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Trutzer IM, Lossos IS. Relapsed mantle cell lymphoma manifesting with soft tissue tumors of the extremities: University of Miami experience and review of the literature. Ann Hematol 2024:10.1007/s00277-024-05997-1. [PMID: 39287654 DOI: 10.1007/s00277-024-05997-1] [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: 05/29/2024] [Accepted: 09/05/2024] [Indexed: 09/19/2024]
Abstract
Mantle cell lymphoma (MCL) is frequently diagnosed at advanced stages and is characterized by multiple extranodal sites of disease, most notably the bone marrow, peripheral blood, and gastrointestinal tract. Historically the prognosis of mantle cell lymphoma has been poor with median survival of four to five years. With new treatment regimens, however, patients have been able to achieve prolonged remissions and require special attention while being evaluated for relapse. This report describes four patients treated for stage IV mantle cell lymphoma at the University of Miami who developed soft tissue relapse presenting as non-tender large masses of the extremities, including one patient who presented without associated nodal involvement. Average time to soft tissue relapse was 99 months (range: 28-240) following initial diagnosis. Providers who care for patients with mantle cell lymphoma should be aware of soft tissue lesions as a presentation of mantle cell lymphoma that merits evaluation for disease relapse.
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Affiliation(s)
| | - Izidore S Lossos
- Division of Hematology, Department of Medicine, University of Miami and Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave (D8-4), Miami, FL, 33136, USA.
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2
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Geropoulos G, Psarras K, Vlachaki E, Kakos C, Vetsiou E, Vamvakis K, Sousos N, Mpouras V, Symeonidis N, Pavlidis ET, Pavlidis TE. Cutaneous manifestations of mantle cell lymphoma: an extensive literature review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [PMID: 33348938 DOI: 10.15570/actaapa.2020.38] [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: 02/05/2023]
Abstract
Mantle cell lymphomas account for about 2 to 10% of non-Hodgkin B-cell lymphomas. Despite the cellular maturity of B-cell lymphomas, the disease is aggressive in the majority of cases and its course is unpredictable. The clinical presentation is variable, and multiple nodal and extranodal manifestations have been described. Cutaneous infiltration is an uncommon (2-6%) location of the disease. An extensive review of the literature was performed, and 24 case reports and five case series were found describing cutaneous locations. These data were thoroughly studied in order to present their clinical and laboratory characteristics in this review.
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Affiliation(s)
- Georgios Geropoulos
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Kyriakos Psarras
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Efthymia Vlachaki
- Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Christos Kakos
- Department of General Surgery, Ulster Hospital, Belfast, UK
| | - Evangelia Vetsiou
- Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Sousos
- Second Department of Internal Medicine, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Mpouras
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Symeonidis
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Efstathios T Pavlidis
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Theodoros E Pavlidis
- Second Propedeutical Department of Surgery, Aristotle University of Thessaloniki, Ippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece
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3
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Fajardo DA, France J, Targonska BI, Kahlon HB, Coppes MJ. Mantle Cell Lymphoma Presenting as a Subcutaneous Mass of the Right Leg. Case Rep Oncol 2020; 13:774-782. [PMID: 32774275 PMCID: PMC7383204 DOI: 10.1159/000507921] [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: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 11/19/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a relatively rare B-cell non-Hodgkin lymphoma, typically presenting with extensive lymphadenopathy, bone marrow involvement, and splenomegaly. Extranodal sites can also be involved. We discuss a 73-year-old man whose MCL presented with a 6-month history of a subdermal mass of the right upper thigh and no systemic symptoms.
