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Rodríguez-Cuadrado FJ, Hospital-Gil M, Suárez-Massa D. Recurrent necrotic plaques and nodules on lower limbs in a 40-year-old woman. J Dtsch Dermatol Ges 2024. [PMID: 39254273 DOI: 10.1111/ddg.15514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/18/2024] [Indexed: 09/11/2024]
Affiliation(s)
| | - Mercedes Hospital-Gil
- Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Dolores Suárez-Massa
- Department of Pathology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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2
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Shaker N, Phelps R, Niedt G, Gupta N, Sangueza OP, Pradhan D. Primary Cutaneous CD4+ Small or Medium T-Cell Lymphoproliferative Disorder With Persistent B-Cell Clone: Clinicopathologic Challenge. Am J Dermatopathol 2024; 46:626-628. [PMID: 39150185 DOI: 10.1097/dad.0000000000002707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - George Niedt
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Neha Gupta
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE; and
| | - Omar P Sangueza
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE; and
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3
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Blanchard M, Morren MA, Busschots AM, Hauben E, Alberti-Violetti S, Berti E, Avallone G, Tavoletti G, Panzone M, Quaglino P, Colonna C, Melchers RC, Vermeer MH, Gniadecki R, Mitteldorf C, Gosmann J, Stadler R, Jonak C, Oren-Shabtai M, Hodak E, Friedland R, Gordon E, Geskin LJ, Scarisbrick JJ, Mayo Martínez F, Noguera Morel L, Pehr K, Amarov B, Faouzi M, Nicolay JP, Kempf W, Blanchard G, Guenova E. Paediatric-onset lymphomatoid papulosis: results of a multicentre retrospective cohort study on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG). Br J Dermatol 2024; 191:233-242. [PMID: 38595050 DOI: 10.1093/bjd/ljae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Lymphomatoid papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population are scarce. OBJECTIVES To characterize the epidemiological, clinical, histopathological and prognostic features of paediatric LyP. METHODS This was a retrospective multicentre international cohort study that included 87 children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years at disease onset were included. LyP diagnosis was made in each centre, based on clinicopathological correlation. RESULTS Eighty-seven patients from 12 centres were included. Mean age at disease onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2 : 1. Mean time between the onset of the first cutaneous lesions and diagnosis was 1.3 years (range 0-14). Initial misdiagnosis concerned 26% of patients. LyP was most often misdiagnosed as pityriasis lichenoides et varioliformis acuta, insect bites or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned in 21% of patients. The main histological subtype was type A in 55% of cases. When analysed, monoclonal T-cell receptor rearrangement was found in 77% of skin biopsies. The overall survival rate was 100%, with follow-up at 5 years available for 33 patients and at 15 years for 8 patients. Associated haematological malignancy (HM) occurred in 10% of cases (n = 7/73), including four patients with mycosis fungoides, one with primary cutaneous anaplastic large cell lymphoma (ALCL), one with systemic ALCL and one with acute myeloid leukaemia. If we compared incidence rates of cancer with the world population aged 0-19 years from 2001 to 2010, we estimated a significantly higher risk of associated malignancy in general, occurring before the age of 19 years (incidence rate ratio 87.49, 95% confidence interval 86.01-88.99). CONCLUSIONS We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall, the disease prognosis is good, with excellent survival rates for all patients. Owing to an increased risk of associated HM, long-term follow-up should be recommended for patients with LyP.
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Affiliation(s)
- Maël Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gabriela Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
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4
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Poupart S, Coulombe J. An enlarging ulcerative nodule. Pediatr Dermatol 2024; 41:744-746. [PMID: 38529733 DOI: 10.1111/pde.15606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/09/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Steffany Poupart
- Division of Dermatology. Centre Hospitalier Universitaire de Montreal (CHUM), Department of Medicine, Université de Montreal, Montreal, Québec, Canada
| | - Jerome Coulombe
- Division of Dermatology, Department of Pediatrics, CHU Sainte-Justine, Université de Montreal, Montreal, Québec, Canada
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5
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Müller VL, Hillen U, Schaller J, Duschner N, Hyun J, Schrickel I, Kreuter A. Disseminated necrotic plaques in a 50-year-old man. J Dtsch Dermatol Ges 2024; 22:1028-1031. [PMID: 38719550 DOI: 10.1111/ddg.15413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/27/2024] [Indexed: 07/10/2024]
Affiliation(s)
- Valentina Laura Müller
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
| | - Uwe Hillen
- Dermatopathology Duisburg Essen, Essen, Germany
| | | | | | - Julia Hyun
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
| | - Isabelle Schrickel
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
| | - Alexander Kreuter
- Department of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, Duisburg, Germany
- Department of Dermatology, Venereology, and Allergology, Helios St. Elisabeth Hospital Oberhausen, University Witten-Herdecke, Oberhausen, Germany
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6
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Almaani N, Mansour AT, Ta'ani ZA. A Case of Lip Swelling. Am J Med 2024; 137:503-505. [PMID: 38281655 DOI: 10.1016/j.amjmed.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/30/2023] [Accepted: 01/06/2024] [Indexed: 01/30/2024]
Affiliation(s)
- Noor Almaani
- Department of Dermatology, School of Medicine, University of Jordan, Amman.
| | - Ahmad T Mansour
- Department of Pathology, University of Cincinnati-College of Medicine, Ohio
| | - Zain Al Ta'ani
- Department of Dermatology, School of Medicine, University of Jordan, Amman
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7
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Mark E, Kempf W, Guitart J, Pulitzer M, Mitteldorf C, Hristov A, Torres-Cabala C, Marchi E, Cropley T, Rodriguez Pinilla SM, Griffin T, Fernandez R, Pileri S, Pileri A, Tabanelli V, Borretta L, Subtil A, Plaza JA, Piris JAMA, Feldman AL, Cerroni L, Gru AA. Lymphomatoid Papulosis With T-cell Receptor-Gamma Delta Expression: A Clinicopathologic Case-series of 26 Patients of an Underrecognized Immunophenotypic Variant of Lymphomatoid Papulosis. Am J Surg Pathol 2024; 48:501-510. [PMID: 38533681 DOI: 10.1097/pas.0000000000002200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Lymphomatoid papulosis (LyP) has several histopathologic presentations. LyP featuring gamma-delta (γδ) T-cell receptor expression may masquerade as and may be misdiagnosed as aggressive cutaneous T-cell lymphoma, particularly primary cutaneous γδ T-cell lymphoma (PCGDTL) or γδ mycosis fungoides. We performed a clinicopathologic analysis of the largest series of LyP featuring γδ T-cell expression. We identified 26 patients with a diagnosis of LyP with γδ T cells from our institutions, as well as through a comprehensive review of the literature, and characterized these cases. Most cases were treated with topical steroids or not treated at all. The majority of cases showed a CD4 - CD8 + phenotype and featured at least one cytotoxic marker. Histopathologic features included an intraepidermal or dermal infiltrate with large cells and frequent angiotropism. One case was initially misdiagnosed as PCGDTL, requiring further therapy. Our case series, the largest international cohort of γδ T cell predominant LyP cases, confirms marked clinicopathologic heterogeneity that may contribute to misdiagnosis, reasserting the need to identify classic clinical features, CD30 + T-cell components, and markers of cytotoxicity when dealing with this differential diagnosis. A limitation of this study includes somewhat limited follow-up, histologic, and immunophenotypic information for some cases.
