation(s)
- M Doerschner
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - A Pekar-Lukacs
- Department of Oncology and Pathology, Lund University, Lund, Sweden
| | | | - C Dommann-Scherrer
- Institute of Pathology, Canton Hospital Winterthur, Winterthur, Switzerland
| | - M Rütti
- Division of Hematology, University Hospital Zurich, Zurich, Switzerland
| | - A M Müller
- Division of Hematology, University Hospital Zurich, Zurich, Switzerland
| | - G Nair
- Division of Hematology, University Hospital Zurich, Zurich, Switzerland
| | - J Kamarachev
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - K Kerl
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - M Beer
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - M Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - K Frauenknecht
- Institute of Neuropathology, University of Zurich, University Hospital Zurich, Zurich, Switzerland
| | - E Haralambieva
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - W Hoetzenecker
- Department of Dermatology, University Hospital Linz, Linz, Austria
| | - L E French
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - E Guenova
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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