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Affiliation(s)
- Drew A Fajardo
- University of Nevada Reno School of Medicine, Reno, Nevada, USA
| | - Joel France
- Sierra Pathology Associates, Reno, Nevada, USA
| | - Bogna I Targonska
- Reno Radiological Associates, Reno, Nevada, USA.,Department of Pediatrics, University of Nevada Reno School of Medicine, Reno, Nevada, USA.,Renown Children's Hospital, Reno, Nevada, USA
| | - H Bobby Kahlon
- Family Medicine, Renown Medical Group, Reno, Nevada, USA
| | - Max J Coppes
- Department of Pediatrics, University of Nevada Reno School of Medicine, Reno, Nevada, USA.,Renown Children's Hospital, Reno, Nevada, USA
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4
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McKay P, Leach M, Jackson B, Robinson S, Rule S. A British Society for haematology good practice paper on the diagnosis and investigation of patients with mantle cell lymphoma. Br J Haematol 2018; 182:63-70. [PMID: 29882587 DOI: 10.1111/bjh.15281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Pamela McKay
- Department of Haematology; Beatson West of Scotland Cancer Centre; Gartnavel Hospital; Glasgow UK
| | - Mike Leach
- Department of Haematology; Beatson West of Scotland Cancer Centre; Gartnavel Hospital; Glasgow UK
| | - Bob Jackson
- Department of Pathology; Queen Elizabeth University Hospital; Glasgow UK
| | - Stephen Robinson
- Department of Haematology; University Hospitals Bristol; Bristol UK
| | - Simon Rule
- Department of Haematology; Plymouth University Peninsula Schools of Medicine and Dentistry; Plymouth UK
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5
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Kazlouskaya V, Spizuoco A, Junkins-Hopkins JM. Two cases of systemic mantle cell lymphoma involving the skin. Indian Dermatol Online J 2016; 7:49-52. [PMID: 26951614 PMCID: PMC4763582 DOI: 10.4103/2229-5178.174317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a form of non-Hodgkin lymphoma that rarely affects skin. Cutaneous involvement is non-specific but usually indicates widespread disease. Herein we present two cases of MCL with secondary skin involvement. One case presented as an acneiform eruption on the face and had aberrant expression of bcl-2 and bcl-6 with weak CD5 expression. The second presented with multiple tumors on the abdomen and thighs. In both cases expression of Cyclin-D1 by the tumor cells was seen. Both patients died shortly after the diagnosis was established.
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Affiliation(s)
| | - Amy Spizuoco
- Ackerman Academy of Dermatopathology, New York, USA
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6
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Hrgovic I, Hartmann S, Steffen B, Vogl T, Kaufmann R, Meissner M. Cutaneous involvement as a rare first sign of systemic mantle cell lymphoma: A case report and review of the literature. Mol Clin Oncol 2016; 4:728-732. [PMID: 27123271 PMCID: PMC4840519 DOI: 10.3892/mco.2016.792] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/09/2016] [Indexed: 01/28/2023] Open
Abstract
Mantle cell lymphoma (MCL) is a unique type of B-cell non-Hodgkin's lymphoma, which very rarely exhibits skin involvement. We herein describe the case of a 55-year-old woman, who initially presented with a nodular mass of the right infraorbital region. On histological analysis of the subcutaneous tissue, a diffuse neoplastic cell infiltration was identified, composed of medium-sized lymphoid cells with irregular nuclei, which was diagnosed as MCL. The tumor cells were positive for CD5, CD20, CD79a, cyclin D1 and sex-determining region Y-box 11, but negative for CD10 and CD23. Our patient received six cycles of R-CHOP chemotherapy and intrathecal methotrexate as central nervous system prophylaxis. However, the patient relapsed 1 year later and was treated with two cycles of R-DHAP and one cycle of intrathecal methotrexate. After achieving partial remission, the patient was consolidated with peripheral blood stem cell transplantation using the BEAM conditioning regime. While prior case studies suggest that skin invasion by MCL is associated with a poor prognosis, our patient remains alive almost 4 years after the initial presentation. Skin involvement as a first sign of systemic MCL is very rare and must be considered.
