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Bayramgürler D, Kazan D, Eruyar T, Demirkesen C, Demirbaş A. The oral cavity and gastric involvement in mycosis fungoides while on systemic bexarotene therapy: A rare case report. Dermatol Ther 2022; 35:e15349. [PMID: 35103368 DOI: 10.1111/dth.15349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/28/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Dilek Bayramgürler
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Didem Kazan
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Tuğrul Eruyar
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Cüyan Demirkesen
- Department of Pathology, Faculty of Medicine, Acıbadem University, İstanbul, Turkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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2
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Simultaneous colonic T-cell lymphoma and graft-versus-host disease: A rare diagnosis. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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3
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Scali E, Presta I, Donato A, Schipani G, Dastoli S, Rossi M, Mignogna C, Malara N, Nisticò SP, Donato G. Mycosis fungoides and gastric T-cell lymphoma: A case report. Mol Clin Oncol 2020; 13:15. [PMID: 32754329 PMCID: PMC7391825 DOI: 10.3892/mco.2020.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
Mycosis fungoides (MF) is a cutaneous malignant lymphoma with an extended clinical course. MF presents in series of dermatological manifestations, beginning with patches and plaques of the skin, and eventually evolving into tumours. Often MF can occur for extended periods without worsening of external symptoms, while the disease advances internally in organs such as lymph nodes, liver, spleen, lung, bone marrow, gastrointestinal tract, pancreas and kidney. The present report presents a clinical case in which gastrointestinal symptomatology occurred a decade after the first dermatological manifestation. Immunohistochemical analysis of the skin, along with small bowel biopsies revealed evidence of gastric T-cell lymphoma. To the best of our knowledge, the present study is the first to describe such a case in the literature.
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Affiliation(s)
- Elisabetta Scali
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Ivan Presta
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Annalidia Donato
- Department of Medical and Surgical Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giusy Schipani
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Stefano Dastoli
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Marco Rossi
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Chiara Mignogna
- Department of Interdipartimental Services Center (CIS), University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Natalia Malara
- Department of Clinical and Experimental Medicine, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Steven Paul Nisticò
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
| | - Giuseppe Donato
- Department of Health Sciences, University 'Magna Græcia' of Catanzaro, Catanzaro I-88100, Italy
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Lu CY, Hsieh MS, Wei KC, Ezmerli M, Kuo CH, Chen W. Gastrointestinal involvement of primary skin diseases. J Eur Acad Dermatol Venereol 2020; 34:2766-2774. [PMID: 32455473 DOI: 10.1111/jdv.16676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022]
Abstract
Less is known about gastrointestinal (GI) involvement of primary skin diseases due to the difference in embryology, histology, microbiology and physiology between integument and alimentary tract. Oesophagus, following the oropharyngeal mucosa, is the most common GI segment affected by primary skin diseases, especially by eosinophilic oesophagitis, lichen planus and autoimmune bullous dermatoses like pemphigus vulgaris, mucosal membrane pemphigoid and epidermolysis bullosa acquisita. Eosinophilic oesophagitis is an emerging chronic atopic disease with oesophageal dysfunction as the typical presentation, and oesophageal narrowing, rings and stricture as late complications. Oesophageal lichen planus mainly involves the proximal to mid-oesophagus in elderly aged women with long-term oral mucosal lesions. In acute attack of pemphigus vulgaris, oesophageal involvement is not uncommon but often neglected and may cause sloughing oesophagitis (oesophagitis dissecans superficialis) with acute GI bleeding in rare cases. GI manifestation of hereditary bradykininergic angio-oedema with colicky acute abdomen mostly affects small intestine, usually in the absence of pruritus or urticaria, and is more severe and long-lasting than the acquired histaminergic form. Strong evidence supports association between inflammatory bowel disease, especially Crohn disease, and hidradenitis suppurativa/acne inversa. Patients with vitiligo need surveillance of autoimmune liver disease, autoimmune atrophic gastritis or coeliac disease when corresponding symptoms become suspect. Melanoma is the most common primary tumour metastatic to the GI tract, with small intestine predominantly targeted. Gastrointestinal involvement is not uncommon in disseminated mycosis fungoides. Extramammary Paget's disease is an intraepidermal adenocarcinoma of controversial origin, and a high association between the anogenital occurrence and colorectal adenocarcinoma has been reported. As GI tract is the largest organ system with multidimensional functions, dermatologists in daily practice should be aware of the gastrointestinal morbidities related to primary skin diseases for an early diagnosis and treatment.
