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Abakarim O, Maghnouj O, Hamdaoui A, Lahlimi F, Tazi I. Relapse of Hodgkin's disease revealed by skin involvement. Clin Case Rep 2022; 10:e6244. [PMID: 36093457 PMCID: PMC9440343 DOI: 10.1002/ccr3.6244] [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: 02/14/2022] [Revised: 07/02/2022] [Accepted: 07/23/2022] [Indexed: 11/12/2022] Open
Abstract
We present a case of a relapse of HL revealed by a skin involvement. A biopsy of the skin lesion showed infiltration by a mixed cellularity and Reed–Sternberg cells. The immunoreactivity was positive for CD30 and CD15. The patient was undergoing ICE protocol with good improvement after three cycles.
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Affiliation(s)
- Ouadii Abakarim
- Department of Clinical Hematology & Bone Marrow Transplantation, University Hospital Centre Mohammed VI, Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakesh Morocco
| | - Oumaima Maghnouj
- Department of Clinical Hematology & Bone Marrow Transplantation, University Hospital Centre Mohammed VI, Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakesh Morocco
| | | | - Fatima Zahra Lahlimi
- Department of Clinical Hematology & Bone Marrow Transplantation, University Hospital Centre Mohammed VI, Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakesh Morocco
| | - Illias Tazi
- Department of Clinical Hematology & Bone Marrow Transplantation, University Hospital Centre Mohammed VI, Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakesh Morocco
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Shrivastava A, Jain S, Malhotra P, Mishra S, Pasricha S, Kapoor G. Classical Hodgkin Lymphoma Presenting as Cutaneous and Soft Tissue Mass Lesion: An Enigmatic Presentation Posing a Diagnostic Challenge—A Case Report and Review of Literature. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0041-1740441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractHodgkin lymphoma (HL) is primarily a nodal disease. Cutaneous involvement of HL as a presenting feature is extremely rare. Skin involvement is usually seen as a metachronous involvement in the course of disease and is associated with poor prognosis. Primary skin and soft tissue involvement can be construed as nonhematological, inflammatory, or infective etiology. We report a 14-year-old girl with fever, weight loss, lymphadenopathy, and multiple papular lesions over the right chest wall as initial manifestation of HL, posing a diagnostic challenge. In view of stage IVBE, patient was managed with intensive chemotherapy regimen and is currently free of disease at 6 months of follow-up.
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Affiliation(s)
- Ayushi Shrivastava
- Department of Pediatric Hematology Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Sandeep Jain
- Department of Pediatric Hematology Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Payal Malhotra
- Department of Pediatric Hematology Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Shalini Mishra
- Department of Pediatric Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Sunil Pasricha
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Gauri Kapoor
- Department of Pediatric Hematology Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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Hakkou D, Belefqih I, Sabri S, Dikhaye S, Bachir H, Hamaz S, Alaoui H, Serraj K. Primary Cutaneous Hodgkin's Lymphoma: An Extremely Rare Entity. Cureus 2021; 13:e19272. [PMID: 34881126 PMCID: PMC8643714 DOI: 10.7759/cureus.19272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/22/2022] Open
Abstract
Skin involvement in Hodgkin's lymphoma (HL) is rare. The diagnosis can be difficult, mainly due to the wide range of cutaneous lesions that can be observed, but also due to the differential diagnosis, even after the immunohistochemical staining. We present the case of a 30-year-old man who presented with a painful cutaneous nodular lesion; biopsy and immunohistochemical stains were consistent with classic HL. The patient was treated with adriamycin, bleomycin, vinblastin, and dacarbazine (ABVD) with complete remission.
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Affiliation(s)
- Darine Hakkou
- Internal Medicine, Mohammed First University, Oujda, MAR
| | - Ismail Belefqih
- Internal Medicine, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Samia Sabri
- Internal Medicine, Mohammed First University, Oujda, MAR
| | - Siham Dikhaye
- Dermatology, Mohammed VI University Hospital, Mohammed First University, Oujda, MAR
| | - Houda Bachir
- Internal Medicine, Mohammed First University, Oujda, MAR
| | - Siham Hamaz
- Internal Medicine, Mohammed First University, Oujda, MAR
| | - Habiba Alaoui
- Internal Medicine, Mohammed First University, Oujda, MAR
| | - Khalid Serraj
- Internal Medicine, Mohammed First University, Oujda, MAR
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Ghosh S, Ghosh S, Amin RJ, Chowdhury F, Prasad NS, Prabu P, Chowdhury S. Classical Hodgkin's lymphoma with cutaneous involvement in an adolescent male: A case study. Cancer Rep (Hoboken) 2021; 5:e1473. [PMID: 34089301 PMCID: PMC8842694 DOI: 10.1002/cnr2.1473] [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: 03/24/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Hodgkin's lymphoma (HL) with skin involvement is reasonably rare. It typically occurs late in the course and is associated with a poor prognosis; however, it may also be indolent in some cases. CASE We report a case of a 15-year-old previously healthy male with Hodgkin's lymphoma who presented with multiple lymphadenopathies of axilla and serpiginous ulcerative nodular lesions involving pectoral skin. A lymph node biopsy was performed following an initial diagnostic workup for a suspected active infectious disease, which revealed a neoplastic invasion from a mixed cellularity classical HL with skin involvement. A total of six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy regimen was administered to the patient. CONCLUSION In comparison to other studies, this case demonstrates that a good response is possible with standard ABVD chemotherapy.