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Affiliation(s)
| | - Werner Kempf
- Department of Dermatology, Kempf und Pfaltz Histologische Diagnostik, University of Zurich, Zurich, Switzerland
| | - Joan Guitart
- Department of Dermatology, Northwestern University, Chicago, IL
| | - Melissa Pulitzer
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York City, NY
| | - Christina Mitteldorf
- Department of Dermatology, University Medical Center Göttingen, Venereology and Allergology, Göttingen, Germany
| | - Alexandra Hristov
- Departments of Pathology and Dermatology, University of Michigan, Ann Arbor, MI
| | - Carlos Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Thomas Cropley
- Department of Dermatology, University of Virginia, Charlottesville, VA
| | | | - Teresa Griffin
- Department of Dermatology, Northwestern University, Chicago, IL
| | - Rony Fernandez
- Department of Dermatology, Northwestern University, Chicago, IL
| | - Stefano Pileri
- Department of Pathology, European Institute of Oncology IRCCS, Hematopathology Division, Milan
| | - Alessandro Pileri
- Department of Surgical and Medical Science, Bologna University, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | | | | | - Antonio Subtil
- Department of Pathology, University of British Columbia, Royal Jubilee Hospital, Victoria, Canada
| | - Jose Antonio Plaza
- Departments of Pathology and Dermatology, The Ohio State University, Columbus, OH
| | | | - Andrew L Feldman
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Alejandro A Gru
- Department of Pathology
- Department of Dermatology, University of Virginia, Charlottesville, VA
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Kaya Terzi N. Decoding Early Mycosis Fungoides: Histopathologic and Immunohistochemical Clues. Cureus 2024; 16:e57545. [PMID: 38577165 PMCID: PMC10993093 DOI: 10.7759/cureus.57545] [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] [Accepted: 04/03/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Primary cutaneous lymphomas, notably mycosis fungoides (MF), present diagnostic challenges in recognizing early mycosis fungoides (eMF) due to their diverse clinical and histopathologic manifestations. The aim of our study was to use adjunctive histopathologic and immunohistochemical methods in eMF cases to make an early diagnosis and to facilitate differentiation from other dermatoses. METHODS This retrospective study analyzed 35 cases of eMF diagnosed at a single center. Demographic and clinicopathologic data were collected, and histopathologic features were assessed. Comparative analyses were conducted with conditions mimicking eMF, including large plaque parapsoriasis (LPP), psoriasis, and chronic dermatitis. Immunohistochemistry for T-cell markers (CD3, CD4, CD8, CD2, CD7) was performed. RESULTS With the scoring we applied in our study, a sensitivity of 91.43% (95% CI; 76.94% to 98.20%) and specificity of 85.71% (95% CI; 69.74% to 95.19%) for distinguishing eMF from LPP. Epidermotropism emerged as a crucial histopathologic marker, with a notable absence in most cases of cutaneous dermatitis (81.6% and 80% for CD and psoriasis, respectively) (P < 0.001). Immunohistochemistry revealed a T-helper phenotype (CD4+/CD8-) in the majority of eMF cases (78.1%), while CD4+/CD8+ and CD8+/CD4- patterns were less common (28.5% and 8.5%, respectively). CONCLUSION This study underscores the complexities in distinguishing eMF from inflammatory skin diseases, advocating for a comprehensive diagnostic approach.
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Stein T, Robak T, Biernat W, Robak E. Primary Cutaneous CD30-Positive Lymphoproliferative Disorders-Current Therapeutic Approaches with a Focus on Brentuximab Vedotin. J Clin Med 2024; 13:823. [PMID: 38337516 PMCID: PMC10856748 DOI: 10.3390/jcm13030823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/16/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
One of the most common subgroups of cutaneous T-cell lymphomas is that of primary cutaneous CD30-positive lymphoproliferative disorders. The group includes lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large cell lymphoma (pcALCL), as well as some borderline cases. Recently, significant progress has been made in understanding the genetics and treatment of these disorders. This review article summarises the clinical evidence supporting the current treatment options for these diseases. Recent years have seen the introduction of novel agents into clinical practice; most of these target CD30, such as anti-CD30 monoclonal antibodies and conjugated antibodies (brentuximab vedotin), bispecific antibodies and cellular therapies, particularly anti-CD30 CAR-T cells. This paper briefly reviews the biology of CD30 that makes it a good therapeutic target and describes the anti-CD30 therapies that have emerged to date.
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Affiliation(s)
- Tomasz Stein
- Department of Dermatology, Medical University of Lodz, 90-647 Lodz, Poland;
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 93-510 Lodz, Poland
- Department of General Hematology, Copernicus Memorial Hospital, 93-510 Lodz, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Ewa Robak
- Department of Dermatology, Medical University of Lodz, 90-647 Lodz, Poland;
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10
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Fattah YH, Crasto D, Liu SS, Linhares Y, Kerdel F, Hanly A, Karai LJ. DUSP22-IRF4 Rearranged CD30-Positive Primary Cutaneous Lymphoproliferative Disorder With Gamma/Delta Phenotype. Am J Dermatopathol 2023; 45:831-834. [PMID: 37883980 DOI: 10.1097/dad.0000000000002573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT CD30-positive primary cutaneous lymphoproliferative disorders (CD30 + PCLPD) are a heterogeneous group of cutaneous T-cell lymphoma (CTCL) that includes lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large cell lymphoma. They exist as a clinical and pathological spectrum, which display significant overlap and variability. The diagnosis is made based on correlation between clinical and histopathologic findings. LyP with 6p25.3 rearrangement subtype represents <5% of LyP cases and is defined by DUSP22-IRF4 rearrangement on 6p25.3 locus. The reported cases express the alpha/beta T-cell receptor and follow an indolent clinical behavior typical of LyP. The same rearrangement is detected in 28% of anaplastic large cell lymphoma. We hereby present an extraordinary case of CD30 + PCLPD with DUSP22-IRF4 rearrangement and novel expression of gamma/delta T-cell immunophenotype in a young patient. Although the gamma/delta T-cell immunophenotype has been described in many other T-cell lymphomas, this is the first reported association with CD30 + PCLPD with DUSP22-IRF4 rearrangement.
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Affiliation(s)
- Yasmin H Fattah
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
| | - David Crasto
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
| | - Shuo S Liu
- Department of Dermatology, Larkin Community Hospital, South Miami, FL
| | | | - Franz Kerdel
- Skin Center of South Miami, South Miami, FL; and
| | - Andrew Hanly
- Global Pathology, Sonic Health Care USA, Miami Lakes, FL
| | - Laszlo J Karai
- Global Pathology, Sonic Health Care USA, Miami Lakes, FL
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Tang H, Matsumoto N, Foss F, Xu M, Ahmed A. Clinicopathologic Features of Cutaneous T-Cell Lymphomas With Extracutaneous Metastasis: A Case Series. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:e405-e410. [PMID: 37659965 DOI: 10.1016/j.clml.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/29/2023] [Accepted: 08/06/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND In advanced stages, Cutaneous T-cell lymphomas (CTCL) can metastasize to extracutaneous regions. CTCL with metastasis exhibits unique clinicopathologic characteristics. PATIENTS AND METHODS This study collected 35 cases of primary CTCL with extracutaneous metastasis from a single institution over a period of 20 years. Clinicopathologic features including demographics, CD30 expression, large cell transformation, metastatic sites, T-cell receptor clonality studies and survival data were analyzed. RESULTS The study identified various CTCL entities including mycosis fungoides (MF), Sezary syndrome (SS), cutaneous anaplastic large cell lymphoma (C-ALCL), and primary cutaneous peripheral T-cell lymphoma, not otherwise specified (pcPTCL-NOS). Limited data showed that metastasis can be independent of large cell transformation and/or CD30 expression. Lymph nodes were the most common site of metastasis, followed by the bone marrow. Oropharyngeal metastasis is likely to accompany visceral organ or brain metastasis (P = .049). MF had a longer interval to metastasis than SS (P = .038). Patients with lymph node only metastasis have better survival than patients with metastasis to other sites (P = .012). CONCLUSION To the best of our knowledge, there are limited studies analyzing the clinicopathologic features of different CTCL entities with metastasis as a single population. This research provides valuable insights into the unique characteristics of metastatic CTCL.
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Affiliation(s)
- Haiming Tang
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | - Nana Matsumoto
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Francine Foss
- Department of Medicine, Section of Hematology, Yale School of Medicine, New Haven, CT
| | - Mina Xu
- Department of Pathology, Yale School of Medicine, New Haven, CT
| | - Aadil Ahmed
- Department of Pathology, Rush University Medical Center, Chicago, IL.
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12
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Almarzooqi K, Almarzooqi N, Abdelhadi Z. A Rare and Isolated Presentation of Primary Cutaneous Anaplastic Large Cell Lymphoma on the Breast. Cureus 2023; 15:e49387. [PMID: 38146564 PMCID: PMC10749640 DOI: 10.7759/cureus.49387] [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] [Accepted: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
Primary cutaneous anaplastic large-cell lymphoma (PC-ALCL) is a subtype of non-Hodgkin lymphoma belonging to the CD30+ spectrum of lymphoproliferative disorders. It constitutes the second most prevalent category within cutaneous T-cell lymphomas (CTCL), encompassing approximately 25% of cases. This disorder is characterized by its exclusive cutaneous involvement and favorable overall prognosis. Patients typically present with reddish-brown nodules, which may evolve into ulcers. Although some cases experience regression, complete resolution is uncommon. While most lesions manifest on the extremities, followed by the head and neck, the breast region may rarely be affected by PC-ALCL. Distinctions between anaplastic lymphoma kinase (ALK)-positive and ALK-negative subtypes have been documented in breast presentations, often associated with breast implants. In this context, we present an isolated PC-ALCL instance in a 26-year-old woman with no history of breast implants.