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Affiliation(s)
- Igor Hrgovic
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
| | - Sylvia Hartmann
- Institute of Pathology, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
| | - Björn Steffen
- Division of Hematology/Oncology, Department of Internal Medicine, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
| | - Thomas Vogl
- Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
| | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
| | - Markus Meissner
- Department of Dermatology, Venereology and Allergology, Johann Wolfgang Goethe University Hospital of Frankfurt, D-60590 Frankfurt am Main, Germany
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7
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Hsi AC, Hurley MY, Lee SJ, Rosman IS, Pang X, Gru A, Schaffer A. Diagnostic utility of SOX11 immunohistochemistry in differentiating cutaneous spread of mantle cell lymphoma from primary cutaneous B-cell lymphomas. J Cutan Pathol 2016; 43:354-61. [PMID: 26762898 DOI: 10.1111/cup.12668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 01/10/2016] [Accepted: 01/10/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mantle cell lymphoma (MCL) is associated with the worst prognosis among low-grade B-cell lymphomas. While cutaneous involvement by nodal or systemic MCL is uncommon, its differentiation from primary cutaneous B-cell lymphoma (CBCL) or cutaneous involvement by other extra-cutaneous BCL is challenging as neither histomorphology nor immunophenotype can be absolutely specific. We analyzed the diagnostic utility of SOX11 immunohistochemistry in differentiating secondary cutaneous MCL from other low-grade CBCL. METHODS Immunohistochemical staining with anti-SOX11 antibody was performed on 8 cases of secondary cutaneous MCL, 16 secondary cutaneous CLL, 20 primary cutaneous MZL, 12 cutaneous FCL (6 primary, 6 secondary), 7 primary cutaneous DLBCL, leg type, 5 systemic DLBCL and 3 B-ALL. SOX11 and cyclin D1 staining were compared in secondary cutaneous MCL. RESULTS Nuclear SOX11 staining was seen in seven of eight cases (88%) of secondary cutaneous MCL, including a case with minimal cyclin D1 expression. All other CBCL lacked detectable nuclear SOX11 expression. The sensitivity and specificity for SOX11 in MCL were 87.5 and 100%, respectively. Both the sensitivity and specificity for combined SOX11 and cyclin D1 immunohistochemistry were 100%. CONCLUSION SOX11 immunohistochemistry could be a useful adjunct in distinguishing secondary cutaneous MCL from other CBCL.
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Affiliation(s)
- Andy C Hsi
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA
| | - M Yadira Hurley
- Department of Dermatology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Sena J Lee
- Division of Dermatology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ilana S Rosman
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA.,Division of Dermatology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Xiaofan Pang
- Department of Biology, Washington University in St. Louis, Saint Louis, MO, USA
| | - Alejandro Gru
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH, USA
| | - András Schaffer
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA.,Division of Dermatology, Washington University School of Medicine, Saint Louis, MO, USA
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Skin Involvement of Mantle Cell Lymphoma May Mimic Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type. Am J Surg Pathol 2015; 39:1093-101. [PMID: 26034867 DOI: 10.1097/pas.0000000000000445] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mantle cell lymphoma (MCL) is a B-cell neoplasm with a variable and generally aggressive clinical course. So far our knowledge of skin involvement of MCL is limited. To understand the clinical and histopathologic features of MCL with skin involvement, the files of the Lymph Node Registry Kiel were screened for MCL diagnosed in the skin. Over a period of 13 years, 1321 biopsy specimens were diagnosed as MCL; among them, 14 patients (1%) showed skin involvement. Of these, skin was the initial site of manifestation in 6/11 (55%) cases. One patient presented with a skin-limited lymphoma. Furthermore, 7/12 (58%) patients presented with lesions on the leg. The lymphomas were highly proliferative with blastoid cytology in 12/14 (86%) cases. Moreover, the immunophenotype with expression of BCL2 (100%), MUM-1/IRF4 (83%), and IgM (82%) and lack of CD10 (25%) and BCL6 (0%) closely resembled the features of primary cutaneous diffuse large B-cell lymphoma, leg type. Solely the expression of cyclin D1 (100%) and the presence of t(11;14) (100%) allowed a distinction from cases of primary cutaneous diffuse large B-cell lymphoma, leg type. Only 2 MCL cases with skin involvement presented with classical cytology. Interestingly, in these 2 cases skin involvement occurred simultaneously in a lesion of coexisting primary cutaneous marginal zone lymphoma. Our data suggest that clinical presentation on the leg and blastoid cytology along with high proliferation and expression of Bcl2, Mum-1/IRF4, and IgM are typical for MCL involving the skin. Lymphomas with these features might be erroneously diagnosed as diffuse large B-cell lymphoma, leg type, if cyclin D1 staining is not performed.
