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Shi J, Jin L, Zhang D, Kang X. Extranodal NK/T-cell lymphoma manifesting as cutaneous lesions and intestinal perforation: A case report. Indian J Dermatol Venereol Leprol 2023; 89:927. [PMID: 37317724 DOI: 10.25259/ijdvl_746_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/22/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Jingyi Shi
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Clinical Research Center For Dermatologic Diseases; Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, XinJiang, China
| | - Lan Jin
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Clinical Research Center For Dermatologic Diseases; Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, XinJiang, China
| | - Dezhi Zhang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Clinical Research Center For Dermatologic Diseases; Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, XinJiang, China
| | - Xiaojing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region; Xinjiang Clinical Research Center For Dermatologic Diseases; Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, XinJiang, China
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2
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Fernandez-Flores A, Cassarino D. CD30 in Cutaneous Pathology. Am J Dermatopathol 2023; 45:593-607. [PMID: 37625801 DOI: 10.1097/dad.0000000000002422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
ABSTRACT The discovery of CD30 as a diagnostic marker was essential in the identification of not only some lymphomas but also many other solid tumors and benign reactive conditions. Many CD30+ cutaneous disorders and tumors have been categorized since the identification of the marker. With the design of targeted therapies against CD30+ tumoral cells, the interest in CD30 determination was not only diagnostic but also mainly therapeutic. In this article, we explore the historical aspects of the discovery of CD30 and examine the main CD30-related cutaneous pathology, susceptible of anti-CD30 modern treatments.
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Affiliation(s)
- Angel Fernandez-Flores
- Dermatopathologist, Department of Histopathology, University Hospital El Bierzo, Ponferrada, Spain
- Department of Cellular Pathology, Hospital de la Reina, Ponferrada, Spain
- Research Department, Institute for Biomedical Research of a Coruña (INIBIC), University of a Coruña (UDC), A Coruña, Spain; and
| | - David Cassarino
- Pathologist, Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Departments of Pathology and Dermatology, Los Angeles, CA
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3
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Magro CM, Mo JH, Telang G. Localized lymphomatoid papulosis: Unilesional lymphomatoid papulosis, regional lymphomatoid papulosis, and persistent agmination of lymphomatoid papulosis. Clin Dermatol 2022; 40:622-638. [PMID: 35907581 DOI: 10.1016/j.clindermatol.2022.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Lymphomatoid papulosis (LYP), the most common primary cutaneous CD30-positive lymphoproliferative disorder, is heralded by multiple papular and nodular lesions at anatomically discontiguous cutaneous sites. The histologic patterns are protean. An uncommon form of LYP is one that is anatomically confined. Cases of unilesional LYP, regional LYP, and persistent agmination of LYP were encountered in the routine and consultative practices of Weill Cornell Medicine, Division of Dermatopathology. The clinical presentation, outcomes, light microscopic findings, and phenotypic profile are reviewed. There were 10 cases of LYP presenting as solitary plaques or nodules primarily occurring in older patients and without a relevant medical history in most. Most cases occurred at an acral site with many localized to the foot; the morphology was one of a necrotizing angiocentric type E pattern and borderline type C morphology. Two of the unilesional patients in our series went on to develop mycosis fungoides, one at the initial site of unilesional type A LYP, and the other at a discontiguous site. Excluding one case, the solitary lesions underwent complete regression; after the lesions regressed, some cases had no apparent recurrence. The second anatomically confined variant of LYP in our series was regional LYP exhibiting a type E morphology in two cases and a hybrid type A and granulomatous eccrinotropic morphology in one case. There was no subsequent development of lymphoma, nor was there any spread to additional anatomic sites. The final category was persistent agmination of LYP, whereby the agminated papules of LYP were superimposed on a plaque of cutaneous T-cell lymphoma represented by mycosis fungoides in two and follicular helper T-cell lymphoma in one. In conclusion, anatomically confined LYP defines an uncommon form of LYP, but it is an important one to recognize because the histology can be worrisome despite an indolent clinical course. The clinical presentation, the infrequent association with lymphoma/leukemia, and histology are similar to conventional LYP, although there appears to be a greater tendency for complete regression without recurrence, excluding cases of persistent agmination of LYP whereby the clinical course warrants categorization as a form of cutaneous T cell lymphoma (CTCL).