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Mu HX, Tang XQ. Primary cutaneous anaplastic large cell lymphoma with over-expressed Ki-67 transitioning into systemic anaplastic large cell lymphoma: A case report. World J Clin Cases 2023; 11:6889-6894. [PMID: 37901027 PMCID: PMC10600844 DOI: 10.12998/wjcc.v11.i28.6889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) differs from systemic anaplastic large cell lymphoma (sALCL) in cell biological behavior, clinical features, treatment, and outcome. PC-ALCL has been reported to rarely transition into sALCL, but the underlying mechanism is not clear. Here we report such a case with certain characteristics that shed light on this. CASE SUMMARY Herein, we report a 43-year-old male with symptoms of a skin nodule and histologically confirmed PC-ALCL with high expression of Ki-67. After three months of observation, two skin nodules re-appeared with muscle layer involvement and was histologically confirmed as sALCL. Seventeen months after receiving six cycles of CHOP regimen, the patient had pain in the chest and back, cough, shortness of breath, and night sweats. This was confirmed as relapse of sALCL by immunohistochemistry and several organs, such as the lung were involved as shown by positron emission tomography/computed tomography. After four cycles of DICE plus chidamide regimens followed by auto-hematopoietic stem cell transplantation (ASCT), complete remission (CR) duration was achieved for twelve months while the patient was on maintenance with chidamide (20 mg) pills. CONCLUSION This case had significantly high expression of Ki-67 when diagnosed as PC-ALCL initially and then transitioned into sALCL, which is rare. Auto-ASCT combined with demethylation drugs effectively maintained CR and prolonged progression free survival.
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Affiliation(s)
- Hai-Xi Mu
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Xiao-Qiong Tang
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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14
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Saleh JS, Subtil A, Hristov AC. Primary cutaneous T-cell lymphoma: a review of the most common entities with focus on recent updates. Hum Pathol 2023; 140:75-100. [PMID: 37802757 DOI: 10.1016/j.humpath.2023.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 10/08/2023]
Abstract
Cutaneous T-cell lymphomas are an heterogeneous group of uncommon lymphoid neoplasms that are challenging to diagnose and require close collaboration between dermatologists, pathologists and hematologists/oncologists. This article reviews the most common cutaneous T-cell lymphomas: mycosis fungoides (both classic and variant forms) as well as its leukemic counterpart Sézary syndrome, CD30+ T-cell lymphoproliferative disorders including the ever-expanding group of lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and primary cutaneous CD4+ small/medium lymphoproliferative disorder. We discuss the classic clinical and histopathologic features of these lymphomas and review how they can be distinguished from reactive entities. In particularly, updates to these diagnostic categories and current controversies in classification are highlighted. Moreover, we review the prognosis and treatment for each entity. These lymphomas exhibit variable prognosis, and therefore it is important to correctly classify atypical cutaneous T-cell infiltrates for appropriate patient treatment and prognosis. Cutaneous T-cell lymphomas are at the interface of several medical specialties; this review seeks to summarize key features of these lymphomas and highlight new and emerging insights into these lymphomas.
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Affiliation(s)
- Jasmine S Saleh
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antonio Subtil
- Department of Pathology, Royal Jubilee Hospital, University of British Columbia, Victoria, British Columbia, V8R1J8, Canada
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA.
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15
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Fernandez-Flores A, Cassarino D. CD30 in Cutaneous Pathology. Am J Dermatopathol 2023; 45:593-607. [PMID: 37625801 DOI: 10.1097/dad.0000000000002422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
ABSTRACT The discovery of CD30 as a diagnostic marker was essential in the identification of not only some lymphomas but also many other solid tumors and benign reactive conditions. Many CD30+ cutaneous disorders and tumors have been categorized since the identification of the marker. With the design of targeted therapies against CD30+ tumoral cells, the interest in CD30 determination was not only diagnostic but also mainly therapeutic. In this article, we explore the historical aspects of the discovery of CD30 and examine the main CD30-related cutaneous pathology, susceptible of anti-CD30 modern treatments.
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Affiliation(s)
- Angel Fernandez-Flores
- Dermatopathologist, Department of Histopathology, University Hospital El Bierzo, Ponferrada, Spain
- Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain
- Research Department, Institute for Biomedical Research of a Coruña (INIBIC), University of a Coruña (UDC), A Coruña, Spain; and
| | - David Cassarino
- Pathologist, Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Departments of Pathology and Dermatology, Los Angeles, CA
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16
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Saleh JS, Subtil A, Hristov AC. Primary cutaneous T-cell lymphoma: a review of the most common entities with focus on recent updates. Hum Pathol 2023; 138:76-102. [PMID: 37307932 DOI: 10.1016/j.humpath.2023.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
Cutaneous T-cell lymphomas are an heterogeneous group of uncommon lymphoid neoplasms that are challenging to diagnose and require close collaboration between dermatologists, pathologists and hematologists/oncologists. This article reviews the most common cutaneous T-cell lymphomas: mycosis fungoides (both classic and variant forms) as well as its leukemic counterpart Sézary syndrome, CD30+ T-cell lymphoproliferative disorders including the ever-expanding group of lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and primary cutaneous CD4+ small/medium lymphoproliferative disorder. We discuss the classic clinical and histopathologic features of these lymphomas and review how they can be distinguished from reactive entities. In particularly, updates to these diagnostic categories and current controversies in classification are highlighted. Moreover, we review the prognosis and treatment for each entity. These lymphomas exhibit variable prognosis, and therefore it is important to correctly classify atypical cutaneous T-cell infiltrates for appropriate patient treatment and prognosis. Cutaneous T-cell lymphomas are at the interface of several medical specialties; this review seeks to summarize key features of these lymphomas and highlight new and emerging insights into these lymphomas.
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Affiliation(s)
- Jasmine S Saleh
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Antonio Subtil
- Department of Pathology, Royal Jubilee Hospital, University of British Columbia, Victoria, British Columbia, V8R1J8, Canada
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA.
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17
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Dumitru AV, Țăpoi DA, Halcu G, Munteanu O, Dumitrascu DI, Ceaușu MC, Gheorghișan-Gălățeanu AA. The Polyvalent Role of CD30 for Cancer Diagnosis and Treatment. Cells 2023; 12:1783. [PMID: 37443818 PMCID: PMC10341339 DOI: 10.3390/cells12131783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
CD30, also known as TNFRSF8 (tumor necrosis factor receptor superfamily member 8), is a protein receptor that is heavily glycosylated inside the Golgi apparatus, as well as a tumor marker that is found on the surface of specific cells in the body, including certain immune cells and cancer ones. This review aims to shed light on the critical importance of CD30, from its emergence in the cell to its position in diagnosing various diseases, including Hodgkin lymphoma, where it is expressed on Hodgkin and Reed-Sternberg cells, as well as embryonal carcinoma, anaplastic large cell lymphoma (ALCL), and cutaneous T-cell lymphoma (CTCL). In addition to its role in positive diagnosis, targeting CD30 has been a promising approach treating CD30-positive lymphomas, and there is ongoing research into the potential use of CD30-targeted therapies for autoimmune disorders. We aim to elaborate on CD30's roles as a tumor marker, supporting thus the hypothesis that this receptor might be the aim of cytostatic treatment.
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Affiliation(s)
- Adrian Vasile Dumitru
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Dana Antonia Țăpoi
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Georgian Halcu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, Colțea Clinical Hospital, 030171 Bucharest, Romania
| | - Octavian Munteanu
- Department of Anatomy, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Obstetrics and Gynecology, University Emergency Hospital, 050098 Bucharest, Romania
| | - David-Ioan Dumitrascu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mihail Constantin Ceaușu
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.V.D.); (M.C.C.)
- Department of Pathology, Alexandru Trestioreanu Institute of Oncology, 022328 Bucharest, Romania
| | - Ancuța-Augustina Gheorghișan-Gălățeanu
- Department of Cellular and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania
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18
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Pan PY, Liao JB, Hsieh SM, Tseng HW. Vesicular Lymphomatoid Papulosis With DUSP22-IRF4 Rearrangement on Chromosome 6p25.3: A Case Report. Am J Dermatopathol 2023; 45:391-396. [PMID: 36939126 DOI: 10.1097/dad.0000000000002403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
ABSTRACT Lymphomatoid papulosis (LyP) with DUSP22-IRF4 rearrangement on chromosome 6p25.3 is a newly identified subtype of LyP. It is characterized by an older age of onset, localized skin lesions, with good prognosis, and it resembles a hybrid of LyP types B and C in histopathology. A limited number of cases have been reported so far. In this article, we reported a case of a 72-year-old man with recurrent episodes of widespread multiple discrete papular or vesicular eruptions on a region of the head, trunk, and 4 extremities for about 3 years. Histopathological examination of a vesicle revealed a subepidermal blister with abundant atypical lymphocytes in the vesicular space, band-like infiltrates in the papillary dermis, along with epidermotropism and pilosebaceous structure involvement. Fluorescence in situ hybridization analysis further demonstrated DUSP22-IRF4 rearrangement on chromosome 6p25.3. A diagnosis of vesicular LyP with this rare subtype was made according to the clinical and pathological findings.
