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Croci GA, Appio L, Cecchetti C, Tabano S, Alberti-Violetti S, Berti E, Rahal D, Cavallaro F, Onida F, Tomasini D, Todisco E. Primary cutaneous, epidermotropic mycosis fungoides-like presentation: critical appraisal and description of two novel cases, broadening the spectrum of ALK+ T-cell lymphoma. Virchows Arch 2024; 485:417-425. [PMID: 38780617 DOI: 10.1007/s00428-024-03832-6] [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: 03/16/2024] [Revised: 04/18/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
Leading from a two-case series, including two patients receiving a diagnosis of epidermotropic T-cell lymphoma, featuring a mycosis fungoides (MF)-like clinical pattern and ALK expression and molecular alteration, we performed a critical appraisal of ALK+ primary cutaneous T-cell lymphomas (pcTCL). Considering our patients and the literature, 32 cases were retrieved, 7 of which featured an MF-like clinical picture over a 4-to-20-year period. MF-like cases show distinctive histology, comprising a predominantly epidermotropic infiltration of small-to-large, atypical-to-pleomorphic, with few anaplastic cells, negligible-to-intense CD30-expression, and a CD4+/cytotoxic granule+ phenotype. These features should prompt a search for ALK expression captured by the ALK D5F3 clone. Bona fide ALK+ pcTCL is very rare, and existent data suggest the presence of a broader pattern of disease, including instances mimicking MF and/or primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma. The major challenges in dealing with this subset include prodromal phases, misinterpreted as inflammatory dermatosis or parapsoriasis/early phase MF both clinically and histologically, while recognition of its ALK-driven biology is hampered both by the unusual clinic-pathologic pattern of the disease, which stands apart from the classical (i.e., nodal) picture of ALK+ anaplastic large cell lymphoma and by the low sensitivity of ALK1 clone. Data on its optimal management are far from being conclusive: An MF-like approach is currently chosen, but depending on CD30 and, most notably, ALK expression, a targeted therapy could be envisaged in advanced stages, as clinical response to ALK inhibition was documented in one patient.
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Affiliation(s)
- Giorgio Alberto Croci
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122, Milan, Italy.
| | - Lorena Appio
- Division of Hematology, ASST ValleOlona Ospedale di Busto Arsizio, Busto Arsizio, Italy
| | - Caterina Cecchetti
- Division of Hematology, ASST ValleOlona Ospedale di Busto Arsizio, Busto Arsizio, Italy
| | - Silvia Tabano
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Medical Genetics Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Alberti-Violetti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Dermatology Unit, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emilio Berti
- Dermatology Unit, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daoud Rahal
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Francesca Cavallaro
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Onida
- Hematology Unit, ASST-Fatebenefratelli-Sacco, University of Milan, Milan, Italy
| | - Dario Tomasini
- Division of Dermatology, ASST ValleOlona Ospedale di Busto Arsizio, Busto Arsizio, Italy
| | - Elisabetta Todisco
- Division of Hematology, ASST ValleOlona Ospedale di Busto Arsizio, Busto Arsizio, Italy
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Wu R, Lim MS. Updates in pathobiological aspects of anaplastic large cell lymphoma. Front Oncol 2023; 13:1241532. [PMID: 37810974 PMCID: PMC10556522 DOI: 10.3389/fonc.2023.1241532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Anaplastic large cell lymphomas (ALCL) encompass several distinct subtypes of mature T-cell neoplasms that are unified by the expression of CD30 and anaplastic cytomorphology. Identification of the cytogenetic abnormality t(2;5)(p23;q35) led to the subclassification of ALCLs into ALK+ ALCL and ALK- ALCL. According to the most recent World Health Organization (WHO) Classification of Haematolymphoid Tumours as well as the International Consensus Classification (ICC) of Mature Lymphoid Neoplasms, ALCLs encompass ALK+ ALCL, ALK- ALCL, and breast implant-associated ALCL (BI-ALCL). Approximately 80% of systemic ALCLs harbor rearrangement of ALK, with NPM1 being the most common partner gene, although many other fusion partner genes have been identified to date. ALK- ALCLs represent a heterogeneous group of lymphomas with distinct clinical, immunophenotypic, and genetic features. A subset harbor recurrent rearrangement of genes, including TYK2, DUSP22, and TP63, with a proportion for which genetic aberrations have yet to be characterized. Although primary cutaneous ALCL (pc-ALCL) is currently classified as a subtype of primary cutaneous T-cell lymphoma, due to the large anaplastic and pleomorphic morphology together with CD30 expression in the malignant cells, this review also discusses the pathobiological features of this disease entity. Genomic and proteomic studies have contributed significant knowledge elucidating novel signaling pathways that are implicated in ALCL pathogenesis and represent candidate targets of therapeutic interventions. This review aims to offer perspectives on recent insights regarding the pathobiological and genetic features of ALCL.
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Affiliation(s)
| | - Megan S. Lim
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Flora A, Gibson M, Toon C, Rawson R, Lowe P. Primary cutaneous CD8+ aggressive epidermotropic T-cell lymphoma mimicking pyoderma gangrenosum. Indian J Dermatol Venereol Leprol 2021; 88:90-92. [DOI: 10.25259/ijdvl_296_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Christopher Toon
- Department of Anatomical Pathology, Royal North Shore Hospital, St. Leonards, Australia,
| | - Robert Rawson
- Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia,
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4
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Barbé J, Escobar G, Marzouki-Zerouali A, Lardenois E, Schmutz JL, Bursztejn AC. Disseminated indolent ALK-positive primary cutaneous anaplastic large cell lymphoma (C-ALCL) lasting for 10 years. Int J Dermatol 2020; 60:e146-e147. [PMID: 33249555 DOI: 10.1111/ijd.15324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/08/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jordane Barbé
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Gabriela Escobar
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | | | - Emilie Lardenois
- Pathologist Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Jean-Luc Schmutz
- Dermatology Department, University Hospital of Nancy, Vandoeuvre les Nancy, France
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The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood 2019; 133:1703-1714. [PMID: 30635287 DOI: 10.1182/blood-2018-11-881268] [Citation(s) in RCA: 741] [Impact Index Per Article: 148.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/07/2019] [Indexed: 12/13/2022] Open
Abstract
Primary cutaneous lymphomas are a heterogeneous group of T- and B-cell lymphomas that present in the skin with no evidence of extracutaneous disease at the time of diagnosis. The 2005 World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) consensus classification has served as a golden standard for the diagnosis and classification of these conditions. In September 2018, an updated version of the WHO-EORTC was published in the fourth edition of the WHO Classification of Skin Tumours Blue Book. In this classification, primary cutaneous acral CD8+ T-cell lymphoma and Epstein-Barr virus positive (EBV+) mucocutaneous ulcer are included as new provisional entities, and a new section on cutaneous forms of chronic active EBV disease has been added. The term "primary cutaneous CD4+ small/medium T-cell lymphoma" was modified to "primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder" because of its indolent clinical behavior and uncertain malignant potential. Modifications have also been made in the sections on lymphomatoid papulosis, increasing the spectrum of histologic and genetic types, and primary cutaneous marginal zone lymphomas recognizing 2 different subtypes. Herein, the characteristic features of these new and modified entities as well as the results of recent molecular studies with diagnostic, prognostic, and/or therapeutic significance for the different types of primary cutaneous lymphomas are reviewed. An update of the frequency and survival of the different types of primary cutaneous lymphomas is provided.