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Affiliation(s)
- Cynthia M Magro
- Division of Dermatopathology, Weill Cornell Medicine, New York, New York, USA.
| | - Joshua H Mo
- Department of Dermatology, Brown University Alpert School of Medicine, Providence, Rhode Island, USA
| | - Gladys Telang
- Department of Dermatology, Brown University Alpert School of Medicine, Providence, Rhode Island, USA
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4
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Duman N, Ceylan C, Yaman B, Hekimgil M. Multiple indurated nodular lesions on the lip, upper trunk and limbs of an 80-year-old man. Clin Exp Dermatol 2022; 47:2322-2326. [PMID: 36250765 DOI: 10.1111/ced.15350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
We report multiple indurated nodular lesions on the lip, upper trunk and extremities of an 80-year-old man.
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Affiliation(s)
- Nilay Duman
- Department of Dermatology, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Can Ceylan
- Department of Dermatology, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Banu Yaman
- Department of Pathology, Faculty of Medicine, Ege University, İzmir, Türkiye
| | - Mine Hekimgil
- Department of Pathology, Faculty of Medicine, Ege University, İzmir, Türkiye
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5
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Genetic and immunohistochemical profiling of NK/T-cell lymphomas reveals prognostically relevant BCOR-MYC association. Blood Adv 2022; 7:178-189. [PMID: 35882439 PMCID: PMC9837655 DOI: 10.1182/bloodadvances.2022007541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 05/06/2022] [Indexed: 01/21/2023] Open
Abstract
Extranodal NK/T-cell lymphoma, nasal type (ENKTL) is an Epstein-Barr virus-positive, aggressive lymphoma with a heterogeneous cell of origin and variable clinical course. Several clinical prognostic indices have been proposed for ENKTL; however, there are few pathological biomarkers. This multi-institutional study sought to identify histologically assessable prognostic factors. We investigated mutation profiles by targeted next-generation sequencing (NGS) and immunohistochemical assessments of expression of MYC, Tyr705-phosphorylated (p-)STAT3, and CD30 in 71 ENKTL samples. The median age of the patients was 66 years (range, 6-100). The most frequent mutations were in STAT3 (27%), JAK3 (4%), KMT2D (19%), TP53 (13%), BCOR (10%), and DDX3X (7%). Immunohistochemistry (IHC) revealed that ENKTLs with STAT3 mutations exhibited higher expression of pSTAT3 and CD30. BCOR mutations were associated with increased MYC expression. Univariate analysis in the entire cohort showed that stage (II, III, or IV), BCOR mutations, TP53 mutations, and high MYC expression (defined as ≥40% positive neoplastic cells) were associated with reduced overall survival (OS). Multivariate modeling identified stage (II, III, or IV) and high MYC expression as independent adverse prognostic factors. In a subgroup analysis of patients treated with anthracycline (AC)-free chemotherapy and/or radiotherapy (RT) with curative intent, BCOR but not high MYC expression was an independent adverse prognostic factor. In conclusion, activating STAT3 mutations are common in ENKTLs and are associated with increased CD30 expression. MYC overexpression is, at least in part, associated with deleterious BCOR mutations, and this BCOR-MYC linkage may have prognostic significance, underscoring the potential utility of IHC for MYC in risk stratification of patients with ENKTL.
