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Di Raimondo C, Parekh V, Song JY, Rosen ST, Querfeld C, Zain J, Martinez XU, Abdulla FR. Primary Cutaneous CD30+ Lymphoproliferative Disorders: a Comprehensive Review. Curr Hematol Malig Rep 2020; 15:333-342. [DOI: 10.1007/s11899-020-00583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
Primary cutaneous CD30+ lymphoproliferative disorders encompass lymphomatoid papulosis (LyP), primary cutaneous anaplastic large cell lymphoma (pcALCL), and indeterminate cases. LyP is a benign disorder characterized by recurrent crops of red or violaceous papulonodules. Patients with LyP are at an increased risk of a secondary malignancy. pcALCL is characterized by a solitary red to violaceous nodule or tumor larger than 20 mm. LyP is benign, is limited to the skin, and self-resolves, with a 5-year survival rate of 100%; pcALCL is limited to the skin and responsive to directed therapies, with a 5-year survival rate of over 95%. Aggressive chemotherapeutic regimens should be avoided.
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MESH Headings
- Disease-Free Survival
- Humans
- Lymphoma, Large-Cell, Anaplastic/diagnosis
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, Large-Cell, Anaplastic/metabolism
- Lymphoma, Large-Cell, Anaplastic/mortality
- Lymphomatoid Papulosis/diagnosis
- Lymphomatoid Papulosis/drug therapy
- Lymphomatoid Papulosis/metabolism
- Lymphomatoid Papulosis/mortality
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/mortality
- Risk Factors
- Skin Neoplasms/diagnosis
- Skin Neoplasms/drug therapy
- Skin Neoplasms/metabolism
- Skin Neoplasms/microbiology
- Survival Rate
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Affiliation(s)
- Maxwell B Sauder
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - John T O'Malley
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, The Center for Cutaneous Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, USA.
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Wieser I, Tetzlaff MT, Torres Cabala CA, Duvic M. Primary cutaneous CD30+lymphoproliferative disorders. J Dtsch Dermatol Ges 2016; 14:767-82. [DOI: 10.1111/ddg.13117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Iris Wieser
- Department of Dermatology; The University of Texas, MD Anderson Cancer Center; Houston Texas U.S.A
- Department of Dermatology; Paracelsus Medical University; Salzburg Austria
| | - Michael T. Tetzlaff
- Departments of Pathology and Translational and Molecular Pathology; The University of Texas, MD Anderson Cancer Center; Houston Texas U.S.A
| | - Carlos A. Torres Cabala
- Departments of Pathology and Dermatology; The University of Texas, MD Anderson Cancer Center; Houston Texas U.S.A
| | - Madeleine Duvic
- Department of Dermatology; The University of Texas, MD Anderson Cancer Center; Houston Texas U.S.A
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Wieser I, Tetzlaff MT, Cabala CAT, Duvic M. Primär kutane CD30 +lymphoproliferative Erkrankungen. J Dtsch Dermatol Ges 2016; 14:767-84. [DOI: 10.1111/ddg.13117_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Iris Wieser
- Dermatologisches Institut der Universität Texas, MD Anderson Cancer Center; Houston Texas U.S.A
- Dermatologisches Institut der Paracelsus Medizinischen Privatuniversität; Salzburg Österreich
| | - Michael T. Tetzlaff
- Institut für Pathologie und Institut für Translationale und Molekulare Pathologie; Universität Texas, MD Anderson Krebszentrum; Houston Texas U.S.A
| | - Carlos A. Torres Cabala
- Pathologisches und Dermatologisches Institute der Universität Texas, MD Anderson Krebszentrum; Houston Texas U.S.A
| | - Madeleine Duvic
- Dermatologisches Institut der Universität Texas, MD Anderson Cancer Center; Houston Texas U.S.A
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Meena M, Martin PA, Abouseif C, Bullpitt P. Lymphomatoid papulosis type C of the eyelid in a young girl: a case report and review of literature. Orbit 2014; 33:395-398. [PMID: 24911471 DOI: 10.3109/01676830.2014.907813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To report an unusual presentation of a case of Lymphomatoid papulosis(LyP) in a young girl. MATERIAL AND METHODS A 14-year-old female presented with a history of swelling of the left upper eyelid of two weeks duration. There was a history of trivial trauma prior to the swelling. The patient was diagnosed as having pre-septal cellulitis elsewhere and was put on oral antibiotics. The lesion was non-responsive to oral antibiotics. The patient was then referred to our hospital. Ocular examination revealed an elevated lesion measuring 15 mm × 10 mm on the left upper eyelid, associated with pre-septal swelling and induration. Ocular movements were normal. The anterior and posterior segment examination was normal. Incision biopsy was done from the eyelid lesion. Multiple cutaneous lesions were also biopsied. RESULTS The histopathology examination confirmed the diagnosis of lymphomatoid papulosis type C. Dermatological and systemic evaluation ruled out the other aggressive forms of CD30(+) lymphoid proliferation. CONCLUSION We report an unusual presentation of lymphomatoid papulosis(LyP) type C in a young girl. Complete systemic work up and histopathological evaluation is mandatory in cases of suspicious lesions, not responding to conservative treatment.
