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Souza PKD, Amorim RO, Sousa LS, Batista MD. Dermatological manifestations of hematologic neoplasms. Part I: secondary specific skin lesions. An Bras Dermatol 2023; 98:5-12. [PMID: 36344350 PMCID: PMC9837649 DOI: 10.1016/j.abd.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/06/2022] Open
Abstract
Cutaneous manifestations occur during the course of hematologic malignancies and precede, follow, or are late events in relation to the diagnosis. They result from paraneoplastic phenomena, tumor infiltrations, and immunosuppression resulting from the hematologic neoplasia itself or its treatment. The dermatologist must be aware of these conditions, which can help both in the diagnosis of the underlying disease and in the reduction of patient morbidity. This review (part I) addresses skin lesions associated with direct infiltration by systemic hematologic malignancies.
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Affiliation(s)
| | - Rafael Oliveira Amorim
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil,Corresponding author.
| | | | - Mariana Dias Batista
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Gru AA, Bacchi CE, Pulitzer M, Bhagat G, Kempf W, Robson A, Plaza JA, Pincus L, Raghavan S, Xu M, Vencato da Silva T, Salavaggione AL, Subtil A, Battistella M. Secondary skin involvement in classic Hodgkin lymphoma: Results of an international collaborative cutaneous lymphoma working group study of 25 patients. J Cutan Pathol 2021; 48:1367-1378. [PMID: 34089205 DOI: 10.1111/cup.14077] [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: 02/10/2021] [Revised: 04/18/2021] [Accepted: 06/01/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cutaneous involvement by classic Hodgkin lymphoma (CHL) is an extraordinarily rare phenomenon in the current era. To date, no single large case series of cutaneous involvement by Hodgkin lymphoma has ever been reported in the literature. METHODS A comprehensive search for cases designated "skin" and "Hodgkin" was performed at different institutions between 1990 and 2020. Twenty-five cases were identified, and each case was independently reviewed by at least three board-certified dermatopathologists and/or hematopathologists. RESULTS All cases represented examples of systemic CHL with secondary skin dissemination. A single lesion, usually a tumor, nodule or infiltrative plaque was observed in 56% of cases and multiple lesions were present in 28% of cases. Most patients (86%-12/14) had a diagnosis of stage IV disease at first diagnosis. The interval between the clinical (first) diagnosis of HL and the development of skin lesions ranged between 6 and 108 months (average 33.75 months). Comprehensive histopathologic evaluation of these cases (at the initial diagnosis) revealed a diagnosis of classic HL not otherwise specified (NOS) in 60% of cases (15/25), nodular sclerosis type in 24% (6/25), mixed cellularity in 12% (3/25), and lymphocyte depleted in 4% (1/25). CONCLUSIONS We provide documentation of a large series of CHL with secondary skin involvement in association with CHL with additional clinical, morphologic, and immunophenotypic features.
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Affiliation(s)
- Alejandro A Gru
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | | | - Melissa Pulitzer
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Govind Bhagat
- Department of Pathology, Columbia University, New York, New York, USA
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Alistair Robson
- Institute of Oncology, Lisbon, Portugal, Portugal and LDPath London, London, UK
| | - Jose A Plaza
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Laura Pincus
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Shyam Raghavan
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | - Mina Xu
- Department of Pathology, Yale University, New Haven, Connecticut, USA
| | | | | | - Antonio Subtil
- Department of Pathology, Royal Jubilee Hospital, Victoria, British Columbia, Canada
| | - Maxime Battistella
- Pathology Department, Université de Paris, Hôpital Saint-Louis, Paris, France
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