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Epstein-Barr Virus-Associated T- and NK-Cell Lymphoproliferative Diseases: A Review of Clinical and Pathological Features. Cancers (Basel) 2021; 13:cancers13133315. [PMID: 34282778 PMCID: PMC8268319 DOI: 10.3390/cancers13133315] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary In most Epstein–Barr virus (EBV)-infected individuals, the virus establishes a lifelong latent infection with no specific clinical manifestation. However, EBV primary infection and secondary reactivation may cause various EBV-associated lymphoproliferative disorders (LPD), including hematologic malignancies. Among them, EBV-positive T/NK LPD are uncommon diseases defined by the proliferation of T- or NK-cells infected by EBV, more commonly encountered in Asians and Latin Americans. They encompass a spectrum of disorders ranging from indolent reactive lesions to malignant and aggressive diseases. Despite novel insights from high-throughput molecular studies, the pathogenesis of these disorders is not well understood, and EBV-positive T/NK LPD diagnoses remain challenging due to their rarity and considerable overlap. Indeed, this article discusses new insights into EBV-positive T/NK LPD and focuses on diagnosis challenges, describing the difficulties to clarify the borders between overlapping LPD subtypes. Abstract Epstein–Barr virus (EBV) is a ubiquitous virus detected in up to 95% of the general population. Most people are asymptomatic, while some may develop a wide range of EBV-associated lymphoproliferative disorders (LPD). Among them, EBV-positive T/NK LPD are uncommon diseases defined by the proliferation of T- or NK-cells infected by EBV. The 2017 World Health Organization (WHO) classification recognizes the following entities characterized by different outcomes: chronic active EBV infection of T- or NK-cell types (cutaneous and systemic forms), systemic EBV-positive T-cell lymphoma of childhood, EBV-positive aggressive NK-cell leukemia, extra nodal NK/T-cell lymphoma nasal type, and the new provisional entity known as primary EBV-positive nodal T/NK-cell lymphoma. In addition, EBV associated-hemophagocytic lymphohistiocytosis is part of EBV-positive T/NK LPD, but has not been included in the WHO classification due to its reactive nature. Despite novel insights from high-throughput molecular studies, EBV-positive NK/T-cell LPD diagnoses remain challenging, especially because of their rarity and overlap. Until now, an accurate EBV-positive NK/T LPD diagnosis has been based on its clinical presentation and course correlated with its histological features. This review aims to summarize clinical, pathological and molecular features of EBV-positive T/NK LPD subtypes and to provide an overview of new understandings regarding these rare disorders.
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7
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Xue W, Zhang M. Updating targets for natural killer/T-cell lymphoma immunotherapy. Cancer Biol Med 2021; 18:52-62. [PMID: 33628584 PMCID: PMC7877170 DOI: 10.20892/j.issn.2095-3941.2020.0400] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/24/2020] [Indexed: 12/29/2022] Open
Abstract
Natural killer/T-cell lymphoma (NKTCL) is a highly invasive subtype of non-Hodgkin lymphoma, typically positive for cytoplasmic CD3, CD56, cytotoxic markers, including granzyme B and TIA1, and Epstein-Barr virus (EBV). The current treatment methods for NKTCL are associated with several drawbacks. For example, chemotherapy can lead to drug resistance, while treatment with radiotherapy alone is inadequate and results in frequent relapses. Moreover, hematopoietic stem cell transplantation exhibits limited efficacy and is not well recognized by domestic and foreign experts. In recent years, immunotherapy has shown good clinical results and has become a hot spot in cancer research. Clinical activity of targeted antibodies, such as daratumumab (anti-CD38 antibody) and brentuximab vedotin (anti-CD30 antibody), have been reported in NKTCL. Additionally, dacetuzumab and Campath-1H have demonstrated promising results. Further encouraging data have been obtained using checkpoint inhibitors. The success of these immunotherapy agents is attributed to high expression levels of programmed death-ligand 1 in NKTCL. Furthermore, anti-CCR4 monoclonal antibodies (mAbs) exert cytotoxic actions on both CCR4+ tumor cells and regulatory T cells. Depletion of these cells and the long half-life of anti-CCR4 mAbs result in enhanced induction of antitumor effector T cells. The role of IL10 in NKTCL has also been investigated. It has been proposed that exploitation of this cytokine might provide potential novel therapeutic strategies. Cellular immunotherapy with engineered cytotoxic T lymphocytes targeted against LMP1 and LMP2 has shown promising results and sustained remission. Cellular immunotherapy may be used either as maintenance therapy following initial induction chemotherapy or in cases of relapsed/refractory disease. The present review outlines the known immunotherapy targets for the treatment of NKTCL.