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9
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Mantle cell lymphoma with skin involvement. Postepy Dermatol Alergol 2015; 32:229-34. [PMID: 26161067 PMCID: PMC4495111 DOI: 10.5114/pdia.2014.44028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 03/12/2014] [Accepted: 05/19/2014] [Indexed: 11/17/2022] Open
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10
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Hamad N, Armytage T, McIlroy K, Singh N, Ward C. Primary Cutaneous Mantle-Cell Lymphoma: A Case Report and Literature Review. J Clin Oncol 2014; 33:e104-8. [PMID: 24733805 DOI: 10.1200/jco.2012.47.2829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Nada Hamad
- Royal North Shore Hospital; University of Sydney, Sydney, Australia
| | | | - Kirsty McIlroy
- Pathology Laboratory Medicine Services, Sydney, Australia
| | - Nisha Singh
- Pathology Laboratory Medicine Services, Sydney, Australia
| | - Christopher Ward
- Royal North Shore Hospital, Northern Blood Research Centre, Kolling Institute; University of Sydney, Sydney, Australia
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11
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Mantle Cell Lymphoma of Blastoid Variant With Skin Lesion and Rapid Progression. Am J Dermatopathol 2013; 35:851-5. [DOI: 10.1097/dad.0b013e31828de73a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Primary cutaneous mantle cell lymphoma: a case report. Case Rep Dermatol Med 2013; 2013:394596. [PMID: 23762653 PMCID: PMC3676998 DOI: 10.1155/2013/394596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/08/2013] [Indexed: 02/06/2023] Open
Abstract
Primary cutaneous mantle cell lymphoma (MCL) is a rare cutaneous proliferation of naive pregerminal CD-5 positive B cells in the skin with no extracutaneous involvement. Overexpression of cyclin D1 is pathognomonic of this condition, and surgery and radiation therapy are the most common therapeutic options. In this case, we describe the clinical, histopathological, immunohistochemical, and molecular characteristics of a new case of primary cutaneous MCL.
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13
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Skin manifestations associated with mantle cell lymphoma: a case report. Mediterr J Hematol Infect Dis 2013; 5:e2013020. [PMID: 23505608 PMCID: PMC3591297 DOI: 10.4084/mjhid.2013.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 02/20/2013] [Indexed: 11/08/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a distinct non-Hodgkin's lymphoma type that commonly affects extra nodal sites. The most often affected sites are bone marrow, gastrointestinal tract and Waldeyer's ring, being the skin rarely involved. We report a case of 56 year-old man with MCL, exhibiting multiple large maculopapular skin rashes and skin ulcers. Histopathological examination had not shown direct infiltration by any atypical cells. He had significant improvement of skin lesions with combination chemotherapy and debridement. Awareness of skin manifestations of MCL is crucial for dermatologists and haematologists to establish the early diagnosis and timely administration of appropriate treatment.
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McKay P, Leach M, Jackson R, Cook G, Rule S. Guidelines for the investigation and management of mantle cell lymphoma. Br J Haematol 2012; 159:405-26. [PMID: 22994971 DOI: 10.1111/bjh.12046] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- P McKay
- Department of Haematology, Beatson West of Scotland Cancer Centre, Gartnavel Hospital, Glasgow, UK
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15
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Mantle Cell Lymphoma With Skin Invasion Characterized by the Common Variant in the Subcutis and Blastoid Transformation in the Overlying Dermis. Am J Dermatopathol 2010; 32:180-2. [DOI: 10.1097/dad.0b013e3181b2ed67] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Dargent JL, Lespagnard L, Feoli F, Debusscher L, Greuse M, Bron D. De novoCD5-positive diffuse large B-cell lymphoma of the skin arising in chronic limb lymphedema. Leuk Lymphoma 2009; 46:775-80. [PMID: 16019518 DOI: 10.1080/10428190500051208] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report the case of a 79-year-old woman with a longstanding lymphedema of the right arm who developed a skin lymphoma involving the right wrist area. Microscopically, the lesion was composed of numerous centroblasts infiltrating both the dermis and the subcutaneous tissue. Phenotypic investigations showed expression of CD20, CD79a, and bcl-2 protein by neoplastic cells. In addition, these cells were CD5 positive. No expression of anaplastic large cell lymphoma kinase (ALK), CD10, CD23, CD30, CD43, bcl-6, cyclin D1, p53 or p16INK4a could be seen. Polymerase chain reaction (PCR) analysis demonstrated a clonal rearrangement of the genes coding for the kappa light chain of the immunoglobulin (Ig). No rearrangement of the genes coding for the Ig heavy chain, t(14;18) or t(11;14) chromosome translocations, or Epstein-Barr virus (EBV) genomic sequences could be found. The tumor was classified as stage IE and was first cured by complete surgical excision. Nineteen months later, a recurrence was noted in the right elbow area. This study further illustrates that lymphoma of the skin may complicate chronic limb lymphedema. Like most of the previously reported cases, this neoplasm belonged to the category of diffuse large B-cell lymphoma. However, it showed CD5 expression as a singular feature.