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Peña C, Russo M, Martinez V, Cabrera ME. Extranodal lymphomas in the public health system in Chile: Analysis of 1251 patients from the National Adult Cancer Program. Hematol Oncol 2018; 37:47-53. [PMID: 30117170 DOI: 10.1002/hon.2547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/26/2018] [Accepted: 06/30/2018] [Indexed: 12/17/2022]
Abstract
The aim of the study was to describe the clinical and epidemiological characteristics, anatomic and histologic distribution, and treatment results of extranodal lymphomas (ENLs), diagnosed and treated in the public health system in Chile. We included patients with ENL diagnosed from 1998 to 2014, in 17 cancer centers, registered prospectively in the database of the National Adult Cancer Program (PANDA) of the Ministry of Health. Treatment was based on the local protocols for each lymphoma subtype. Extranodal lymphoma was documented in 1215 of 4907 non-Hodgkin lymphomas diagnosed in that period (25%). Median age was 59 years (range, 16-95), and 55% were female. The gastrointestinal (GI) tract was the most common location (38%), followed by the head and neck (24%) and the skin (15%). B-cell lymphomas accounted for 78% of cases, diffuse large B-cell lymphoma being the most common histologic subtype (68%). Mycosis fungoides/Sezary syndrome was the most frequent T-cell subtype (36%), followed by NK/T-cell lymphomanasal type (24%). In comparison with western countries, Chile showed a significantly high prevalence of NK/T-cell lymphoma nasal type, while the frequency of B-cell ENL and the anatomic distribution appeared similar, being GI the most commonly involved site.
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Affiliation(s)
- Camila Peña
- Medicine Service, Hematology Section, Hospital del Salvador, Santiago, Chile
| | - Moises Russo
- Radiation Oncology, Fundación Arturo Lopez Perez, Faculty of Medicine, Diego Portales University, Santiago, Chile
| | | | - Maria Elena Cabrera
- Medicine Service, Hematology Section, Hospital del Salvador, University of Chile, Santiago, Chile
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Allogeneic hematopoietic stem cell transplantation in Primary Cutaneous T Cell Lymphoma. Ann Hematol 2018; 97:1041-1048. [PMID: 29442161 DOI: 10.1007/s00277-018-3275-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 02/02/2018] [Indexed: 11/12/2022]
Abstract
In our retrospective study, 16 patients affected by advanced cutaneous T cell lymphoma (CTCL) underwent allogeneic hematopoietic stem cell transplantation (HSCT). Two patients (12.5%) were in complete remission (CR), nine (56.3%) in partial remission (PR), and five (31.2%) with active disease. The patients were transplanted from an HLA-identical (n = 7) from a mismatched (n = 1) or haploidentical (n = 1) sibling, from matched unrelated donor (n = 5), or from a single cord blood unit (n = 2). Conditioning regimen was standard myeloablative in 6 patients and at reduced intensity in 10. Seven patients died from non relapse mortality (NRM) and four patients relapsed or progressed, three of them achieved a second CR after donor lymphocyte infusion (DLI) or chemotherapy plus DLI. To date, with a median follow-up of 76 months (range 6-130), nine patients are alive, eight in CR, and one with active disease. Overall survival (OS) and disease-free survival (DFS) at 1 and 10 years are 61% (95% CI 40-91%) and 54% (95% CI 33-86%), 40% (95% CI 22-74%), and 34% (95% CI 16-68%), respectively. The time from diagnosis to transplant seems to influence negatively both OS (log-rank p < 0.04) and DFS (log-rank p < 0.05). Our results confirm on a long follow-up that CTCL appears particularly susceptible to the graft versus lymphoma (GVL) effect, so that allogeneic HSCT represents a possibility of cure for advanced CTCL. The timing of HSCT in the clinical course of disease remains an open issue.
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Hathuc VM, Hristov AC, Smith LB. Primary Cutaneous Acral CD8+ T-Cell Lymphoma. Arch Pathol Lab Med 2017; 141:1469-1475. [DOI: 10.5858/arpa.2017-0230-ra] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Primary cutaneous acral CD8+ T-cell lymphoma is a new provisional entity in the 2016 revision of the World Health Organization classification of lymphoid neoplasms. This is a challenging diagnosis because of its rarity, as well as its morphologic and immunophenotypic overlap with other CD8+ cytotoxic lymphoid proliferations. Appropriate classification of this entity is crucial because of its indolent clinical behavior compared with other CD8+ T-cell lymphomas. Knowledge of the clinical setting, sites of involvement, and morphologic features can aid in correct diagnosis. Here, we review the clinical and pathologic features of primary cutaneous acral CD8+ T-cell lymphoma with an emphasis on the differential diagnosis among other C8+ T-cell lymphomas.