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Affiliation(s)
- Weili Xue
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Lymphoma Diagnosis and Treatment Center of Henan, Zhengzhou 450052, China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Lymphoma Diagnosis and Treatment Center of Henan, Zhengzhou 450052, China
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8
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Lungu M, Telehuz A, Voinescu DC, Sapira V, Trifan A, Elkan EM, Fătu A, Creangă VZ, Polinschi M, Stoleriu G, Niculet E. NK/T-cell non-Hodgkin lymphoma: Case report and review of the literature. Exp Ther Med 2020; 21:91. [PMID: 33363602 PMCID: PMC7725024 DOI: 10.3892/etm.2020.9523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/26/2020] [Indexed: 11/25/2022] Open
Abstract
Natural killer (NK)/T-cell lymphomas represent a rare type of lymphoid malignancy with mostly extranodal involvement, having NK cell or (rare) T cell lineage, classified by the World Health Organization into several subtypes which can involve the head and neck region, with the most frequent one being the nasal type. This article presents the case of a 31-year-old patient who presented at the Emergency Unit of Saint Andrew Emergency Clinical Hospital of Galati suffering from mycosis fungoides-like cutaneous lesions, associated with partial left eyelid ptosis of unknown etiology, as well as a poor health status with fever and respiratory failure. The final diagnosis was NK/T-cell non-Hodgkin lymphoma, possibly nasal type with medium sized T cells. The complexity of the rare diagnosis, associated with the unusual rapid patient evolution towards exitus 3 months after diagnosis, the intra-orbital metastatic involvement and the absence of a standardized treatment are case peculiarities, some of which are consistent with current literature data.
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Affiliation(s)
- Mihaiela Lungu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Anca Telehuz
- Research Center of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Doina Carina Voinescu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Violeta Sapira
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Angel Trifan
- Research Center of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Eva Maria Elkan
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Ana Fătu
- Research Center of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Valerica Zărnescu Creangă
- Research Center of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Mihai Polinschi
- Research Center of Medical and Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Gabriela Stoleriu
- Clinical Department, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University of Galati, 800008 Galati, Romania
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9
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Guan P, Dong T, Zhang L, Zhao S, Liu R, Chen Z. Staging challenges in extranasal and juvenile extranodal NK/T-cell lymphoma. Leukemia 2020; 34:3428-3431. [PMID: 32665697 DOI: 10.1038/s41375-020-0975-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/02/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Pujun Guan
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Tian Dong
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Sha Zhao
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Rongbo Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Zihang Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.
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10
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Rodriguez-Pinilla SM, Domingo-Domenech E, Climent F, Sanchez J, Perez Seoane C, Lopez Jimenez J, Garcia-Cosio M, Caballero D, Blanco Muñez OJ, Carpio C, Castellvi J, Martinez Pozo A, Gonzalez Farre B, Bendaña A, Aliste C, Gonzalez AJ, Gonzalez de Villambrosia S, Piris MA, Gomez Codina J, Mayordomo-Aranda E, Navarro B, Bellas C, Rodriguez G, Borrero JJ, Ruiz-Zorrilla A, Grande M, Montoto C, Cordoba R. Clinical and pathological characteristics of peripheral T-cell lymphomas in a Spanish population: a retrospective study. Br J Haematol 2020; 192:82-99. [PMID: 32426847 PMCID: PMC7818499 DOI: 10.1111/bjh.16741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
We investigated the clinicopathological features and prognostic factors of patients with peripheral T‐cell lymphoma (PTCL) in 13 sites across Spain. Relevant clinical antecedents, CD30 expression and staining pattern, prognostic indices using the International Prognostic Index and the Intergruppo Italiano Linfomi system, treatments, and clinical outcomes were examined. A sizeable proportion of 175 patients had a history of immune‐related disorders (autoimmune 16%, viral infections 17%, chemo/radiotherapy‐treated carcinomas 19%). The median progression‐free survival (PFS) and overall survival (OS) were 7·9 and 15·8 months, respectively. Prognostic indices influenced PFS and OS, with a higher number of adverse factors resulting in shorter survival (P < 0·001). Complete response (CR) to treatment was associated with better PFS (62·6 vs. 4 months; P < 0·001) and longer OS (67·0 vs. 7·3 months; P < 0·001) compared to no CR. CD30 was expressed across all subtypes; >15% of cells were positive in anaplastic lymphoma kinase‐positive and ‐negative anaplastic large‐cell lymphoma and extranodal natural killer PTCL groups. We observed PTCL distribution across subtypes based on haematopathological re‐evaluation. Poor prognosis, effect of specific prognostic indices, relevance of histopathological sub‐classification, and response level to first‐line treatment on outcomes were confirmed. Immune disorders amongst patients require further examination involving genetic studies and identification of associated immunosuppressive factors.