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Affiliation(s)
- Po-Yang Pan
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jia-Bin Liao
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Min Hsieh
- Department of Clinical Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hui-Wen Tseng
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan; and
- Ministry of Health and Welfare Pintung Hospital, Pintung, Taiwan
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19
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Qiu L, Tang G, Li S, Vega F, Lin P, Wang SA, Wang W, Iyer SP, Malpica L, Miranda RN, Konoplev S, Tang Z, Fang H, Medeiros LJ, Xu J. DUSP22 rearrangement is associated with a distinctive immunophenotype but not outcome in patients with systemic ALK-negative anaplastic large cell lymphoma. Haematologica 2023; 108:1604-1615. [PMID: 36453104 PMCID: PMC10230410 DOI: 10.3324/haematol.2022.281222] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/07/2022] [Indexed: 08/28/2023] Open
Abstract
DUSP22 rearrangement (R) has been associated with a favorable outcome in systemic ALK-negative anaplastic large cell lymphoma (ALCL). However, a recent study found that patients with DUSP22-R ALK-negative ALCL have a poorer prognosis than was reported initially. In this study, we compared the clinicopathological features and outcomes of patients with ALKnegative ALCL with DUSP22-R (n=22) versus those without DUSP22-R (DUSP22-NR; n=59). Patients with DUSP22-R ALCL were younger than those with DUSP22-NR neoplasms (P=0.049). DUSP22-R ALK-negative ALCL cases were more often positive for CD15, CD8, and less frequently expressed pSTAT3Tyr705, PD-L1, granzyme B and EMA (all P<0.05). TP63 rearrangement (TP63-R) was detected in three of the 66 (5%) ALK-negative ALCL cases tested and none of these cases carried the DUSP22-R. Overall survival of patients with DUSP22-R ALCL was similar to that of the patients with DUSP22-NR neoplasms regardless of International Prognostic Index score, stage, age, or stem cell transplantation status (all P>0.05), but was significantly shorter than that of the patients with ALK-positive ALCL (median overall survival 53 months vs. undefined, P=0.005). Five-year overall survival rates were 40% for patients with DUSP22-R ALCL versus 82% for patients with ALK-positive ALCL. We conclude that DUSP22-R neoplasms represent a distinctive subset of ALK-negative ALCL. However, in this cohort DUSP22-R was not associated with a better clinical outcome. Therefore, we suggest that current treatment guidelines for this subset of ALK-negative ALCL patients should not be modified at present.
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Affiliation(s)
- Lianqun Qiu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Swaminathan P Iyer
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center
| | - Luis Malpica
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Sergej Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center.
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20
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Bhabha FK, McCormack C, Campbell BA, Lade S, Buelens O, Van Der Weyden C, Prince HM. CD30-positive lymphoproliferative disorders-An Australian Clinical Practice Statement from the Peter MacCallum Cancer Centre. Australas J Dermatol 2023; 64:194-203. [PMID: 36892928 DOI: 10.1111/ajd.14016] [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: 07/31/2022] [Revised: 02/01/2023] [Accepted: 02/12/2023] [Indexed: 03/10/2023]
Abstract
The CD30-postive lymphoproliferative disorders, including lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, account for up to 30% of all cutaneous T-cell lymphomas (CTCLs) and are the second most common form of CTCLs after mycosis fungoides. Both conditions differ in their clinical presentations; however, they share the expression of the CD30 antigen as a common immunophenotypic hallmark. There is a wide spectrum of management options depending on factors such as extent of disease, staging and treatment tolerability. This Clinical Practice Statement is reflective of the current clinical practice in Australia.
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Affiliation(s)
- Friyana K Bhabha
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Christopher McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Belinda A Campbell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Stephen Lade
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Odette Buelens
- Nurse Practitioner, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Carrie Van Der Weyden
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - H Miles Prince
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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21
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Diagnosis and management of cutaneous lymphomas and lymphoid proliferations in children, adolescents and young adults (CAYA). Best Pract Res Clin Haematol 2023; 36:101448. [PMID: 36907638 DOI: 10.1016/j.beha.2023.101448] [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: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Cutaneous lymphomas and lymphoid proliferations (LPD) in children, adolescents, and young adults (CAYA) are a heterogeneous group of lymphoid neoplasms that present formidable diagnostic challenges to clinicians and pathologists alike. Although rare overall, cutaneous lymphomas/LPD occur in real-world settings and awareness of the differential diagnosis, potential complications, and various therapeutic approaches will help ensure the optimal diagnostic work-up and clinical management. Lymphomas/LPD involving the skin can occur as primary cutaneous disease in a patient that characteristically has lymphoma/LPD confined to the skin, or as secondary involvement in patients with systemic disease. This review will comprehensively summarize both primary cutaneous lymphomas/LPD that occur in the CAYA population as well as those CAYA systemic lymphomas/LPD with propensity for secondary cutaneous involvement. Focus on the most common primary entities occurring in CAYA will include lymphomatoid papulosis, primary cutaneous anaplastic large cell lymphoma, mycosis fungoides, subcutaneous panniculitis-like T-cell lymphoma, and hydroa vacciniforme lymphoproliferative disorder.
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22
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Osto M, Afify O, Musa A, Ahmed U, Rehman R, Mehregan D. Woringer-Kolopp disease (localized pagetoid reticulosis): a systematic review. Int J Dermatol 2023; 62:312-321. [PMID: 35485962 DOI: 10.1111/ijd.16224] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 03/08/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Woringer-Kolopp disease (WKD), also known as localized pagetoid reticulosis, is a rare variant of mycosis fungoides as described by the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification system for cutaneous lymphomas. Our objective was to conduct a comprehensive review that describes and evaluates patient demographics, clinical presentation, immunohistochemical findings, management, and outcomes of WKD. METHODS The databases PubMed, Embase, and Cochrane Library were searched for relevant literature. Patient demographics, imaging, treatments, and other clinical characteristics were obtained. The literature search was conducted on December 7, 2020. Studies were included if they contained primary data related to WKD. Non-pertinent studies, non-English studies, non-human studies, review articles, or studies with insufficient case information were excluded. The quality of the included studies and the risk of bias were evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation Group (GRADE) criteria (2016), Oxford Centre for Evidence-Based Medicine: Levels of Evidence (OCEBM) (March 2009), and the Methodological Index for Non-Randomized Studies (MINORS) criteria (2003). RESULTS A total of 84 studies with 143 patients met the inclusion criteria for this study. The most common chief complaint was an asymptomatic, slow-growing, and erythematous plaque. The average time from initial skin eruption to presentation was 97.6 months. Histologically, 128 cases of WKD displayed epidermotropism (97.7%). Various therapies, including radiotherapy, surgery, and local chemotherapy, were used. In total, 92 (78.6%) cases had complete remission and 11 (9.4%) cases recurred. CONCLUSIONS WKD is a rare cutaneous T-cell lymphoma that often presents as a single plaque on the extremities with an indolent course and a favorable prognosis. However, it is often misdiagnosed, leading to delays in treatment. The diagnosis of WKD involves clinical appraisal, a biopsy of suspicious lesions, and immunohistochemistry. Monotherapy appears to be preferred compared to combination therapy for WKD with radiotherapy demonstrating among the highest cure rates and lowest recurrence. Future retrospective and prospective studies are needed to accurately determine the epidemiology, prognosis, and effective treatments for WKD. Limitations include a possibility of missed studies, heterogeneity in reporting methods, publication, and selection bias.
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Affiliation(s)
- Muhammad Osto
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Omar Afify
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Arif Musa
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Uddin Ahmed
- Michigan State University College of Osteopathic Medicine, Lansing, Michigan, USA
| | - Rafey Rehman
- Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Darius Mehregan
- Wayne State University School of Medicine, Detroit, Michigan, USA
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23
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. [Translated article] Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T291-T298. [PMID: 36848951 DOI: 10.1016/j.ad.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+ lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, Spain
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, Spain
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, Spain
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, Spain
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, Spain
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, Spain
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, Spain
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, Spain
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, Spain
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, Spain
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, Spain
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, Spain
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, Spain
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, Spain
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, Spain
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, Spain
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, Spain; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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24
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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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25
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Goodlad JR, Cerroni L, Swerdlow SH. Recent advances in cutaneous lymphoma-implications for current and future classifications. Virchows Arch 2023; 482:281-298. [PMID: 36278991 PMCID: PMC9852132 DOI: 10.1007/s00428-022-03421-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/27/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023]
Abstract
The Revised European-American Classification of mature lymphoid neoplasms published in 1994 and the 2001, 2008 and 2016 WHO classifications that followed, were the product of international collaboration and consensus amongst haematopathologists, geneticists, molecular scientists and clinicians. Primary cutaneous lymphomas were fully incorporated into this process following the publication of the WHO-EORTC classification of cutaneous lymphomas in 2005. The definition, diagnostic criteria and recommended studies for primary cutaneous lymphoma continue to be refined. The 2022 International Consensus Classification represents the most recent update and an overview of all the main entities presenting primarily in the skin, together with the major changes in classification, are summarized herein. Primary cutaneous marginal zone lymphoma is segregated from other extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma) and downgraded to a lymphoproliferative disorder in line with its markedly indolent behaviour. In addition, two subtypes are recognised, based largely but not exclusively on whether they are heavy chain class-switched or IgM positive. Similarly, in keeping with a trend to greater conservatism, primary cutaneous acral CD8 positive T cell lymphoma is now also classified as a lymphoproliferative disorder. In addition, significant new insights into the biology of primary cutaneous lymphoma have also recently been forthcoming and will be presented. These studies have enhanced our knowledge of genetic, epigenetic and transcriptional changes in this group of diseases. They not only identify potential targets for novel therapies, but also raise as yet unanswered questions as to how we categorise cutaneous lymphomas, particularly with respect to relationships with similar lymphomas at extracutaneous sites.