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Affiliation(s)
- Vivian M. Hathuc
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
| | - Alexandra C. Hristov
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
| | - Lauren B. Smith
- From the Sections of Hematopathology (Drs Hathuc and Smith) and Dermatopathology (Dr Hristov) in the Department of Pathology, University of Michigan Medical Center, Ann Arbor
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Geller S, Canavan TN, Pulitzer M, Moskowitz AJ, Myskowski PL. ALK-positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature. Int J Dermatol 2017; 57:515-520. [PMID: 29057463 DOI: 10.1111/ijd.13804] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/07/2017] [Accepted: 09/15/2017] [Indexed: 12/11/2022]
Abstract
Anaplastic large cell lymphoma (ALCL) limited to the skin is a distinct disease that is designated primary cutaneous ALCL (pcALCL). It has an indolent course with a significantly better prognosis compared to systemic ALCL (sALCL). Anaplastic lymphoma kinase (ALK) expression in lesions of cutaneous ALCL is classically considered to be a marker for skin involvement by sALCL. However, recent reports of patients with ALK-positive pcALCL challenge this concept and raise prognostic and therapeutic dilemmas. Herein, we report a case of ALK-positive pcALCL in a 45-year-old woman who was treated with local radiotherapy. We review previously reported cases in the literature to better characterize this rare variant. Overall, the rates of cutaneous recurrence, systemic dissemination, and disease-related mortality in ALK-positive pcALCL do not differ from those previously reported in pcALCL. ALK-positive pcALCL is diagnosed at younger age and has a better disease course in children compared to adults with lower incidences of skin recurrence and progression to systemic disease. We conclude that ALK-positivity in cutaneous ALCL does not necessarily imply systemic disease. ALK-positive pcALCL has an excellent prognosis and should be treated by excision and/or radiotherapy. However, patients must remain under close long-term follow-up as recurrence and progression to systemic disease may occur.
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Affiliation(s)
- Shamir Geller
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine, New York, NY, USA
| | - Theresa N Canavan
- Department of Dermatology, University of Alabama, Birmingham, AL, USA
| | - Melissa Pulitzer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medicine, New York, NY, USA
| | - Alison J Moskowitz
- Lymphoma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine, New York, NY, USA
| | - Patricia L Myskowski
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medicine, New York, NY, USA
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Abstract
T-cell lymphoma, a collection of subtypes of Non-Hodgkin lymphoma, is a rare malignancy. The low prevalence of this disease has made it challenging to identify subtype-specific risk factors. Potential risk factors could enable us to identify high-risk patients and predict patient outcomes. Here, we report on the current epidemiologic and prognostic factors data associated with the individual subtypes both of peripheral T-cell lymphoma (PTCL) and cutaneous T-cell lymphoma (CTCL) found in large cohort and case studies. Additionally, with recent findings, as well as updates in the new World Health Organization (WHO) classification of lymphoid neoplasms, we consider what this could do to change our approach to this group of diseases.
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Clinicopathologic Spectrum of Gastrointestinal T-cell Lymphoma: Reappraisal Based on T-cell Receptor Immunophenotypes. Am J Surg Pathol 2017; 40:777-85. [PMID: 26975035 DOI: 10.1097/pas.0000000000000630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The differential diagnosis of primary gastrointestinal EBV T-cell lymphoma (GITCL) includes enteropathy-associated T-cell lymphoma (EATL), peripheral T-cell lymphoma, not otherwise specified, adult T-cell leukemia/lymphoma, and anaplastic large cell lymphoma. Type II EATL is considered to be a tumor of intraepithelial lymphocytes. However, the evaluation of intraepithelial lymphocytosis by biopsy specimens is challenging, which poses a diagnostic problem between the EATL and peripheral T-cell lymphoma, not otherwise specified. This situation requested us to establish a pragmatic diagnostic approach for the classification of GITCL. We identified 42 cases of GITCL and analyzed clinicopathologic features, especially addressing their T-cell receptor (TCR) phenotype. Nine (21%) of 42 GITCL cases were positive for TCRγ protein expression. Among these TCRγ cases, TCRβ expression or not was detected in 5 and 4, respectively, but resulted in no further clinicopathologic differences. TCRβ positivity without TCRγ expression (βγ) was seen in 9 GITCL patients (21%). Twenty-four patients (57%) were negative for TCRβ and γ expression (βγ). Compared with TCRβγ or βγ type, TCRγ cases were characterized by exclusive involvement of intestinal sites (100% vs. 11%, P<0.001; 100% vs. 58%, P=0.032, respectively), but not of stomach (0% vs. 78%, P=0.002; 0% vs. 38%, P=0.039, respectively). Notably, TCRγ positivity was an independent unfavorable prognostic factor among our GITCL patients (P<0.001). Considering our results, TCRγ GITCL, that is, intestinal γδ T-cell lymphoma, appears to constitute a distinct disease entity.
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Virmani P, Jawed S, Myskowski PL, Horwitz S, Skripnik Lucas A, Moskowitz A, Pulitzer M, Zain J, Rosen ST, Querfeld C. Long-term follow-up and management of small and medium-sized CD4 + T cell lymphoma and CD8 + lymphoid proliferations of acral sites: a multicenter experience. Int J Dermatol 2017; 55:1248-1254. [PMID: 27369070 DOI: 10.1111/ijd.13340] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/12/2016] [Accepted: 02/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Primary cutaneous CD4+ small-medium pleomorphic T cell lymphoma (SMPTCL) is a low-grade cutaneous T cell lymphoma. Its clinical and histopathologic features are comparable with those of CD8+ lymphoid proliferations (LPs) of the ear and acral sites. OBJECTIVES We performed a retrospective analysis of patients with CD4+ SMPTCL or CD8+ LP to elucidate the clinical course, prognosis, and outcomes. METHODS Demographic, clinical, and treatment data were reviewed. Histopathologic data based on architectural, cytomorphologic, and immunohistochemical features were assessed. Immunohistochemical staining for T and B cell markers was evaluated. RESULTS A total of 25 patients including 22 with CD4+ SMPTCL and three with CD8+ LP were identified. All patients presented with a single lesion, predominantly on the head, neck, or upper trunk (84%). No patients showed extracutaneous disease at any evaluation. The most common histopathologic changes showed a dense nodular infiltrate of small cells with hyperchromatic nuclei without significant follicular or adnexal involvement. Patients were treated with excision (48%), local radiation (28%), or topical or intralesional steroids (24%). All patients achieved complete resolution of disease. Five patients demonstrated cutaneous relapse at new sites. CONCLUSIONS The CD4+ SMPTCL/CD8+ LP subgroup usually presents with solitary lesions and demonstrates an indolent clinical course. Typical presentation, classic histopathology, widespread expression of follicular T helper cell markers, and loss of a T cell antigen are diagnostic features of CD4+ SMPTCL, whereas monomorphous CD8+ infiltrate without follicular T helper cell markers is consistent with CD8+ LP. Local skin-directed therapy is appropriate in these patients.