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Affiliation(s)
- Jean-Louis Dargent
- Department of Pathology, CHU Saint-Pierre and Institut Jules Bordet, Brussels, Belgium.
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Abstract
Mantle cell lymphoma (MCL) commonly involves extranodal sites, usually as a manifestation of disseminated disease. In rare cases, MCLs may arise as a primary tumor in the skin. Blastoid mantle cell lymphoma (BV-MCL) is a rare variant and has a more aggressive clinical course. The phenotype of BV-MCL is characterized as CD20+, CD5+, cyclin D1+, CD23-, and CD10-. Interphase fluorescence in situ hybridization shows a characteristic t(11;14) fusion pattern. We report a case of a BV-MCL arising in skin as primary cutaneous MCL with the characteristic immunophenotype and translocation.
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18
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FISH, applications en anatomie pathologique. Ann Pathol 2004. [DOI: 10.1016/s0242-6498(04)94058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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19
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Vergier B, Belaud-Rotureau MA, Benassy MN, Beylot-Barry M, Dubus P, Delaunay M, Garroste JC, Taine L, Merlio JP. Neoplastic cells do not carry bcl2-JH rearrangements detected in a subset of primary cutaneous follicle center B-cell lymphomas. Am J Surg Pathol 2004; 28:748-55. [PMID: 15166666 DOI: 10.1097/01.pas.0000126775.27698.6e] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Whether primary cutaneous follicular lymphoma (PCFL) may or not represent a cutaneous equivalent to nodal follicular lymphoma (FL) is not determined. We have therefore investigated a series of PCFL to determine if tumoral cells carry or not the t(14;18)(q32;q21) translocation, a cytogenetic hallmark of nodal FL. Thirty cases of PFCL were selected according to the criteria of both the European Organisation for Research and Treatment of Cancer and the World Health Organization with 21 cases classified as grade 1 or 2 and 9 cases as grade 3. First, cutaneous tumors were studied by PCR for the amplification of bcl-2/JH rearrangements and by interphase fluorescence in situ hybridization using a dual color probe spanning t(14;18) breakpoints. Second, we tried to determine the origin of bcl2-JH-positive cells by a parallel bcl2-JH and immunoglobulin heavy chain gene amplification of blood mononuclear cells DNA and of DNA extracted from single microdissected B cells. Bcl2-JH rearrangements were amplified by PCR in skin of 9 of 30 (30%) patients with a similar-sized bcl2-JH rearrangement detected in the blood of 7 of these 9 cases. No t(14;18) breakpoint was detected by interphase fluorescence in situ hybridization analysis of 11 bcl2-JH-negative and 5 bcl2-JH-positive PCFL in contrast with its detection in the secondary cutaneous FL and in the nodal FL cases. Single-cell/multigene analysis showed that no single monoclonal B cells of PCFL carried the bcl2-JH rearrangement. Bystander or nontumoral t(14;18)+ B cells emigrating from blood may account for the detection of bcl2-JH rearrangements within PCFL material. Our study also underlines the diagnostic value of interphase fluorescence in situ hybridization to discriminate between t(14;18)-negative PCFL and extracutaneous FL involving the skin.
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MESH Headings
- Bystander Effect
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 18
- Female
- Gene Amplification
- Gene Rearrangement
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Interphase
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/genetics
- Lymphoma, Follicular/classification
- Lymphoma, Follicular/genetics
- Male
- Microdissection
- Middle Aged
- Polymerase Chain Reaction
- Proto-Oncogene Proteins c-bcl-2/genetics
- Skin Neoplasms/classification
- Skin Neoplasms/genetics
- Translocation, Genetic
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Affiliation(s)
- Béatrice Vergier
- Equipe Histologie et Pathologie Moléculaire, Université Victor Segalen, Bordeaux, France.
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