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Affiliation(s)
- Manju Meena
- Oculoplastic Unit, Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital , Macquarie Street, Sydney, NSW , Australia and
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Anaplastic lymphoma kinase (ALK1) immunohistochemistry in diagnostic dermatopathology; an update. Am J Dermatopathol 2013; 35:403-8; quiz 409-11. [PMID: 23689691 DOI: 10.1097/dad.0b013e31823d2943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The use of anaplastic lymphoma kinase antibodies (ALK1) as a diagnostic aid has expanded since becoming a routinely available immunohistochemical stain. Because the skin may be the site of a wide variety of hematolymphoid and fibroblastic proliferations, dermatopathologists commonly use ALK1 as part of a broader staining panel in diagnosing soft tissue and cutaneous hematolymphoid neoplasms. Furthermore, new entities and differential diagnostic contexts are emerging, which broaden the utility of ALK1 immunohistochemistry. We review the expanding role of ALK1 immunohistochemistry in contemporary dermatopathology.
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Choi YJ, Jin HC, Kim NJ, Choung HK, Khwarg SI. A Case of Lymphomatoid Papulosis of the Eyelid. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.4.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Youn Joo Choi
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Chul Jin
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Nam Ju Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ho Kyung Choung
- Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Sang In Khwarg
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea
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Fernández-Guarino M, Carrillo-Gijón R, Jaén-Olasolo P. [Lymphomatoid papulosis: clinical and pathological findings in 18 patients]. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:388-93. [PMID: 22261676 DOI: 10.1016/j.ad.2011.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 07/16/2011] [Accepted: 08/28/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a CD30(+) lymphoproliferative skin disease that has been described in association with Hodgkin lymphoma. It has also been reported to progress to mycosis fungoides or cutaneous anaplastic large-cell lymphoma. OBJECTIVE To study the clinical and histologic features of LyP and response to treatment in a patient series. MATERIALS AND METHODS For this retrospective, descriptive, observational study of patients with histologically confirmed LyP and sufficient follow-up data on record, we extracted histologic findings on skin biopsy, clinical presentation, clinical course, and response to treatments. RESULTS Eighteen patients (10 male, 8 female) were identified. Most biopsies (14/18, 78%) showed a wedge-shaped lymphocytic infiltrate with CD30(+), CD3(+), and CD56(-) cells. A type A histologic pattern was present in the biopsies of 83% of the patients. The most common presentation (83%) consisted of papules on the trunk; for 62% LyP resolved after a single episode. Twelve percent of the patients developed mycosis fungoides (mean follow-up, 7 years); no other associations were noted. DISCUSSION Although few series of patients with LyP have been published in recent years, the findings reported generally coincide with our observations. CONCLUSION LyP is typically a CD30(+) lymphoproliferative disorder that usually runs a benign course and responds well to treatment.
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Affiliation(s)
- M Fernández-Guarino
- Servicio de Dermatología, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, Spain.