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Affiliation(s)
- Pooja Virmani
- Dermatology Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Sarah Jawed
- Dermatology Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Patricia L Myskowski
- Dermatology Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Steven Horwitz
- Lymphoma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Anna Skripnik Lucas
- Dermatology Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Alison Moskowitz
- Lymphoma Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Melissa Pulitzer
- Department of Pathology, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA
| | - Jasmine Zain
- Departments of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Steven T Rosen
- Departments of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Christiane Querfeld
- Dermatology Service, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA. .,Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
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A Woman With Recurrent Facial Ulcers. Am J Dermatopathol 2017; 39:155-156. [DOI: 10.1097/dad.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Abstract
Cutaneous CD30+ T-cell lymphoproliferative disorders (CD30+ T-LPD) represent a spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL) and borderline lesions. They share the expression of CD30 as a common phenotypic marker. They differ however in their clinical presentation, the histological features and clinical course. Moreover, LyP and PcALCL show numerous clinical, histological and phenotypic variants. Overlapping features of LyP and pcALCL with themselves and with other cutaneous and systemic lymphomas emphasize the importance of careful clinicopathologic correlation and staging in the diagnosis of CD30+ T-LPD. Furthermore, an increasing number of inflammatory and infectious skin disorders harboring medium-sized to large CD30+ cells have to be considered in the differential diagnosis. Whereas the expression of CD30 in cutaneous CD30+ T-LPD stands for a favourable prognosis, its expression in other cutaneous and systemic lymphomas has a divergent impact. The assessment of CD30 expression does not only provide prognostic information, but is of potential therapeutic relevance as CD30 can serve as a therapeutic target. This review focuses on the clinicopathological and phenotypic spectrum of CD30+ T-LPD, its differential diagnoses and the role of CD30 as a diagnostic, prognostic and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Zürich, Switzerland; Department of Dermatology, University Hospital Zurich, CH-8091, Zurich, Switzerland.
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Fatal Case of Primary Cutaneous Aggressive T-Cell Lymphoma Switching From a CD4+ to a CD8+ Phenotype: Progressive Disease With Bexarotene and Romidepsin Treatment. Am J Dermatopathol 2016; 38:832-837. [DOI: 10.1097/dad.0000000000000609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Gorodetskiy VR, Mukhortova OV, Aslanidis IP, Klapper W, Probatova NA. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography evaluation of subcutaneous panniculitis-like T cell lymphoma and treatment response. World J Clin Cases 2016; 4:258-263. [PMID: 27672640 PMCID: PMC5018622 DOI: 10.12998/wjcc.v4.i9.258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/22/2016] [Accepted: 07/13/2016] [Indexed: 02/05/2023] Open
Abstract
Subcutaneous panniculitis-like T cell lymphoma (SPTCL) is a very rare variant of non-Hodgkin’s lymphoma. Currently, there is no standard imaging method for staging of SPTCL nor for assessment of treatment response. Here, we describe our use of fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging and monitoring of treatment response in 3 cases of SPTCL. Primary staging by PET/CT showed that all 3 patients had multiple foci in the subcutaneous fat tissue, with SUVmax from 10.5 to 14.6. Involvement of intra-abdominal fat with high SUVmax was identified in 2 of the patients. Use of the triple drug regimen of gemcitabine, cisplatin and methylprednisolone (commonly known as “GEM-P”) as first-line therapy or second-line therapy facilitated complete metabolic response for all 3 cases. FDG PET/CT provides valuable information for staging and monitoring of treatment response and can reveal occult involvement of the intra-abdominal visceral fat. High FDG uptake on pre-treatment PET can identify patients with aggressive disease and help in selection of first-line therapy.
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18
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Genomic imbalances and microRNA transcriptional profiles in patients with mycosis fungoides. Tumour Biol 2016; 37:13637-13647. [DOI: 10.1007/s13277-016-5259-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 07/15/2016] [Indexed: 01/12/2023] Open
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Caselli E, Borghi A, Maritati M, Gafà R, Lanza G, Di Luca D, Virgili A, Contini C. Relapses of primary cutaneous anaplastic large-cell lymphoma in a female immunocompetent patient with persistent chlamydophila pneumoniae and human herpesvirus 8 infection. Infect Agent Cancer 2016; 11:31. [PMID: 27382410 PMCID: PMC4932675 DOI: 10.1186/s13027-016-0079-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 05/18/2016] [Indexed: 11/24/2022] Open
Abstract
Background We have previously reported the case of an immunocompetent female patient with a primary cutaneous CD30+ anaplastic large-cell lymphoma (PCALCL) located on her upper right eyelid characterized by the presence of a concurrent active infection by C. pneumoniae and Human herpesvirus 8 (HHV8). This finding suggested for the first time a possible association of C. pneumoniae and/or HHV8 infection, or both together, with PCALCL pathogenesis in non-immunocompromised and HIV-negative subjects. The subsequent course of the same patient’s medical history is herein reported. Findings During the 4 years following the surgical excision of the first PCALCL, the patient developed five further skin lesions located at different anatomical sites, all histologically proven as PCALCLs. The patient underwent several cycles of doxycycline as prophylaxis against Chlamydia. Skin presence of Chlamydia spp and HHV8 was investigated in all recurrences as well as in routine control blood samples. Amplification fragments corresponding to Chlamydia were found in all skin tissues analysed except one (4/5; 80 %), whereas it was not detected in any of the peripheral blood mononuclear cell samples. Conversely, HHV8 was detected in 2/5 (40 %) of the skin biopsies, including the sample negative for Chlamydia, but in all the blood samples analysed. Conclusions These findings further support the hypothesis of a potential role of C. pneumoniae and HHV8 infection in the development and course of the described cutaneous lymphoma. A reciprocally promoting interaction between the two pathogens may be supposed to be relevant for PCALC occurrence and relapse.