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Affiliation(s)
- C-Y Lu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - M-S Hsieh
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - K-C Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - M Ezmerli
- Department of Dermatology, Faculty of Medicine in Rabigh, Kingdom of Saudi Arabia, King Abdulaziz University, Jeddah, Saudi Arabia
| | - C-H Kuo
- Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - W Chen
- Center for Research & Development, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
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5
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Nakata Y, Suga H, Awaji K, Oka T, Miyagaki T, Sugaya M, Sato S. A case of mycosis fungoides with small intestinal involvement. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2019. [DOI: 10.1002/cia2.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yukihiro Nakata
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
| | - Hiraku Suga
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
| | - Kentaro Awaji
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
| | - Tomonori Oka
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
| | - Tomomitsu Miyagaki
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
| | - Makoto Sugaya
- Department of Dermatology International University of Health and Welfare Chiba Japan
| | - Shinichi Sato
- Department of Dermatology The University of Tokyo Graduate School of Medicine Tokyo Japan
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Emge DA, Bassuner J, Lewis DJ, Duvic M. A Rare Case of Mycosis Fungoides in the Oral Cavity and Small Intestine Complicated by Perforation. Case Rep Dermatol 2016; 8:294-302. [PMID: 27920681 PMCID: PMC5126588 DOI: 10.1159/000452326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/09/2016] [Indexed: 11/19/2022] Open
Abstract
Extracutaneous involvement in mycosis fungoides (MF) carries a poor prognosis. Oral and gastrointestinal (GI) tract lesions are both rare locations of disease. We describe the clinical findings of one case with oral and GI MF complicated by perforation after systemic antineoplastic treatment, and review the relevant literature. The patient had a 1-year history of MF before development of tongue and palate tumors. He was treated with local electron beam radiation, but re-presented to the hospital after what was found to be small intestine perforation following systemic antineoplastic therapy. The case reveals key insights into the progression and complications of lymphomas with GI tract involvement.
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Affiliation(s)
| | - Juri Bassuner
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel J. Lewis
- Baylor College of Medicine, Houston, TX, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Madeleine Duvic
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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7
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Matnani R, Ganapathi KA, Lewis SK, Green PH, Alobeid B, Bhagat G. Indolent T- and NK-cell lymphoproliferative disorders of the gastrointestinal tract: a review and update. Hematol Oncol 2016; 35:3-16. [PMID: 27353398 DOI: 10.1002/hon.2317] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 12/17/2022]
Abstract
Primary gastrointestinal (GI) T- and NK-cell lymphomas are usually aggressive neoplasms associated with high morbidity and mortality. Over the past two decades, however, cases of primary GI lymphoproliferative disorders (LPDs) or lymphomas of T- or NK-cell derivation with indolent behavior have been reported. These LPDs are rare and they can be challenging to diagnose as they share clinical and pathological features with both, inflammatory disorders and aggressive T- and NK-cell lymphomas. Primary, indolent clonal T-cell proliferations of the GI tract, which can be CD4+, CD8+ or CD4- CD8-, have been included as a provisional entity in the newly revised World Health Organization (WHO) classification of lymphoid neoplasms and designated 'indolent T-cell LPD of the GI tract'. It is currently unclear whether the indolent NK-cell LPDs represent reactive or neoplastic proliferations. In this review, we describe the clinical, morphologic, immunophenotypic and genetic features of indolent GI T- and NK-cell LPDs and provide guidance in differentiating them from other inflammatory and neoplastic diseases. We believe that greater awareness of these LPDs amongst physicians and the research community will lead to timely and accurate diagnoses, stimulate investigations into the pathogenetic mechanisms underlying different entities thereby enhancing our understanding of disease biology and enable the development of effective therapeutic regimens. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Rahul Matnani
- Department of Pathology and Cell Biology, Division of Hematopathology, Columbia University Medical Center, New York, NY, USA
| | - Karthik A Ganapathi
- Department of Pathology and Cell Biology, Division of Hematopathology, Columbia University Medical Center, New York, NY, USA
| | - Suzanne K Lewis
- Department of Medicine, Division of Digestive and Liver diseases, Columbia University Medical Center, New York, NY, USA
| | - Peter H Green
- Department of Medicine, Division of Digestive and Liver diseases, Columbia University Medical Center, New York, NY, USA
| | - Bachir Alobeid
- Department of Pathology and Cell Biology, Division of Hematopathology, Columbia University Medical Center, New York, NY, USA
| | - Govind Bhagat
- Department of Pathology and Cell Biology, Division of Hematopathology, Columbia University Medical Center, New York, NY, USA
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Machado I, Sanmartin O, Diez-Ares JA, Traves V, Avaria A, Salazar C, Rubio L, Lavernia J. [Intestinal infiltration of high-grade large T-cell non-Hodgkin lymphoma with cyclin-D1 overexpression and aberrant CD79a expression in a patient with a diagnosis of tumour stage mycosis fungoides]. GASTROENTEROLOGIA Y HEPATOLOGIA 2016; 39:362-4. [PMID: 26826778 DOI: 10.1016/j.gastrohep.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/28/2015] [Accepted: 12/04/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Isidro Machado
- Servicio de Patología, Instituto Valenciano de Oncología, Valencia, España.