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Affiliation(s)
- JR Goodlad
- Department of Pathology, NHS Greater Glasgow and Clyde, Level 3 Laboratory Medicine Building Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF UK
| | - L Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - SH Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
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26
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Falkenhain-López D, Muniesa C, Estrach MT, Morillo-Andújar M, Peñate Y, Acebo E, Pujol RM, García-Muret MP, Machan S, Medina S, Botella-Estrada R, Fernández de Misa R, Blanes M, Flórez A, Pérez-Paredes G, Izu R, Yanguas I, Silva-Díaz E, Pérez-Ferriols A, Prieto-Torres L, Zayas A, Parera-Amer ME, Pérez A, Aspe L, Román C, Sánchez-Caminero MP, Bassas-Vila J, Domínguez-Auñón JD, Calzado L, Navedo M, Ortiz-Prieto A, Servitje O, Polo-Rodríguez I, Torres I, Hernández-Hernández MN, Mitxelena-Eceiza J, García-Vázquez A, García-Doval I, Ortiz-Romero PL. Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. ACTAS DERMO-SIFILIOGRAFICAS 2022; 114:291-298. [PMID: 36529273 DOI: 10.1016/j.ad.2022.11.010] [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: 11/02/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.
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Affiliation(s)
- D Falkenhain-López
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - C Muniesa
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - M T Estrach
- Departamento de Dermatología, Hospital Clínico, IDIBAPS, Universitario de Barcelona, Barcelona, España
| | - M Morillo-Andújar
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España
| | - Y Peñate
- Departamento de Dermatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Gran Canaria, España
| | - E Acebo
- Departamento de Dermatología, Hospital Universitario de Cruces, Barakaldo, Bizkaia, España
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Barcelona, España
| | - M P García-Muret
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, UAB Barcelona, Barcelona, España
| | - S Machan
- Departamento de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - S Medina
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - R Botella-Estrada
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - R Fernández de Misa
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - M Blanes
- Departamento de Dermatología, Hospital General Universitario de Alicante, Alicante, España
| | - A Flórez
- Departamento de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España
| | - G Pérez-Paredes
- Departamento de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander Cantabria, España
| | - R Izu
- Departamento de Dermatología, Hospital Universitario de Basurto, Bilbao, Bizkaia, España
| | - I Yanguas
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - E Silva-Díaz
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - A Pérez-Ferriols
- Departamento de Dermatología, Hospital General Universitario de Valencia, Valencia, España
| | - L Prieto-Torres
- Departamento de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - A Zayas
- Departamento de Dermatología, Hospital Universitario Dr. Peset, Valencia, España
| | - M E Parera-Amer
- Departamento de Dermatología, Hospital Universitario Son Llàtzer, Palma, Islas Baleares, España
| | - A Pérez
- Departamento de Dermatología, Hospital Universitario Nuestra Señora De Valme, Sevilla, España
| | - L Aspe
- Departamento de Dermatología, Hospital Universitario de Araba, Vitoria-Gasteiz, Álava, España
| | - C Román
- Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España
| | - M P Sánchez-Caminero
- Departamento de Dermatología, Hospital General de Ciudad Real, Ciudad Real, España
| | - J Bassas-Vila
- Departamento de Dermatología, Hospital Germans Trias i Pujol, Barcelona, España
| | - J D Domínguez-Auñón
- Departamento de Dermatología, Hospital Universitario del Henares, Coslada, Madrid, España
| | - L Calzado
- Departamento de Dermatología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España
| | - M Navedo
- Departamento de Dermatología, Complejo Asistencial Universitario de León, León, España
| | - A Ortiz-Prieto
- Departamento de Dermatología, Hospital Puerta del Mar, Cádiz, España
| | - O Servitje
- Departamento de Dermatología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - I Polo-Rodríguez
- Departamento de Dermatología, Hospital Universitario Príncipe de Asturias, Madrid, España
| | - I Torres
- Departamento de Dermatología, Hospital Universitario La Fe, Valencia, España
| | - M N Hernández-Hernández
- Departamento de Dermatología, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España
| | - J Mitxelena-Eceiza
- Departamento de Dermatología Complejo Hospitalario de Navarra, Navarra, España
| | - A García-Vázquez
- Departamento de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - I García-Doval
- Unidad de Investigación, Fundación Piel Sana AEDV, León, España; Departamento de Dermatología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España
| | - P L Ortiz-Romero
- Departamento de Dermatología, Hospital Universitario 12 de Octubre, Madrid, España
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27
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LaTour D, Lee MP, Gardner JT, Dao H, Kerstetter J, Elsensohn A. Pseudocarcinomatous Hyperplasia Masquerading as a Well-Differentiated Squamous Cell Carcinoma Associated With Primary Cutaneous Anaplastic Large-Cell Lymphoma. Am J Dermatopathol 2022; 44:952-954. [PMID: 36197055 DOI: 10.1097/dad.0000000000002319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]
Abstract
ABSTRACT Pseudocarcinomatous hyperplasia (PCH) is a reactive proliferation of the epidermis associated with CD30 + lymphoproliferative disorders. In this article, we report the case of a 42-year-old man who presented with a 10-year history of a solitary erythematous patch on the right thigh that progressed to an ulcerated, crusted plaque. Histologic examination revealed an infiltrate of atypical CD30 + lymphocytes consistent with primary cutaneous anaplastic large-cell lymphoma with overlying well differentiated keratinocyte hyperplasia akin to a well-differentiated invasive squamous cell carcinoma. This case demonstrates the phenomenon of pseudocarcinomatous hyperplasia mimicking features of invasive squamous cell carcinoma. It highlights the necessity of careful clinical correlation when diagnosing squamous cell carcinomas in younger patients on non-sun-exposed areas and the exclusion of accompanying known causes of pseudocarcinomatous hyperplasia.
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Affiliation(s)
- Donn LaTour
- School of Medicine, Loma Linda University Health, Loma Linda, CA
| | - Michael P Lee
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA; and
| | - Jeffrey T Gardner
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA; and
| | - Harry Dao
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA; and
| | - Justin Kerstetter
- Department of Pathology and Human Anatomy, Loma Linda University Health, Loma Linda, CA
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA; and
- Department of Pathology and Human Anatomy, Loma Linda University Health, Loma Linda, CA
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28
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Nowicka D, Mertowska P, Mertowski S, Hymos A, Forma A, Michalski A, Morawska I, Hrynkiewicz R, Niedźwiedzka-Rystwej P, Grywalska E. Etiopathogenesis, Diagnosis, and Treatment Strategies for Lymphomatoid Papulosis with Particular Emphasis on the Role of the Immune System. Cells 2022; 11:cells11223697. [PMID: 36429125 PMCID: PMC9688547 DOI: 10.3390/cells11223697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/04/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022] Open
Abstract
Lymphomatoid papulosis (LyP) is a very rare disease that belongs to the group of CD30+ lymphoproliferative skin diseases. LyP is localized or generalized and usually presents as isolated or clustered red/brown-red lesions in the form of nodules and/or papules. The course of the disease is in most cases mild; however, depending on concomitant risk factors and history, it may progress to lymphoma, significantly reducing the survival rate and prognosis. Importantly, the clinical picture of the disease remains somewhat ambiguous, leading to a large number of misdiagnoses that result in inappropriate treatment, which is usually insufficient to alleviate symptoms. In addition to clinical manifestations, the histological characteristics vary widely and usually overlap with other conditions, especially those belonging to the group of lymphoproliferative disorders. Although diagnosis remains a challenge, several recommendations and guidelines have been introduced to standardize and facilitate the diagnostic process. This article reviews the available literature on the most important aspects of etiopathogenesis, clinical and histopathological features, diagnostic criteria, and possible treatment strategies for LyP, with particular emphasis on the role of the immune system.
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Affiliation(s)
- Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wrocław Medical University, 50-368 Wrocław, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Anna Hymos
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland
| | - Adam Michalski
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Izabela Morawska
- Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland
| | - Rafał Hrynkiewicz
- Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
| | | | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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29
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Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas. Diagnostics (Basel) 2022; 12:diagnostics12082001. [PMID: 36010351 PMCID: PMC9407466 DOI: 10.3390/diagnostics12082001] [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: 07/17/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells. PTCLs comprise numerous disease entities, with over 30 distinct entities listed in the latest WHO classification. They predominantly affect adults and elderly people and usually exhibit an aggressive clinical course with poor prognosis. According to their presentation, PTCLs can be divided into nodal, extranodal or cutaneous, and leukemic types. The most frequent primary sites of PTCLs are lymph nodes, with over half of cases showing nodal presentation. Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified. Adult T-cell leukemia/lymphoma also frequently affects lymph nodes. Recent pathological and molecular findings in nodal PTCLs have profoundly advanced the identification of tumor signatures and the refinement of the classification. Therefore, the therapies and pathological diagnosis of nodal PTCLs are continually evolving. This paper aims to provide a summary and update of the pathological and molecular features of nodal PTCLs, which will be helpful for diagnostic practice.