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Affiliation(s)
- Elisabetta Caselli
- Department of Medical Sciences, Section of Microbiology, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - Martina Maritati
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - Roberta Gafà
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology and Molecular Diagnostics, University of Ferrara, Ferrara, Italy
| | - Giovanni Lanza
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology and Molecular Diagnostics, University of Ferrara, Ferrara, Italy
| | - Dario Di Luca
- Department of Medical Sciences, Section of Microbiology, University of Ferrara, Ferrara, Italy
| | - Annarosa Virgili
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
| | - Carlo Contini
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy
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No TP63 rearrangements in a selected group of primary cutaneous CD30+ lymphoproliferative disorders with aggressive clinical course. Blood 2016; 128:141-3. [PMID: 27146432 DOI: 10.1182/blood-2016-02-694455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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21
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James E, Sokhn JG, Gibson JF, Carlson K, Subtil A, Girardi M, Wilson LD, Foss F. CD4 + primary cutaneous small/medium-sized pleomorphic T-cell lymphoma: a retrospective case series and review of literature. Leuk Lymphoma 2016; 56:951-7. [PMID: 24996443 DOI: 10.3109/10428194.2014.938331] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
CD4 + primary cutaneous small/medium-sized pleomorphic T-cell lymphoma (CD4 + PCSM-TCL) is a rare T-cell lymphoma associated with a favorable prognosis. A retrospective study of 23 patients with CD4 + PCSM-TCL as defined by World Health Organization-European Organisation for Research and Treatment of Cancer (WHO-EORTC) and WHO classifications was conducted. Median age was 63 years. The head and neck were the most commonly affected locations, followed by the trunk. Two patients had evidence of systemic involvement at relapse. All tumors were CD3 + and CD4+. CD5 and CD7 loss occurred in 52% and 84%, respectively. The median follow-up was 33.6 months. Eleven patients had excisional biopsy only, six had localized radiotherapy and two received excision and localized radiation. Cytotoxic chemotherapy and localized radiation were used in one patient with aggressive and invasive features. All patients had a complete remission but one developed systemic involvement. Our case series demonstrates that CD4 + PCSM-TCL is an indolent T-cell lymphoma that can be treated with local modalities and raises the question of its current classification as a lymphoma.
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Affiliation(s)
- Edward James
- Department of Medical Oncology, Yale University School of Medicine , New Haven, CT , USA
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22
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Gorodetskiy VR, Probatova NA, Vasilyev VI, Mukhortova OV, Aslanidi IP, Sidorova YV, Ryzhikova NV, Radenska-lopovok SG, Egorova ON. Subcutaneous panniculitis-like T-cell lymphoma: The authors’ experience of diagnosis and treatment. TERAPEVT ARKH 2016; 88:49-55. [DOI: 10.17116/terarkh201688749-55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
PURPOSE OF REVIEW Cutaneous T-cell lymphoma (CTCL) is a heterogeneous group of skin-homing T-cell neoplasms, which represent approximately 75% of all primary cutaneous lymphomas. Currently available drug therapies, when effective, simply control disease and the only option for curing CTCL is stem cell transplant. RECENT FINDINGS In the last year, there has been an incredible effort made to improve the understanding and treatment of CTCL. Recent findings indicate that epigenetic aberrations are integral to active disease. Furthermore, multiple tumor-derived immunological factors have also been shown to inhibit viability, proliferation, and cytokine production of nonmalignant T cells. Several novel targeted therapies show great potential, most promising being antibody drug conjugates targeting surface markers such as CD30 in some CTCL subtypes. Additional attractive targets involve the global modulation of epigenetic markers such as demethylation agents or HDAC inhibitors, either as single agents or in combination therapies. SUMMARY This is a concise review of recent advances in the field of CTCL with special focus on research articles over the preceding year.
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Wehkamp U, Oschlies I, Nagel I, Brasch J, Kneba M, Günther A, Klapper W, Weichenthal M. ALK-positive primary cutaneous T-cell-lymphoma (CTCL) with unusual clinical presentation and aggressive course. J Cutan Pathol 2015; 42:870-7. [DOI: 10.1111/cup.12547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 11/17/2014] [Accepted: 01/11/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Ulrike Wehkamp
- Department of Dermatology; University of Kiel; Kiel Germany
| | - Ilske Oschlies
- Department of Pathology, Section for Hematopathology; University of Kiel; Kiel Germany
| | - Inga Nagel
- Department of Human Genetics; University of Kiel; Kiel Germany
| | - Jochen Brasch
- Department of Dermatology; University of Kiel; Kiel Germany
| | - Michael Kneba
- Medical Department II; University of Kiel; Kiel Germany
| | - Andreas Günther
- Division of Stem Cell Transplantation and Immunotherapy; University of Kiel; Kiel Germany
| | - Wolfram Klapper
- Department of Pathology, Section for Hematopathology; University of Kiel; Kiel Germany
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Dewar R, Andea AA, Guitart J, Arber DA, Weiss LM. Best practices in diagnostic immunohistochemistry: workup of cutaneous lymphoid lesions in the diagnosis of primary cutaneous lymphoma. Arch Pathol Lab Med 2015; 139:338-50. [PMID: 25724031 DOI: 10.5858/arpa.2014-0018-cp] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Primary cutaneous lymphoma is a common extranodal non-Hodgkin lymphoma. These lesions share common features with their nodal counterparts, but also have differences in morphology, unique clinical presentations, and immunohistochemical features. OBJECTIVE To review the 2008 World Health Organization (WHO) and 2005 consensus WHO-EORTC (European Organisation for Research and Treatment of Cancer) classifications, and address the immunohistochemical findings in the most common primary cutaneous T- and B-cell lymphomas. Since clonality testing is commonly used as an ancillary test in the evaluation of cutaneous lymphoma, a brief section in the use and pitfalls of clonality testing is included. DATA SOURCES The WHO and EORTC classification publications and the relevant recent literature were used to compile appropriate and practical guidelines in this review. CONCLUSIONS The practice of dermatopathology and hematopathology varies widely. Thus, while this review provides an overview and guideline for the workup of lymphoid lesions of the skin, the practitioner should understand the importance of clinical correlation as well as appropriate utility of available resources (such as clonality testing) in arriving at a diagnosis in cutaneous lymphoid lesions.