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Affiliation(s)
| | - Eva Domingo-Domenech
- Hematology Department, Institut Català d'Oncologia L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Fina Climent
- Pathology Department, Hospital Universitari de Bellvitge. IDIBELL, L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Joaquin Sanchez
- Hematology Department and Pathology Department, Hospital Universitario Reina Sofía, Cordoba, Spain
| | - Carlos Perez Seoane
- Hematology Department and Pathology Department, Hospital Universitario Reina Sofía, Cordoba, Spain
| | | | - Monica Garcia-Cosio
- Anatomical Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, CIBERONC, Madrid, Spain
| | - Dolores Caballero
- Hematology Department, Hospitalario Universitario de Salamanca (HUS/IBSAL) and CIBERONC, Salamanca, Spain
| | | | - Cecilia Carpio
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Castellvi
- Pathology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonio Martinez Pozo
- Pathology Department, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERONC, Universitat de Barcelona, Barcelona, Spain
| | - Blanca Gonzalez Farre
- Hematopathology Unit, Hospital Clínic Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) CIBERONC Universitat de Barcelona, Barcelona, Spain
| | - Angeles Bendaña
- Hematology Department, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña,, Spain
| | - Carlos Aliste
- Hematology Department, Complexo Hospitalario Universitario de Santiago de Compostela, La Coruña,, Spain
| | - Ana Julia Gonzalez
- Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Miguel A Piris
- Hospital Universitario Fundación Jiménez Díaz, Madrid, CIBERONC, Madrid, Spain
| | - Jose Gomez Codina
- Medical Oncology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Belen Navarro
- Hematology Department, Hospital Universitario Puerta de Hierro, Madrid, CIBERONC, Madrid, Spain
| | - Carmen Bellas
- Pathology Department, Hospital Universitario Puerta de Hierro, Madrid, CIBERONC, Madrid, Spain
| | - Guillermo Rodriguez
- Anatomical Pathology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/Universidad de Sevilla, Sevilla, Spain
| | - Juan Jose Borrero
- Anatomical Pathology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/Universidad de Sevilla, Sevilla, Spain
| | | | - Marta Grande
- Medical Department, Takeda Farmacéutica España S.A, Madrid, Spain
| | - Carmen Montoto
- Medical Department, Takeda Farmacéutica España S.A, Madrid, Spain
| | - Raul Cordoba
- Hematology Department, Fundación Jiménez Díaz, Madrid, CIBERONC, Madrid, Spain
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Abstract
While our understanding of the biology of CD30 in lymphoma continues to evolve, our need to detect and measure its expression at the protein level remains critically important for diagnosis and patient care. In addition to its diagnostic and prognostic utility, CD30 has emerged as a vehicle for drug targeting through the antibody-drug conjugate brentuximab-vedotin (BV). Given the numerous ways that CD30 is utilized and its emergence as a predictive/prognostic biomarker, pathologists must come to a general consensus on the best reporting structure and methodology to ensure appropriate patient care. In this manuscript, we review the indications for testing, various modalities for testing, technical challenges, pitfalls, and potential standards of reporting. The following questions will try to be addressed in the current review article: What defines a "POSITIVE" level of CD30 expression?; How do we evaluate and report CD30 expression?; What are the caveats in the evaluation of CD30 expression?
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12
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Liu LH, Huang Q, Liu YH, Yang J, Fu H, Jin L. Muscular involvement of extranodal natural killer/T cell lymphoma misdiagnosed as polymyositis: A case report and review of literature. World J Clin Cases 2020; 8:963-970. [PMID: 32190634 PMCID: PMC7062622 DOI: 10.12998/wjcc.v8.i5.963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/23/2019] [Accepted: 12/13/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Natural killer (NK)/T cell lymphoma is a rare and highly aggressive malignant tumor, and is a special form of non-Hodgkin's lymphoma. Although extranodal involvement is frequently found in tissues such as the skin, testicular and gastrointestinal tract etc, its presence in skeletal muscle has scarcely been reported in the literature.