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30
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Kumar S, Dhamija B, Attrish D, Sawant V, Sengar M, Thorat J, Shet T, Jain H, Purwar R. Genetic alterations and oxidative stress in T cell lymphomas. Pharmacol Ther 2022; 236:108109. [PMID: 35007658 DOI: 10.1016/j.pharmthera.2022.108109] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/20/2022]
Abstract
T cell lymphomas encompass a diverse group of Non-Hodgkin lymphomas with a wide spectrum of clinical, immunological and pathological manifestations. In the last two decades there has been a progress in our understanding of the cell of origin, genetic abnormalities and their impact on behaviour in T cell lymphomas. Genetic alterations are one of the critical drivers of the pathogenesis of T cell lymphoma. Disease progression has been correlated with multiple genetic abnormalities where malignant clones arise primarily out of the host immune surveillance arsenal. There are many cellular processes involved in disease development, and some of them are T cell signaling, differentiation, epigenetic modifications, and immune regulation. Modulation of these crucial pathways via genetic mutations and chromosomal abnormalities possessing either point or copy number mutations helps tumor cells to develop a niche favourable for their growth via metabolic alterations. Several metabolic pathways especially regulation of redox homeostasis is critical in pathogenesis of lymphoma. Disruption of redox potential and induction of oxidative stress renders malignant cells vulnerable to mitochondrial damage and triggers apoptotic pathways causing cell death. Targeting genetic abnormalities and oxidative stress along with current treatment regime have the potential for improved therapeutics and presents new combination approaches towards selective treatment of T cell lymphomas.
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Affiliation(s)
- Sushant Kumar
- Department of Biosciences & Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra 400076, India
| | - Bhavuk Dhamija
- Department of Biosciences & Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra 400076, India
| | - Diksha Attrish
- Department of Biosciences & Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra 400076, India
| | - Vinanti Sawant
- Department of Biosciences & Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra 400076, India
| | - Manju Sengar
- Medical Oncology, Tata memorial Hospital, Mumbai, Maharashtra 400012, India
| | - Jayashree Thorat
- Medical Oncology, Tata memorial Hospital, Mumbai, Maharashtra 400012, India
| | - Tanuja Shet
- Medical Oncology, Tata memorial Hospital, Mumbai, Maharashtra 400012, India
| | - Hasmukh Jain
- Medical Oncology, Tata memorial Hospital, Mumbai, Maharashtra 400012, India
| | - Rahul Purwar
- Department of Biosciences & Bioengineering, Indian Institute of Technology Bombay, Mumbai, Maharashtra 400076, India.
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31
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Jung JM, Lee MY, Won CH, Chang SE, Park CS, Lee MW, Lee WJ. Clinicopathological Factors Associated with the Prognosis and Chronicity of Lymphomatoid Papulosis: A Retrospective Cohort Study. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2022; 22:e541-e548. [PMID: 35307318 DOI: 10.1016/j.clml.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The clinical and pathological features of lymphomatoid papulosis (LYP) are diverse. The objective of this study is to evaluate the clinical and pathological features associated with the prognosis and clinical course of LYP. PATIENTS AND METHODS The clinical and pathological features of LYP in a medical center database were retrospectively retrieved. RESULTS Overall, 58 LYP patients were included in the study. The mean age at diagnosis was 39.1 years and the female-to-male ratio was 1:1.2. More than two-thirds (40/58, 69.0%) of the patients showed a chronic and recurrent disease course. A longer pre-diagnosis duration (odds ratio (OR), 1.01; 95% confidence interval (CI), 1.00-1.03) was significantly associated with secondary lymphoma development. Lower extremity involvement (OR, 10.40; 95% CI, 1.17-92.28) and the absence of eosinophils in the lesions (OR, 11.28; 95% CI, 1.01-126.24) were found to be significantly associated with the chronic and recurrent course of LYP. CONCLUSION A longer pre-diagnosis duration is associated with secondary lymphoma, while a lower extremity involvement and the absence of lesional eosinophil infiltration are associated with the chronicity of LYP.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Young Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Chan-Sik Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Songpa-gu, Seoul, Korea.
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32
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Wechsler J, Ingen-Housz-Oro S, Deschamps L, Brunet-Possenti F, Deschamps J, Delfau MH, Calderaro J, Ortonne N. Prevalence of T-cell antigen losses in mycosis fungoides and CD30-positive cutaneous T-cell lymphoproliferations in a series of 153 patients. Pathology 2022; 54:729-737. [DOI: 10.1016/j.pathol.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 10/18/2022]
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33
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Heng SSL, Mat Johar F, Ganandran T, Mohd Fauzi NA, Hussain FA, Wan Sulaiman WA. Master of mimicry: Rare primary cutaneous anaplastic large cell lymphoma presenting as fungating parotid tumor–case report and review. Int J Surg Case Rep 2022; 94:107135. [PMID: 35658304 PMCID: PMC9077532 DOI: 10.1016/j.ijscr.2022.107135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/21/2022] Open
Affiliation(s)
- Sophia Si Ling Heng
- Plastic, Reconstructive and Aesthetic Surgery Unit, Department of Surgery, Faculty of Health and Medical Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia; Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia; Reconstructive Sciences Unit, Hospital Universiti Sains Malayisa, Jalan Raja Perempuan Zainab II, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - Fatimah Mat Johar
- Reconstructive Sciences Unit, Hospital Universiti Sains Malayisa, Jalan Raja Perempuan Zainab II, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - Thevarasan Ganandran
- Reconstructive Sciences Unit, Hospital Universiti Sains Malayisa, Jalan Raja Perempuan Zainab II, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
| | - Nurul Anis Mohd Fauzi
- Department of Otorhinolaryngology-Head and Neck Surgery, Universiti Sains Malaysia, Kelantan, Malaysia.
| | | | - Wan Azman Wan Sulaiman
- Reconstructive Sciences Unit, Hospital Universiti Sains Malayisa, Jalan Raja Perempuan Zainab II, Kubang Kerian, 16150 Kota Bharu, Kelantan, Malaysia.
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34
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Gupta I, Ramteke P, Narwal A, Sharma MC, Bakhshi S, Mallick S. ALK-Negative Primary Cutaneous Anaplastic Large Cell Lymphoma With Systemic Involvement or Systemic ALCL With Cutaneous Lesion. A Diagnostic Dilemma. Am J Dermatopathol 2022; 44:376-379. [PMID: 35234192 DOI: 10.1097/dad.0000000000002168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Primary cutaneous anaplastic large-cell lymphoma (C-ALCL) is a cutaneous CD30-positive lymphoproliferative disorder. The patients usually present with single or multiple cutaneous nodules or papules and about 10% cases present with extracutaneous manifestations, which are predominantly in the form of regional lymph nodal involvement. Visceral involvement especially pulmonary or hepatic involvement in C-ALCL is only rarely described in the scientific literature. Approximately 20%-42% cases show spontaneous regression, about 50% cases may recur; however, C-ALCL generally carries a good prognosis. We present a rare case of primary C-ALCL in a 66-year-old man with regional lymph nodal and hepatic involvement. Differential diagnostic entities are discussed in this report with the review of the literature.
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Affiliation(s)
| | | | | | | | - Sameer Bakhshi
- Medical Oncology, Dr B. R. A. Institute Rotary Cancer Hospital (Dr. B. R. A. IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, India
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35
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Primary cutaneous lymphoma: the 2018 update of the WHO-EORTC classification. Presse Med 2022; 51:104126. [DOI: 10.1016/j.lpm.2022.104126] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/02/2022] [Indexed: 11/22/2022] Open
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36
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Anaplastic Large Cell Lymphoma: Molecular Pathogenesis and Treatment. Cancers (Basel) 2022; 14:cancers14071650. [PMID: 35406421 PMCID: PMC8997054 DOI: 10.3390/cancers14071650] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Anaplastic large cell lymphoma is a rare type of disease that occurs throughout the world and has four subtypes. A summary and comparison of these subtypes can assist with advancing our knowledge of the mechanism and treatment of ALCL, which is helpful in making progress in this field. Abstract Anaplastic large cell lymphoma (ALCL) is an uncommon type of non-Hodgkin’s lymphoma (NHL), as well as one of the subtypes of T cell lymphoma, accounting for 1 to 3% of non-Hodgkin’s lymphomas and around 15% of T cell lymphomas. In 2016, the World Health Organization (WHO) classified anaplastic large cell lymphoma into four categories: ALK-positive ALCL (ALK+ALCL), ALK-negative ALCL (ALK−ALCL), primary cutaneous ALCL (pcALCL), and breast-implant-associated ALCL (BIA-ALCL), respectively. Clinical symptoms, gene changes, prognoses, and therapy differ among the four types. Large lymphoid cells with copious cytoplasm and pleomorphic characteristics with horseshoe-shaped or reniform nuclei, for example, are found in both ALK+ and ALK−ALCL. However, their epidemiology and pathogenetic origins are distinct. BIA-ALCL is currently recognized as a new provisional entity, which is a noninvasive disease with favorable results. In this review, we focus on molecular pathogenesis and management of anaplastic large cell lymphoma.