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Kinney MC, Higgins RA, Medina EA. Anaplastic large cell lymphoma: twenty-five years of discovery. Arch Pathol Lab Med 2011; 135:19-43. [PMID: 21204709 DOI: 10.5858/2010-0507-rar.1] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT The year 2010 commemorates the 25th year since the seminal publication by Karl Lennert and Harald Stein and others in Kiel, West Germany, describing an unusual large cell lymphoma now known as anaplastic large cell lymphoma (ALCL). Investigators at many universities and hospitals worldwide have contributed to our current in-depth understanding of this unique peripheral T-cell lymphoma, which in its systemic form, principally occurs in children and young adults. OBJECTIVE To summarize our current knowledge of the clinical and pathologic features of systemic and primary cutaneous ALCL. Particular emphasis is given to the biology and pathogenesis of ALCL. DATA SOURCES Search of the medical literature (Ovid MEDLINE In-Process & Other Non-Indexed Citations and Ovid MEDLINE: 1950 to Present [National Library of Medicine]) and more than 20 years of diagnostic experience were used as the source of data for review. CONCLUSIONS Based on immunostaining for activation antigen CD30 and the presence of dysregulation of the anaplastic lymphoma kinase gene (2p23), the diagnosis of ALCL has become relatively straightforward for most patients. Major strides have been made during the last decade in our understanding of the complex pathogenesis of ALCL. Constitutive NPM-ALK signaling has been shown to drive oncogenesis via an intricate network of redundant and interacting pathways that regulate cell proliferation, cell fate, and cytoskeletal modeling. Nevertheless, pathomechanistic, therapeutic, and diagnostic challenges remain that should be resolved as we embark on the next generation of discovery.
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Affiliation(s)
- Marsha C Kinney
- Department of Pathology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78229-3900, USA.
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Secondary ALK Negative Anaplastic Large Cell Lymphoma in a Patient With Lymphomatoid Papulosis of 40 Years Duration. Am J Dermatopathol 2010; 32:708-12. [DOI: 10.1097/dad.0b013e3181d46eba] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Evolving purple lesions and nodules on the abdomen and forearm. JAAPA 2010. [DOI: 10.1097/01720610-201007000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Calzado-Villarreal L, Polo-Rodríguez I, Ortiz-Romero P. Primary Cutaneous CD30+ Lymphoproliferative Disorders. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/s1578-2190(10)70598-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Calzado-Villarreal L, Polo-Rodríguez I, Ortiz-Romero P. Síndrome linfoproliferativo CD30+ cutáneo primario. ACTAS DERMO-SIFILIOGRAFICAS 2010. [DOI: 10.1016/j.ad.2009.07.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Sanka RK, Eagle RC, Wojno TH, Neufeld KR, Grossniklaus HE. Spectrum of CD30+ lymphoid proliferations in the eyelid lymphomatoid papulosis, cutaneous anaplastic large cell lymphoma, and anaplastic large cell lymphoma. Ophthalmology 2009; 117:343-51. [PMID: 19969358 DOI: 10.1016/j.ophtha.2009.07.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 06/12/2009] [Accepted: 07/07/2009] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To report the clinicopathologic features of 3 patients with CD30(+) lymphoid proliferations of the eyelid. DESIGN Retrospective case series. PARTICIPANTS Patients with cutaneous CD30(+) lymphoproliferative lesions of the eyelid. METHODS Three patients with CD30(+) non-mycosis fungoides T-cell lymphoid infiltrates of the eyelid were identified. The histories, clinical findings, pathologic features including immunohistochemical staining, treatments, and outcomes were reviewed and compared. MAIN OUTCOME MEASURES Pathologic findings including immunohistochemical analysis. RESULTS The patients included an 81-year-old man, an 18-year-old man, and a 42-year-old woman with CD30(+) lymphoid proliferations of the eyelid and adjacent soft tissue. The first patient had an isolated crateriform eyelid lesion that was classified as lymphomatoid papulosis (LyP). The second patient had an isolated multinodular lesion of the eyelid that was classified as cutaneous anaplastic large cell lymphoma (cALCL). The third patient presented with eyelid edema with an underlying mass and was found to have widely disseminated anaplastic large cell lymphoma (ALCL). Diagnoses were dependent on clinical findings. CONCLUSIONS The CD30(+) lymphoid proliferations represent a spectrum of conditions ranging from indolent LyP, to moderately aggressive cALCL, to highly aggressive ALCL. Interpretation of the pathologic findings in CD30(+) lymphoid proliferations is based in part on clinical findings. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any material discussed in this article.
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Affiliation(s)
- R Krishna Sanka
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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Differential diagnosis and treatment of primary, cutaneous, anaplastic large cell lymphoma: not always an easy task. Int J Hematol 2009; 90:226-229. [PMID: 19548068 DOI: 10.1007/s12185-009-0365-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Revised: 05/27/2009] [Accepted: 06/01/2009] [Indexed: 10/20/2022]
Abstract
Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is a rare and distinct neoplasm appearing de novo on the skin. We present a case of a 75-year-old man diagnosed with PC-ALCL in his left femoral region. We describe the morphology of lesions along with the differential diagnosis, treatment, clinical course and prognosis. We further discuss parameters concerning treatment that should be considered when a PC-ALCL is diagnosed. Our case report demonstrates the complexity in classification, staging, differential diagnosis and therapy selection of PC-ALCLs. It is crucial to emphasize the importance of clinical criteria in diagnosing a PC-ALCL in combination with immunohistochemistry.