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Affiliation(s)
- Sumon Ghosh
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sajib Ghosh
- Department of Pathology, Eastern Medical College & Hospital, Cumilla, Bangladesh
| | - Rownak Jahan Amin
- Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | - Fahmida Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | | | | | - Sukanta Chowdhury
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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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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Anterior chest wall reconstruction for cutaneous involvement of Hodgkin’s lymphoma. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.592917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Szablewski V, Dereure O, René C, Tempier A, Durand L, Alame M, Cacheux V, Costes-Martineau V. Cutaneous localization of angioimmunoblastic T-cell lymphoma may masquerade as B-cell lymphoma or classical Hodgkin lymphoma: A histologic diagnostic pitfall. J Cutan Pathol 2018; 46:102-110. [PMID: 30370547 DOI: 10.1111/cup.13382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 09/12/2018] [Accepted: 10/22/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND We report the cases of three patients presenting skin lesions whose biopsies showed nodular polymorphic infiltrates consisting of lymphocytes, plasma cells, histiocytes, eosinophils, B blasts, and Hodgkin Reed-Sternberg (HRS)-like cells. Two of them were initially diagnosed as classical Hodgkin lymphoma (cHL), on the other hand, the last one as a B-cell lymphoma. All patients have been treated for angioimmunoblastic T-cell lymphoma (AITL). METHODS We performed a second review of the skin biopsies with further immunophenotypic molecular analyses. Scrupulous observation revealed, in the background of the three cases, atypical small to medium-sized lymphocytes carrying a CD3+, CD4+ T-cell phenotype and expressing PD1 and CXCL13 follicular helper T-cell markers. The two lesions initially diagnosed as cHL showed scattered HRS-like cells with CD30+, CD15+, PAX5+, CD20-, Epstein Barr Virus (EBV) + classical phenotype. The case initially diagnosed as B-cell lymphoma showed a diffuse B-cell proliferation associated with small B-cell and medium to large-sized B blasts that were positive for EBV. CONCLUSION Those cases highlighted that atypical T-cells may be obscured by B-cell proliferation mimicking cHL or B-cell lymphoma in cutaneous localization of AITL and confirmed the requirement of collecting clinical information before performing a diagnosis.
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Affiliation(s)
- Vanessa Szablewski
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Olivier Dereure
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département de Dermatologie, CHU Montpellier, Hôpital Saint-Eloi, Montpellier
| | - Céline René
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Immunologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Ariane Tempier
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
| | - Luc Durand
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,MEDIPATH, Grabels, France
| | - Melissa Alame
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valère Cacheux
- Université Montpellier 1, Faculté de Médecine, Montpellier, France.,Département d'Hématologie Biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valérie Costes-Martineau
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Université Montpellier 1, Faculté de Médecine, Montpellier, France
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Duncan JR, Carr D, Kaffenberger BH. The utility of positron emission tomography with and without computed tomography in patients with nonmelanoma skin cancer. J Am Acad Dermatol 2016; 75:186-96. [PMID: 26992283 DOI: 10.1016/j.jaad.2016.01.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
Combined positron emission tomography (PET) and computed tomography (CT) scans are widely used in the staging and monitoring of most malignancies. The differential for PET-positive cutaneous lesions includes primary skin cancers, infections, cutaneous metastases from distant malignancies, and benign neoplasms. In dermatology, PET/CT scans have been most widely studied in patients with melanoma and Merkel cell carcinoma. The role of PET/CT scans in the management of other cutaneous malignancies is less clear, but it has shown great promise in the management of patients with squamous cell carcinoma and cutaneous lymphoma. This review seeks to address the usefulness of PET/CT scans in nonmelanoma skin cancer and to provide guidance regarding the management of patients with incidental PET-positive nodules. Currently, there is limited experience with PET/CT scans for staging and monitoring of non-head and neck metastatic basal cell and squamous cell carcinomas, and results show limited sensitivity and specificity. We also address the evidence for management of an incidental PET-positive cutaneous nodule and recommend obtaining a biopsy specimen in patients with a known noncutaneous malignancy, a history of primary skin cancer, or a high risk of either cutaneous or noncutaneous malignancy.
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Affiliation(s)
| | - David Carr
- Division of Dermatology, Wexner Medical Center at Ohio State University, Ghanna, Ohio
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