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Aggressive Primary Cutaneous Anaplastic T-Cell Lymphoma Successfully Treated with Autologous Stem Cell Transplant and Brentuximab Vedotin Consolidation: Case Report and Review of the Literature. Hematol Rep 2022; 14:61-66. [PMID: 35466174 PMCID: PMC9036212 DOI: 10.3390/hematolrep14020010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/21/2022] Open
Abstract
Primary cutaneous CD30+ lymphoproliferative disorders include primary cutaneous anaplastic large cell lymphoma (pcALCL) and lymphomatoid papulosis. The prognosis of the disease is usually excellent but, in a minority of cases, it presents with extracutaneous involvement and aggressive behavior. The case we present—relapsed after surgical excision, immunosuppressive therapy, and conventional chemotherapy—is the first one treated with Autologous Stem Cell transplant followed by Brentuximab Vedotin consolidation, a scheme already used for high risk Hodgkin Lymphoma.
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Genetic profiling and biomarkers in peripheral T-cell lymphomas: current role in the diagnostic work-up. Mod Pathol 2022; 35:306-318. [PMID: 34584212 DOI: 10.1038/s41379-021-00937-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/08/2022]
Abstract
Peripheral T-cell lymphomas are a heterogeneous, and usually aggressive, group of mature T-cell neoplasms with overlapping clinical, morphologic and immunologic features. A large subset of these neoplasms remains unclassifiable with current diagnostic methods ("not otherwise specified"). Genetic profiling and other molecular tools have emerged as widely applied and transformative technologies for discerning the biology of lymphomas and other hematopoietic neoplasms. Although the application of these technologies to peripheral T-cell lymphomas has lagged behind B-cell lymphomas and other cancers, molecular profiling has provided novel prognostic and diagnostic markers as well as an opportunity to understand the biologic mechanisms involved in the pathogenesis of these neoplasms. Some biomarkers are more prevalent in specific T-cell lymphoma subsets and are being used currently in the diagnosis and/or risk stratification of patients with peripheral T-cell lymphomas. Other biomarkers, while promising, need to be validated in larger clinical studies. In this review, we present a summary of our current understanding of the molecular profiles of the major types of peripheral T-cell lymphoma. We particularly focus on the use of biomarkers, including those that can be detected by conventional immunohistochemical studies and those that contribute to the diagnosis, classification, or risk stratification of these neoplasms.
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Matsuzawa T, Shu J, Nakamura Y, Hino M, Ikeda JI, Sugaya M, Matsue H. Anaplastic large-cell lymphoma presenting as large ulcerated tumors and small papules in a 15-year-old girl. DERMATOL SIN 2022. [DOI: 10.4103/ds.ds_5_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Corail DR, Mondoloni M, Calvo AS, Quilhot P, Lescaille G, Baaroun V, Rochefort J. Oral manifestation of lymphomatoid papulosis: systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2021043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Lymphomatoid Papulosis (LyP) is a lymphoproliferative disorder with typical histopathological criteria and a spontaneous regression. Only few cases of oral involvement have been reported. We wondered about their clinical characteristics and their association with lymphoma. Method: This systematic review is conducted according to the PRISMA statement. The Oxford Centre for Evidence Based Medicine table (OCEBM) and the scoring from the National Agency for Accreditation and Assessment in Health (ANAES) was assigned to each study. Results: We have included 16 references. LyP can occur at any age with a female predilection. Oral lesions were unique ulcer and tongue was mostly affected. Histological types A, and C were dominant and LyP resolved spontaneously. 1 case was associated with a lymphoma. Discussion: Cutaneous LyP more affects men and are mostly classified as type A while those orals are type A or C. Oral LyP is probably a progressive lesion whose evolution is not illustrated by the histological aspect which often reflects only the initial acute period. Conclusion: Our literature review has shown that the epidemiological aspects between oral and cutaneous LyP are not the same. LyP may be associated with an increased risk of developing systemic lymphoproliferative disorders.
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Oncogenic Mutations and Gene Fusions in CD30-Positive Lymphoproliferations and Clonally Related Mycosis Fungoides Occurring in the Same Patients. JID INNOVATIONS 2021; 1:100034. [PMID: 34909731 PMCID: PMC8659398 DOI: 10.1016/j.xjidi.2021.100034] [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] [Received: 12/21/2020] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/27/2022] Open
Abstract
The emergence of a common progenitor cell has been postulated for the association of CD30-positive lymphoproliferative disease (LPD) and mycosis fungoides (MF) within the same patient. Up to now, no comprehensive analysis has yet addressed the genetic profiles of such concurrent lymphoma subtypes. We aimed to delineate the molecular alterations of clonally related CD30-positive LPD and MF occurring in the same two patients. We analyzed the molecular profile of 16 samples of two patients suffering both from CD30-positive LPD and MF being obtained over a time course of at least 5 years. To detect oncogenic mutations, we applied targeted sequencing technologies with a hybrid capture-based DNA library preparation approach, and for the identification of fusion transcripts, an anchored multiplex PCR enrichment kit was used. In all samples of CD30-positive LPD and MF, oncogenic fusions afflicting the Jak/signal transducer and activator of transcription signaling pathway were present, namely NPM1‒TYK2 in patient 1 and ILF3‒JAK2 in patient 2. Additional signal transducer and activator of transcription 5A gene STAT5A mutations exclusively occurred in lesions of CD30-positive LPD in one patient. CD30-positive LPD and MF may share genetic events when occurring within the same patients. Constitutive activation of the Jak/signal transducer and activator of transcription signaling pathway may play a central role in the molecular pathogenesis of both entities.
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Watton TC, Purzycka K, Fitzgerald E. Computed tomographic findings and clinical features in dogs with canine cutaneous lymphoma: 10 cases (2007-2018). J Am Vet Med Assoc 2021; 259:1433-1440. [PMID: 34757940 DOI: 10.2460/javma.20.11.0635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To report clinical features, CT findings, treatment protocols, and outcomes for dogs in which canine cutaneous lymphoma (CCL) was diagnosed. ANIMALS 10 client-owned dogs with CCL. PROCEDURES Medical records of dogs in which a diagnosis of CCL had been made between September 2007 and July 2018 and in which CT had been performed prior to treatment were reviewed. All available CT studies were reviewed, and an anatomical reference system was developed to map observed lesions. Treatment protocols and patient outcomes were summarized. RESULTS 14 CT examinations were performed on the 10 dogs, and 9 dogs had lesions consistent with CCL on CT images. Nodular lesions were present in 8 dogs, and cutaneous or subcutaneous mass lesions were seen in 3. Well-defined, diffusely distributed, contrast-enhancing, cutaneous or subcutaneous nodules were most common; mass lesions were more variable in appearance. Nine dogs had lymphadenopathy, with the mandibular and axillary lymph nodes most commonly affected. Four dogs had confirmed nodal involvement, and 4 had confirmed visceral involvement. Nine dogs received treatment with chemotherapy, and 5 had a complete response. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs with CCL may have a wide spectrum of CT findings. Many of these lesions, including affected lymph nodes, would be unlikely to be detected clinically, suggesting that CT may be a useful modality to assess the severity of disease and for guiding selection of local versus systemic treatment.
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Affiliation(s)
- Thom C Watton
- From the Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Katarzyna Purzycka
- From the Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Ella Fitzgerald
- From the Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
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Podkonjak T, Cranmer H, Scarisbrick J, McCarthy G, Lilley C, Cheng LI. Cost-effectiveness of brentuximab vedotin for the treatment of cutaneous T-cell lymphoma. J Comp Eff Res 2021; 11:193-202. [PMID: 34879742 DOI: 10.2217/cer-2021-0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To assess the cost-effectiveness of brentuximab vedotin (BV) versus physician's choice (methotrexate or bexarotene) for treating advanced cutaneous T-cell lymphoma. Materials & methods: A partitioned-survival model was developed from the National Health Service perspective in England and Wales. Model inputs were informed by the ALCANZA trial, real-world UK data, published literature or clinical experts. Results: Over the modeled lifetime, BV dominated physician's choice and provided an additional 1.58 life-years and 1.09 higher quality-adjusted life years with a net cost saving of £119,565. The net monetary benefit was £152,326 using a willingness-to-pay threshold of £30,000/quality-adjusted life year. Results were robust in sensitivity and scenario analyses. Conclusion: BV is a highly cost-effective treatment for advanced cutaneous T-cell lymphoma.