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Affiliation(s)
- Rajan Dewar
- From the Department of Pathology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (Dr Dewar); the Department of Pathology, University of Michigan, Ann Arbor (Dr Andea); the Department of Pathology and Dermatology, Northwestern University, Chicago, Illinois (Dr Guitart); the Department of Pathology, Stanford University Medical Center, Stanford, California (Dr Arber); and the Department of Hematopathology, Clarient Pathology Services, Inc, Aliso Viejo, California (Dr Weiss)
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26
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Sandlund JT, Perkins SL. Uncommon non-Hodgkin lymphomas of childhood: pathological diagnosis, clinical features and treatment approaches. Br J Haematol 2015; 169:631-46. [PMID: 25851546 DOI: 10.1111/bjh.13359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We provide a review of the pathological and clinical features for uncommon B-cell and T-cell lymphomas of childhood with a specific focus on advances in treatment approaches and outcomes. There is clearly a need for prospective investigation of both the clinical and biological features of the uncommon non-Hodgkin lymphoma subtypes in childhood. These results should lead to more uniform and more effective treatment approaches.
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Affiliation(s)
- John T Sandlund
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Sherrie L Perkins
- Department of Pathology, University of Utah and ARUP Laboratories, Salt Lake City, UT, USA
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28
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Abstract
T-cell lymphomas are a group of predominantly rare hematologic malignancies that tend to recapitulate different stages of T-cell development, in a similar way that B-cell lymphomas do. As opposed to B-cell lymphomas, the understanding of the biology and the classification of T-cell lymphomas are somewhat rudimentary, and numerous entities are still included as 'provisional categories' in the World Health Classification of hematolopoietic malignancies. A relevant and useful classification of these disorders have been difficult to accomplish because of the rarity nature of them, the relative lack of understanding of the molecular pathogenesis, and their morphological and immunophenotypical complexity. Overall, T-cell lymphomas represent only 15 % of all non-Hodgkin lymphomas. This review is focused on addressing the current status of the categories of mature T-cell leukemias and lymphomas (nodal and extranodal) using an approach that incorporates histopathology, immunophenotype, and molecular understanding of the nature of these disorders, using the same philosophy of the most recent revised WHO classification of hematopoietic malignancies.
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Affiliation(s)
- Alejandro Ariel Gru
- Department of Pathology and Dermatology, Divisions of Hematopathology and Dermatopathology, Cutaneous Lymphoma Program, The Ohio State University Wexner Medical Center, Richard Solove 'The James' Comprehensive Cancer Center, 333 W 10th Ave, Columbus, OH, 43210, USA,
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29
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Sagasta A, Molina-Urra R, Martinez D, Gonzalez-Farre B, Marti E, Herranz MJ, Estrach T, Campo E, Colomo L. CD8-positive peripheral T-cell lymphoma with aberrant expression of CD20 and concurrent in situ follicular lymphoma. J Cutan Pathol 2014; 42:66-72. [PMID: 25354337 DOI: 10.1111/cup.12409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/13/2014] [Accepted: 10/25/2014] [Indexed: 11/28/2022]
Abstract
A case of a 78-year-old woman with a CD8-positive peripheral T-cell lymphoma with aberrant expression of CD20 associated with follicular lymphoma in situ (FLIS) is reported. The neoplasm presented initially as cutaneous macules, papules, plaques and nodules. A skin biopsy was performed and the diagnosis of peripheral T-cell lymphoma (PTCl) with aberrant expression of CD20 was made. The staging procedures included an excisional inguinal lymph node biopsy that showed findings similar to those of the previous diagnosis. In addition, FLIS was identified. The clinicopathologic features of PTCLs with aberrant CD20 expression involving the skin as well as this uncommon association are reviewed.
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Affiliation(s)
- Amaia Sagasta
- Hematopathology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
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30
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Abstract
The cytotoxic T-cell and natural killer (NK)-cell lymphomas and related disorders are important but relatively rare lymphoid neoplasms that frequently are a challenge for practicing pathologists. This selective review, based on a meeting of the International Lymphoma Study Group, briefly reviews T-cell and NK-cell development and addresses questions related to the importance of precise cell lineage (αβ-type T cell, γδ T cell, or NK cell), the implications of Epstein-Barr virus infection, the significance of anatomic location including nodal disease, and the question of further categorization of enteropathy-associated T-cell lymphomas. Finally, developments subsequent to the 2008 World Health Organization Classification, including the recognition of indolent NK-cell and T-cell disorders of the gastrointestinal tract are presented.
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31
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Somatic rearrangement of the TP63 gene preceding development of mycosis fungoides with aggressive clinical course. Blood Cancer J 2014; 4:e253. [PMID: 25325303 PMCID: PMC4220651 DOI: 10.1038/bcj.2014.73] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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32
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Guenova E, Schanz S, Hoetzenecker W, DeSimone J, Mehra T, Voykov B, Urosevic‐Maiwald M, Berneburg M, Dummer R, French L, Kerl K, Kamarashev J, Fierlbeck G, Cozzio A. Systemic corticosteroids for subcutaneous panniculitis‐like T‐cell lymphoma. Br J Dermatol 2014; 171:891-4. [DOI: 10.1111/bjd.13053] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- E. Guenova
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
| | - S. Schanz
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
| | - W. Hoetzenecker
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
| | - J.A. DeSimone
- Washington Hospital Center Department of Dermatology Georgetown University Washington DC U.S.A
| | - T. Mehra
- Medical Directorate University Hospital of Zürich Rämistraße 100 8091 Zürich Switzerland
| | - B. Voykov
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
| | - M. Urosevic‐Maiwald
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
| | - M. Berneburg
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
- Department of Dermatology University Hospital Regensburg Franz‐Josef‐Strauss‐Allee 11 D‐93053 Regensburg Germany
| | - R. Dummer
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
| | - L.E. French
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
| | - K. Kerl
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
| | - J. Kamarashev
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
| | - G. Fierlbeck
- Department of Dermatology University of Tübingen Liebermeisterstrasse 25 72076 Tübingen Germany
| | - A. Cozzio
- Department of Dermatology University Hospital Zurich Gloriastraße 31 Zürich Switzerland
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Abstract
Cutaneous CD30+ lymphoproliferative disorders are the second most common types of cutaneous T-cell lymphomas. They represent a well-defined spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL), and borderline lesions. They share the expression of CD30 as a common phenotypic hallmark, but they differ in their clinical presentation, course, and histologic features. New variants have been recently identified, including CD8+ epidermotropic LyP type D, angioinvasive LyP type E, and ALK-positive pcALCL. This review describes clinical, histopathologic, and phenotypic variants; their differential diagnoses (benign and malignant); and the role of CD30 as a diagnostic, prognostic, and therapeutic marker.