CASE SUMMARY We report a case of extranodal NK/T cell lymphoma with muscle swelling as the first clinical manifestation. A 42-year-old man, who initially presented with localized swelling in the double lower extremities, demonstrated gradual facial and eyelid swelling, and his imaging results showed multiple sites of muscle damage throughout the body. The final pathological results suggested NK/T cell lymphoma, and immunohistochemistry showed CD20 (-), CD3Ɛ (+), CD30 (+), CD56 (-), EBER (+), Ki67 (60%), TIA-1 (+) and CD68 (±) staining. The muscle swelling significantly improved after treatment with chemotherapy regimens.
CONCLUSION This disease is difficult to diagnose and highly invasive, and should be included in the differential diagnosis of unexplained muscle swelling.
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Affiliation(s)
- Li-Hui Liu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Department of Geriatrics Stroke Center, Cerebrovascular disease clinical research center of Hunan province, Changsha 410008, Hunan Province, China
| | - Qing Huang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Department of Geriatrics Stroke Center, Cerebrovascular disease clinical research center of Hunan province, Changsha 410008, Hunan Province, China
| | - Yun-Hai Liu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Department of Geriatrics Stroke Center, Cerebrovascular disease clinical research center of Hunan province, Changsha 410008, Hunan Province, China
| | - Jie Yang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Department of Geriatrics Stroke Center, Cerebrovascular disease clinical research center of Hunan province, Changsha 410008, Hunan Province, China
| | - Han Fu
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Lin Jin
- Department of Neurology, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
- Department of Geriatrics Stroke Center, Cerebrovascular disease clinical research center of Hunan province, Changsha 410008, Hunan Province, China
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13
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Saleem A, Natkunam Y. Extranodal NK/T-Cell Lymphomas: The Role of Natural Killer Cells and EBV in Lymphomagenesis. Int J Mol Sci 2020; 21:ijms21041501. [PMID: 32098335 PMCID: PMC7073055 DOI: 10.3390/ijms21041501] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/15/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023] Open
Abstract
Natural killer (NK) cells are lymphocytes involved in innate and adaptive immune functions. They are the presumed cell of origin of distinct hematolymphoid malignancies, including aggressive NK-cell leukemia and extranodal NK/T-cell lymphoma (ENKTL). This review focuses on the role of NK cells and Epstein–Barr virus (EBV) in ENKTL pathogenesis.
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Guan P, Chen Z, Chu L, Zhen L, Zhang L, Pan L, Liu W, Liu R. Extranodal NK/T-cell lymphoma in adolescents: imaging findings of a consecutive 7-year case series. J Int Med Res 2019; 47:1210-1220. [PMID: 30727780 PMCID: PMC6421368 DOI: 10.1177/0300060518822406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives Extranodal NK/T-cell lymphoma is reportedly a rare but emerging type of
lymphoma in adolescents. The present study was performed to specify its
imaging characteristics. Methods Our hospital’s picture archiving and communication systems were searched from
January 2009 to December 2016. We identified 13 patients aged <18 years
with pathologically confirmed extranodal NK/T-cell lymphoma in the head and
neck region. The computed tomography and magnetic resonance images were
reviewed to summarize the imaging characteristics of extranodal NK/T-cell
lymphoma in adolescents. Results The mean age at onset was 15.2 ± 1.46 years (range, 12–17 years) with a
male:female ratio of 1.17:1.00. Most of the patients (n = 10) displayed
nasal cavity and/or paranasal involvement. The tumor was homogeneous in both
computed tomography and magnetic resonance images and showed slight
enhancement. No calcification or liquefactive necrosis was observed.
Adjacent structures were usually involved. Conclusion Suggestive imaging characteristics could acquaint specialists with extranodal
NK/T-cell lymphoma in adolescents, facilitating improved early recognition
of the diagnosis and helping to improve the patient’s outcome.
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Affiliation(s)
- Pujun Guan
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.,*These authors contributed equally to this work
| | - Zihang Chen
- 2 Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.,3 Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.,*These authors contributed equally to this work
| | - Lei Chu
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhen
- 4 Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li Zhang
- 3 Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Pan
- 3 Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Weiping Liu
- 2 Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Rongbo Liu
- 1 Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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