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Affiliation(s)
| | - Holly Cranmer
- Takeda Pharmaceuticals International Co., London, UK
| | - Julia Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham B15 2TH, UK
| | | | | | - Lung-I Cheng
- Global Value & Access Oncology, Takeda Pharmaceutical America, Inc., Lexington, MA 02421, USA
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Pathania YS, Budania A, Lahoria U, Vishwajeet V. Recurrent and Persistent Lymphomatoid Papulosis in an Elderly Male with Hodgkin's Lymphoma. Am J Med 2021; 134:1362-1364. [PMID: 34197790 DOI: 10.1016/j.amjmed.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/20/2021] [Accepted: 05/23/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Anil Budania
- Department of Dermatology, Venereology and Leprology.
| | | | - Vikarn Vishwajeet
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India
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Nguyen T, Yaghsezian A, Lin YL, Klokkevold P. An unusual case of cluster of differentiation 30-positive T-cell lymphoproliferative disorder manifesting as mandibular gingival ulceration: A case report. J Am Dent Assoc 2021; 153:175-182. [PMID: 34756592 DOI: 10.1016/j.adaj.2021.07.015] [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: 05/03/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Primary cutaneous cluster of differentiation 30-positive (CD30+) T-cell lymphoproliferative disorders are the second most common type of skin T-cell lymphoma. The lesions exhibit an indolent course, with a morphology resembling high-grade T-cell lymphoma. CASE DESCRIPTION A 67-year-old healthy man sought treatment for a large nonhealing ulcer on the buccal gingiva of the mandibular right premolars. He reported a history of recurrent cutaneous lesions, for which he was seen 1 year earlier at a hospital. Results of incisional biopsy showed a dense lymphoid cell infiltrate composed of atypical CD30+ T-cells intermixed with eosinophils. The diagnosis was updated to CD30+ T-cell lymphoproliferative disorder, which was similar to the cutaneous lesion diagnosis. The lesion area healed completely, and there were no signs of recurrence at 18-month follow-up. PRACTICAL IMPLICATIONS Oral CD30+ T-cell lymphoproliferative disorder has a favorable outcome, but it is commonly misdiagnosed. Biopsy is crucial and should be combined with clinical examination to avoid chemotherapeutic treatments intended for high-grade lymphoma.
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Genetic and epigenetic insights into cutaneous T-cell lymphoma. Blood 2021; 139:15-33. [PMID: 34570882 DOI: 10.1182/blood.2019004256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 01/30/2021] [Indexed: 11/20/2022] Open
Abstract
Primary cutaneous T-cell lymphomas (CTCL) constitute a heterogeneous group of non-Hodgkin T-cell lymphomas that present in the skin. In recent years significant progress has been made in the understanding of the pathogenesis of CTCL. Progress in CTCL classifications combined with technical advances, in particular next generation sequencing (NGS), enabled a more detailed analysis of the genetic and epigenetic landscape and transcriptional changes in clearly defined diagnostic entities. These studies not only demonstrated extensive heterogeneity between different CTCL subtypes but also identified recurrent alterations that are highly characteristic for diagnostic subgroups of CTCL. The identified alterations in particular involve epigenetic remodelling, cell cycle regulation, and the constitutive activation of targetable, oncogenic pathways. In this respect, aberrant JAK-STAT signaling is a recurrent theme, however not universal for all CTCL and with seemingly different underlaying causes in different entities. A number of the mutated genes identified are potentially actionable targets for the development of novel therapeutic strategies. Moreover, these studies have produced an enormous amount of information that will be critically important for the further development of improved diagnostic and prognostic biomarkers that can assist in the clinical management of CTCL patients. In the present review the main findings of these studies in relation to their functional impact on the malignant transformation process are discussed for different subtypes of CTCL.
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Abstract
Primary cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of lymphomas that present in the skin with no evidence of extracutaneous disease at the time of diagnosis. CTCL subtypes demonstrate a variety of clinical, histological, and molecular features, and can follow an indolent or a very aggressive course. The underlying pathogenetic mechanisms are not yet entirely understood. The pathophysiology of CTCL is complex and a single initiating factor has not yet been identified. Diagnosis is based on clinicopathological correlation and requires an interdisciplinary team. Treatment decision is made based on short-term and long-term goals. Therapy options comprise skin-directed therapies, such as topical steroids or phototherapy, and systemic therapies, such as monoclonal antibodies or chemotherapy. So far, the only curative treatment approach is allogeneic haematopoietic stem cell transplantation. Novel therapies, such as chimeric antigen receptor T cells, monoclonal antibodies or small molecules, are being investigated in clinical trials. Patients with CTCL have reduced quality of life and a lack of effective treatment options. Further research is needed to better identify the underlying mechanisms of CTCL development and course as well as to better tailor treatment strategies to individual patients.
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Merlio JP, Kadin ME. Cytokines, Genetic Lesions and Signaling Pathways in Anaplastic Large Cell Lymphomas. Cancers (Basel) 2021; 13:4256. [PMID: 34503066 PMCID: PMC8428234 DOI: 10.3390/cancers13174256] [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] [Received: 07/22/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022] Open
Abstract
ALCL is a tumor of activated T cells and possibly innate lymphoid cells with several subtypes according to clinical presentation and genetic lesions. On one hand, the expression of transcription factors and cytokine receptors triggers signaling pathways. On the other hand, ALCL tumor cells also produce many proteins including chemokines, cytokines and growth factors that affect patient symptoms. Examples are accumulation of granulocytes stimulated by IL-8, IL-17, IL-9 and IL-13; epidermal hyperplasia and psoriasis-like skin lesions due to IL-22; and fever and weight loss in response to IL-6 and IFN-γ. In this review, we focus on the biology of the main ALCL subtypes as the identification of signaling pathways and ALCL-derived cytokines offers opportunities for targeted therapies.
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Affiliation(s)
- Jean-Philippe Merlio
- Tumor Biology and Tumor Bank Laboratory, Centre Hospitalier et Universitaire de Bordeaux, 33600 Pessac, France
- INSERM U1053, University Bordeaux, 33000 Bordeaux, France
| | - Marshall E. Kadin
- Department of Pathology and Laboratory Medicine, Brown University Alpert School of Medicine, Providence, RI 02903, USA
- Department of Dermatology, Boston University, Boston, MA 02215, USA
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Wohlmuth-Wieser I. Primary cutaneous T-cell lymphomas in childhood and adolescence. J Dtsch Dermatol Ges 2021; 19:563-581. [PMID: 33861015 DOI: 10.1111/ddg.14509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Primary cutaneous lymphomas are extranodal non-Hodgkin lymphomas of T- or B- cell origin, that predominantly affect older patients but have been reported in all age groups and as early as in the first years of life. Diagnosis of cutaneous lymphomas is challenging and requires high clinical suspicion and close collaboration between dermatologists, pediatric oncologists and pathologists. Skin involvement of non-Hodgkin lymphomas in children or adolescents can either be primary cutaneous or secondary due to an underlying nodal lymphoma. The most common primary cutaneous lymphomas encountered in children are of T-cell origin, with mycosis fungoides being the most prevalent cutaneous T-cell lymphoma, followed by CD30+ lymphoproliferative disorders. While cutaneous lymphomas share clinicopathologic characteristics between juvenile and adult forms, there are important differences in terms of clinical presentation, diagnosis and treatment. The hypopigmented variant of mycosis fungoides seems to be overrepresented in the pediatric age group. Prognosis and treatment of mycosis fungoides are stage dependent. The majority of children present with early-stage disease and respond well to topical corticosteroids and phototherapy.
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Affiliation(s)
- Iris Wohlmuth-Wieser
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
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Diaz de la Pinta FJ, Machan S, Manso Alonso R, Carvajal N, Nieves Salgado R, Piris MÁ, Rodríguez Pinilla SM. DUSP22 Rearrangement in primary cutaneous T-cell Lymphoma with features intermediate between Mycosis Fungoides, Anaplastic Large-cell Lymphoma and Lymphomatoid Papulosis. Histopathology 2021; 80:446-449. [PMID: 34252219 DOI: 10.1111/his.14448] [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: 04/09/2021] [Revised: 06/23/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
A 79-year-old man with a long-standing history of eczema with no other remarkable medical history came to our hospital complaining of a round, non-ulcerated, 3-cm-diameter, tumoral nodule of sudden growth (Figure 1A, 1B). Histological study revealed a CD30+, CD3+ biphasic lymphoid infiltrate with large cells in the dermis and smaller lymphocytes that exhibited a striking epidermotropism that was also present in the contiguous epidermis, where it had a pagetoid pattern (Figure 2A, 2B, 2C, 2D, 2E). TCR-ß was positive and CD8 was focally and weakly positive. CD4, CD20, ALK, TIA1, Perforin, Granzyme, PSTAT3 and TCR-γ were all negative.
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Affiliation(s)
| | - Salma Machan
- Dermatology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Rebeca Manso Alonso
- Pathology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Nerea Carvajal
- Pathology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Rocio Nieves Salgado
- Hematology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Miguel Ángel Piris
- Pathology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
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