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Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz, Histologische Diagnostik, Seminarstrasse 1, Zürich CH-8042, Switzerland; Department of Dermatology, University Hospital, Zürich CH-8091, Switzerland.
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López-Lerma I. Linfoma cutáneo primario de células T CD4+ de tamaño pequeño-mediano. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.piel.2013.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Cutaneous T-cell lymphomas (CTCLs), other than mycosis fungoides/Sézary syndrome and the group of cutaneous CD30(+) lymphoproliferative disorders, are rare. These include subcutaneous panniculitis-like T-cell lymphoma (SPTCL); extranodal natural killer/T-cell lymphoma, nasal type; primary cutaneous peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS); and rare subtypes of PTCL, NOS. Apart from SPTCL and primary cutaneous CD4-positive small-medium pleomorphic T-cell lymphoma, these lymphomas have in common aggressive clinical behavior and poor prognosis. Differentiation between these different types of CTCL may be difficult and requires integration of histopathologic findings with clinical data and the results of phenotypic and often molecular genetic studies.
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Affiliation(s)
- Rein Willemze
- Department of Dermatology, Leiden University Medical Center, B1-Q-93, PO Box 9600, Leiden 2300 RC, The Netherlands.
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36
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Chuang SS, Ko YH. Cutaneous nonmycotic T- and natural killer/T-cell lymphomas: Diagnostic challenges and dilemmas. J Am Acad Dermatol 2014; 70:724-735. [DOI: 10.1016/j.jaad.2013.11.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/15/2013] [Accepted: 11/19/2013] [Indexed: 11/17/2022]
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Peripheral T cell lymphoma in Asia. Int J Hematol 2014; 99:227-39. [DOI: 10.1007/s12185-014-1520-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023]
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Nakai N, Hagura A, Yamazato S, Katoh N. Mycosis fungoides palmaris et plantaris successfully treated with radiotherapy: Case report and mini-review of the published work. J Dermatol 2014; 41:63-7. [DOI: 10.1111/1346-8138.12308] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/05/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Noriaki Nakai
- Department of Dermatology; Kyoto Prefectural University of Medicine Graduate School of Medical Science; Kamigyo-ku Kyoto Japan
| | - Asami Hagura
- Department of Dermatology; Kyoto Prefectural University of Medicine Graduate School of Medical Science; Kamigyo-ku Kyoto Japan
| | - Shiho Yamazato
- Department of Dermatology; Kyoto Prefectural University of Medicine Graduate School of Medical Science; Kamigyo-ku Kyoto Japan
| | - Norito Katoh
- Department of Dermatology; Kyoto Prefectural University of Medicine Graduate School of Medical Science; Kamigyo-ku Kyoto Japan
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Guenova E, Hoetzenecker W, Rozati S, Levesque MP, Dummer R, Cozzio A. Novel therapies for cutaneous T-cell lymphoma: what does the future hold? Expert Opin Investig Drugs 2014; 23:457-67. [PMID: 24397291 DOI: 10.1517/13543784.2014.876407] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Cutaneous T-cell lymphomas (CTCLs) represent a group of extranodal non-Hodgkin lymphomas, of which mycosis fungoides (MF) is the most frequent. Standard therapeutic approaches are well established and often achieve stable disease. However, cure for MF is rare and thus novel therapies are needed. AREAS COVERED This review provides a discussion of the most promising new therapeutic approaches in the management of MF and other rare CTCLs. It includes targeted therapies with antibodies against surface molecules on malignant T cells (e.g., brentuximab), novel chemotherapeutic agents (e.g., pralatrexate), small-molecule compounds (e.g., panobinostat) and evidence of emerging targets in CTCLs (e.g., anti-IL-31). It also provides discussion of immune checkpoint inhibitors such as anti-PD1 that are worth considering in the treatment of leukaemic CTCL variants. Finally, it gives a brief overview of the possible use of stem-cell transplantation. EXPERT OPINION There is no doubt that progress has been made in the treatment of CTCLs with new, innovative and promising therapies approaching. However, there is still an urgent need to identify and test additional targets in well-designed clinical trials.
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Affiliation(s)
- Emmanuella Guenova
- University Hospital of Zürich, Department of Dermatology , Gloriastrasse 31, 8091 Zürich , Switzerland +41 44 255 5528 ;
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41
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The microenvironment in T-cell lymphomas: emerging themes. Semin Cancer Biol 2013; 24:49-60. [PMID: 24316493 DOI: 10.1016/j.semcancer.2013.11.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/26/2013] [Accepted: 11/29/2013] [Indexed: 11/20/2022]
Abstract
Peripheral T-cell lymphomas (PTCLs) are heterogeneous and uncommon malignancies characterized by an aggressive clinical course and a mostly poor outcome with current treatment strategies. Despite novel insights into their pathobiology provided by recent genome-wide molecular studies, several entities remain poorly characterized. In addition to the neoplastic cell population, PTCLs have a microenvironment component, composed of non-tumor cells and stroma, which is quantitatively and qualitatively variable, and which may have an effect on their pathological and clinical features. The best example is provided by angioimmunoblastic T-cell lymphoma (AITL), a designation reflecting the typical vascularization and reactive immunoblastic content of the tumor tissues. In this disease, a complex network of interactions between the lymphoma cells and the microenvironment exists, presumably mediated by the neoplastic T cells with follicular helper T-cell properties. A better understanding of the crosstalk between neoplastic T or NK cells and their microenvironment may have important implications for guiding the development of novel therapies.