| | - Onofre Sanmartin
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | | | - Victor Traves
- Servicio de Patología, Instituto Valenciano de Oncología, Valencia, España
| | - Amparo Avaria
- Unidad de Hematología, Instituto Valenciano de Oncología, Valencia, España
| | - Claudia Salazar
- Unidad de Hematología, Instituto Valenciano de Oncología, Valencia, España
| | - Luis Rubio
- Laboratorio de Biología Molecular, Instituto Valenciano de Oncología, Valencia, España
| | - Javier Lavernia
- Servicio de Oncología Médica, Instituto Valenciano de Oncología, Valencia, España
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Vetro C, Bonanno G, Giulietti G, Romano A, Conticello C, Chiarenza A, Spina P, Coppolino F, Cunsolo R, Raimondo FD. Rare gastrointestinal lymphomas: The endoscopic investigation. World J Gastrointest Endosc 2015; 7:928-949. [PMID: 26265987 PMCID: PMC4530327 DOI: 10.4253/wjge.v7.i10.928] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/01/2015] [Accepted: 07/09/2015] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal lymphomas represent up to 10% of gastrointestinal malignancies and about one third of non-Hodgkin lymphomas. The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma. However, the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization. Due to their rarity and the multifaceted histology, an endoscopic classification has not been validated yet. This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up, according to the involved site and lymphoma subtype. Existing, new and emerging endoscopic technologies have been examined. In particular, we investigated the diagnostic, prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas, lymphomatous polyposis and mantle cell lymphoma, follicular lymphoma, plasma cell related disease, gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract. Contrarily to more frequent gastrointestinal lymphomas, data about rare lymphomas are mostly extracted from case series and case reports. Due to the data paucity, a synergism between gastroenterologists and hematologists is required in order to better manage the disease. Indeed, clinical and prognostic features are different from nodal and extranodal or the bone marrow (in case of plasma cell disease) counterpart. Therefore, the approach should be based on the knowledge of the peculiar behavior and natural history of disease.
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Tan E, Shao H, Friedman M. Mycosis Fungoides of the Rectum: Case Report and Review of the Literature. J Gastrointest Cancer 2015. [PMID: 26195195 DOI: 10.1007/s12029-015-9751-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Elaine Tan
- University of South Florida Morsani College of Medicine, 12902 USF Magnolia Drive FOB-2 Rm 5.2111, Tampa, FL, 33612, USA. .,Department of Hematopathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. .,Department of Gastroenterology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA.
| | - Haipeng Shao
- Department of Hematopathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mark Friedman
- Department of Gastroenterology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
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Indolent small intestinal CD4+ T-cell lymphoma is a distinct entity with unique biologic and clinical features. PLoS One 2013; 8:e68343. [PMID: 23861889 PMCID: PMC3701677 DOI: 10.1371/journal.pone.0068343] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/28/2013] [Indexed: 12/26/2022] Open
Abstract
Enteropathy-associated T-cell lymphomas (EATL) are rare and generally aggressive types of peripheral T-cell lymphomas. Rare cases of primary, small intestinal CD4+ T-cell lymphomas with indolent behavior have been described, but are not well characterized. We describe morphologic, phenotypic, genomic and clinical features of 3 cases of indolent primary small intestinal CD4+ T-cell lymphomas. All patients presented with diarrhea and weight loss and were diagnosed with celiac disease refractory to a gluten free diet at referring institutions. Small intestinal biopsies showed crypt hyperplasia, villous atrophy and a dense lamina propria infiltrate of small-sized CD4+ T-cells often with CD7 downregulation or loss. Gastric and colonic involvement was also detected (n = 2 each). Persistent, clonal TCRβ gene rearrangement products were detected at multiple sites. SNP array analysis showed relative genomic stability, early in disease course, and non-recurrent genetic abnormalities, but complex changes were seen at disease transformation (n = 1). Two patients are alive with persistent disease (4.6 and 2.5 years post-diagnosis), despite immunomodulatory therapy; one died due to bowel perforation related to large cell transformation 11 years post-diagnosis. Unique pathobiologic features warrant designation of indolent small intestinal CD4+ T-cell lymphoma as a distinct entity, greater awareness of which would avoid misdiagnosis as EATL or an inflammatory disorder, especially celiac disease.
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