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Webb TR, Slavish J, George RE, Look AT, Xue L, Jiang Q, Cui X, Rentrop WB, Morris SW. Anaplastic lymphoma kinase: role in cancer pathogenesis and small-molecule inhibitor development for therapy. Expert Rev Anticancer Ther 2009; 9:331-56. [PMID: 19275511 DOI: 10.1586/14737140.9.3.331] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Anaplastic lymphoma kinase (ALK), a receptor tyrosine kinase in the insulin receptor superfamily, was initially identified in constitutively activated oncogenic fusion forms - the most common being nucleophosmin-ALK - in anaplastic large-cell lymphomas, and subsequent studies have identified ALK fusions in diffuse large B-cell lymphomas, systemic histiocytosis, inflammatory myofibroblastic tumors, esophageal squamous cell carcinomas and non-small-cell lung carcinomas. More recently, genomic DNA amplification and protein overexpression, as well as activating point mutations, of ALK have been described in neuroblastomas. In addition to those cancers for which a causative role for aberrant ALK activity is well validated, more circumstantial links implicate the full-length, normal ALK receptor in the genesis of other malignancies - including glioblastoma and breast cancer - via a mechanism of receptor activation involving autocrine and/or paracrine growth loops with the reported ALK ligands, pleiotrophin and midkine. This review summarizes normal ALK biology, the confirmed and putative roles of ALK in the development of human cancers and efforts to target ALK using small-molecule kinase inhibitors.
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Affiliation(s)
- Thomas R Webb
- Department of Chemical Biology and Therapeutics, St Jude Children's Research Hospital, 332 North Lauderdale Street, Mail Stop 1000, Memphis, TN 38105, USA
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Humme D, Lukowsky A, Steinhoff M, Beyer M, Walden P, Sterry W, Assaf C. Dominance of Nonmalignant T-Cell Clones and Distortion of the TCR Repertoire in the Peripheral Blood of Patients with Cutaneous CD30+ Lymphoproliferative Disorders. J Invest Dermatol 2009; 129:89-98. [DOI: 10.1038/jid.2008.204] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Oncogenes involved in recurrent chromosomal translocations serve as diagnostic markers and therapeutic targets in hematopoietic tumors. In contrast to myeloid and B-cell neoplasms, translocations in peripheral T-cell lymphomas (PTCLs) are poorly understood. Here, we identified recurrent translocations involving the multiple myeloma oncogene-1/interferon regulatory factor-4 (IRF4) locus in PTCLs. IRF4 translocations exist in myeloma and some B-cell lymphomas, but have not been reported previously in PTCLs. We studied 169 PTCLs using fluorescence in situ hybridization and identified 12 cases with IRF4 translocations. Two cases with t(6;14)(p25;q11.2) had translocations between IRF4 and the T-cell receptor-alpha (TCRA) locus. Both were cytotoxic PTCLs, unspecified (PTCL-Us) involving bone marrow and skin. Eight of the remaining ten cases were cutaneous ALCLs without TCRA rearrangements (57% of cutaneous ALCLs tested). These findings identified IRF4 translocations as a novel recurrent genetic abnormality in PTCLs. Cytotoxic PTCL-Us involving bone marrow and skin and containing IRF4/TCRA translocations might represent a distinct clinicopathologic entity. Translocations involving IRF4 but not TCRA appear to occur predominantly in cutaneous ALCLs. Detecting these translocations may be useful in lymphoma diagnosis. Further, due to its involvement in translocations, MUM1/IRF4 protein may play an important biologic role in some PTCLs, and might represent a possible therapeutic target.
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Kempf W, Kutzner H, Cozzio A, Sander CA, Pfaltz M, Müller B, Pfaltz M. MUM1 expression in cutaneous CD30+ lymphoproliferative disorders: a valuable tool for the distinction between lymphomatoid papulosis and primary cutaneous anaplastic large-cell lymphoma. Br J Dermatol 2008; 158:1280-7. [DOI: 10.1111/j.1365-2133.2008.08566.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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