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Attygalle AD, Cabeçadas J, Gaulard P, Jaffe ES, de Jong D, Ko YH, Said J, Klapper W. Peripheral T-cell and NK-cell lymphomas and their mimics; taking a step forward - report on the lymphoma workshop of the XVIth meeting of the European Association for Haematopathology and the Society for Hematopathology. Histopathology 2013; 64:171-99. [PMID: 24128129 DOI: 10.1111/his.12251] [Citation(s) in RCA: 121] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Mature T-cell and T/NK-cell neoplasms are both uncommon and heterogeneous, among the broad category of non-Hodgkin lymphomas. Owing to the lack of specific genetic alterations in the vast majority, most currently defined entities show overlapping morphological and immunophenotypic features, and therefore pose a challenge to the diagnostic pathologist. In the light of recent immunophenotypic, cytogenetic and molecular genetics advances in the field of T-cell and T/NK-cell lymphomas, the focus of the lymphoma workshop of the European Association for Haematopathology/Society for Hematopathology meeting in Lisbon, Portugal, in October 2012 was to refine existing diagnostic criteria and clarify the borders between overlapping entities. The panel reviewed over 200 submitted cases, which were grouped into five categories: (i) angioimmunoblastic T-cell lymphoma and T-follicular-helper-cell-associated lymphomas; (ii) CD30-positive T-cell lymphomas/lymphoproliferative diseases; (iii) extranodal T-cell and NK-cell neoplasms; (iv) EBV-associated T-cell/NK-cell lymphomas/lymphoproliferative diseases; and (v) peripheral T-cell lymphoma, not otherwise specified, post-transplant lymphoproliferative disorders, and mimics. This report summarizes the discussions and conclusions of the workshop, which question current diagnostic criteria and provide recommendations for refining existing classifications.
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Song SX, Willemze R, Swerdlow SH, Kinney MC, Said JW. Mycosis fungoides: report of the 2011 Society for Hematopathology/European Association for Haematopathology workshop. Am J Clin Pathol 2013; 139:466-90. [PMID: 23525617 DOI: 10.1309/ajcpobdp2oqaj5br] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Session 1 of the 2011 Workshop of the Society for Hematopathology and European Association for Haematopathology focused on mycosis fungoides (MF), the most common cutaneous lymphoma. The 62 cases in this case group demonstrated a wide spectrum of clinicopathologic features, including those seen in typical cases as well as those, by contrast, with atypical clinical history, morphology, immunophenotype, and/or genotype. Of the 62 cases, 27 (44%) were presented at the workshop and highlighted diagnostic challenges plus related issues. This report summarizes the approach recommended for making a confident diagnosis of MF and its clinically significant variants; emphasizes pitfalls in evaluating early MF, assessing nodal involvement, and diagnosing transformed MF; and discusses the relationship between MF and primary cutaneous CD30+ T-cell lymphoproliferative disorders. Last, Sézary syndrome is discussed, with concentration on those features distinct from MF.
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Affiliation(s)
- Sophie X. Song
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Steven H. Swerdlow
- Department of Pathology, Division of Hematopathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Marsha C. Kinney
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX
| | - Jonathan W. Said
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA
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Sarantopoulos GP, Palla B, Said J, Kinney MC, Swerdlow SM, Willemze R, Binder SW. Mimics of cutaneous lymphoma: report of the 2011 Society for Hematopathology/European Association for Haematopathology workshop. Am J Clin Pathol 2013; 139:536-51. [PMID: 23525620 DOI: 10.1309/ajcpx4bxtp2qbrko] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The Society for Hematopathology and European Association for Haematopathology workshop, from October 27 to 29, 2011, in Los Angeles, CA, exhibited many exemplary skin biopsy specimens with interesting inflammatory changes mimicking features of cutaneous lymphoma. This article reviews features observed in cutaneous lymphoid hyperplasia, cutaneous drug reactions, lupus-associated panniculitis, pityriasis lichenoides, hypereosinophilic syndrome, histiocytic necrotizing lymphadenitis, traumatic ulcerative granuloma with stromal eosinophils, and pigmented purpuric dermatosis, as well as a brief review of the pertinent literature and discussion of submitted conference cases. For the pathologist, it is important to be aware of diagnostic pitfalls as well as the limitations of ancillary testing (eg, clonality studies). Finally, correlation with total clinical information, good communication with clinical colleagues, close clinical follow-up with rebiopsy, and prudent use of laboratory studies are vital and will likely offer the best path toward a correct diagnosis.
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Affiliation(s)
| | - Beth Palla
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA
| | - Jonathan Said
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA
| | | | - Steven M. Swerdlow
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Scott W. Binder
- Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA
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Swerdlow SH, Quintanilla-Martinez L, Willemze R, Kinney MC. Cutaneous B-cell lymphoproliferative disorders: report of the 2011 Society for Hematopathology/European Association for Haematopathology workshop. Am J Clin Pathol 2013; 139:515-35. [PMID: 23525619 DOI: 10.1309/ajcpnlc9nc9wtqyy] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The diagnosis and classification of the cutaneous B-cell lymphomas can be quite a challenge, with a definitive diagnosis sometimes being elusive, even when an extensive workup has been performed. Distinction of benign from neoplastic disorders can be difficult, with some hyperplasias mimicking lymphomas and vice versa. There are only a limited number of skin-specific B-cell lymphomas, including primary cutaneous follicle center lymphoma and primary cutaneous diffuse large B-cell lymphoma, leg type. Cutaneous marginal zone lymphomas have distinctive features but are classified with the other mucosa-associated lymphoid tissue lymphomas. It is important, however, to also remember that many other B-cell lymphomas/ plasma cell neoplasms can primarily, or more often secondarily, involve the skin. Some may mimic one of the skin-specific lymphomas but have very different clinical implications. Iatrogenic and senescent immunodeficiency-associated lymphoproliferative disorders that are often Epstein-Barr virus (EBV) positive can also primarily involve the skin, including cases also known as EBV-positive mucocutaneous ulcer.
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Affiliation(s)
- Steven H. Swerdlow
- Department of Pathology, Division of Hematopathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marsha C. Kinney
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX
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