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Petraglia AF, Davick JJ, Mandell JW, Lapides DA. Rosai-Dorfman Disease: A Less Common Cause of Leptomeningeal and Nerve Root Enhancement. Neurohospitalist 2020; 10:309-313. [PMID: 32983353 DOI: 10.1177/1941874420929187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A 46-year-old male experienced progressive neurocognitive decline, weight loss, intermittent headaches, and weakness over 6 months. Magnetic resonance imaging of the brain revealed hydrocephalus and the spinal cord imaging showed diffuse leptomeningeal enhancement with prominent nerve root involvement. Intradural biopsy of lumbar arachnoid tissue found mixed inflammatory infiltrate consisting predominantly of histiocytes, S100 and CD68 positivity, and lymphocytophagocytosis (emperipolesis) consistent with extranodal Rosai-Dorfman disease. Rosai-Dorfman disease, a non-Langerhans cell histocytic disorder, can mimic the appearance of neurosarcoidosis and leptomeningeal carcinomatosis and should remain on the differential of a patient presenting with diffuse leptomeningeal enhancement, a common occurrence on a neurohospitalist service.
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Affiliation(s)
| | - Jonathan J Davick
- Department of Pathology, University of Virginia Health System, VA, USA
| | - James W Mandell
- Department of Pathology, University of Virginia Health System, VA, USA
| | - David A Lapides
- Department of Neurology, University of Virginia Health System, VA, USA
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Stelow EB, Dill EA, Davick JJ, McCabe MB, Shami VM. High-Grade Squamous Intraepithelial Lesion of the Gastroesophageal Junction Secondary to High-Risk Human Papillomavirus. Am J Clin Pathol 2019; 152:359-364. [PMID: 31216362 DOI: 10.1093/ajcp/aqz039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Although the role of human papillomavirus (HPV) in the development of some carcinomas (eg, anogenital and oropharyngeal squamous cell carcinomas) is nondebatable, there is still significant controversy regarding the relationship of HPV and esophageal squamous cell carcinomas (SCCs). METHODS All cases were sampled at or near the gastroesophageal junctions in patients with reflux and/or known Barrett esophagus and appear to have been initially sampled "incidentally." Patients were all men, aged 56 to 80 years. None had a known history of other HPV-related disease. RESULTS We present four cases of high-grade squamous intraepithelial lesion of the gastroesophageal junction secondary to high-risk HPV that have identical histologic features to similar lesions of the anogenital tract. CONCLUSIONS Whether such lesions are at risk for developing into invasive SCC remains unclear.
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Affiliation(s)
- Edward B Stelow
- Department of Pathology, University of Virginia, Charlottesville
| | - Erik A Dill
- Department of Pathology, University of Virginia, Charlottesville
| | | | - Michael B McCabe
- Division of Gastroenterology, Department of Internal Medicine, University of Virginia, Charlottesville
| | - Vanessa M Shami
- Division of Gastroenterology, Department of Internal Medicine, University of Virginia, Charlottesville
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Lapides DA, Abusamaan MS, Davick JJ, Sharma AM, Mandell JW, Lopes MBS, Provencio JJ, Worrall BB, Southerland AM. Segmental arterial mediolysis: A rare cause of rapidly progressive arterial dissections. Neurol Clin Pract 2018; 7:e43-e46. [PMID: 29431173 DOI: 10.1212/cpj.0000000000000403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/10/2017] [Indexed: 11/15/2022]
Affiliation(s)
- David A Lapides
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - Mazen S Abusamaan
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - Jonathan J Davick
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - Aditya M Sharma
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - James W Mandell
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - M Beatriz S Lopes
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - J Javier Provencio
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - Bradford B Worrall
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
| | - Andrew M Southerland
- Departments of Neurology (DAL, JJP, BBW, AMS), Medicine (MSA, AMS), Pathology (JJD, JWM, MBSL), and Public Health Sciences (BBW, AMS), University of Virginia Health System, Charlottesville
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Davick JJ, Gaughan E, Barry M, Gru AA. Primary Cutaneous Small/Medium CD4+ T-CELL Lymphoproliferative Disorder Occurring in a Patient With Metastatic Melanoma. Am J Dermatopathol 2018; 40:60-63. [PMID: 28719434 DOI: 10.1097/dad.0000000000000960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Therapeutic agents designed to stimulate the immune system are now cornerstones in the treatment of metastatic melanoma. These drugs promote lymphocyte growth and survival, which could plausibly result in clinical lymphoproliferative disorders. We report the case of a 62-year-old female with metastatic melanoma who developed primary cutaneous small/medium CD4 T-cell lymphoproliferative disorder (PC-SMTCL) after treatment with vemurafenib and recombinant high-dose interleukin-2 (IL-2). The patient developed a painless red papule behind the ear. A biopsy showed a dense population of CD4 lymphocytes with a T-follicular helper cell phenotype. Molecular studies confirmed the presence of a clonal population of T cells, and the process was classified as PC-SMTCL. The patient was diagnosed with metastatic melanoma approximately 3 years before the development of the cutaneous lymphoma and had been treated with vemurafenib followed by 2 courses of IL-2. The patient's last course of IL-2 was completed in April of 2013. She developed the cutaneous lymphoma behind her ear in December of 2015. An association between PC-SMTCL and vemurafenib treatment for advanced melanoma has been reported previously in one patient; however, an association between PC-SMTCL and IL-2 treatment has not been documented. The immunostimulatory properties of IL-2 or vemurafenib may be responsible for the development of PC-SMTCL in our patient. Additionally, antigenic stimulation of the immune system by melanoma itself could contribute to clonal selection of lymphocytes.
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Affiliation(s)
- Jonathan J Davick
- Department of Pathology, University of Virginia Medical Center, Charlottesville, VA
| | - Elizabeth Gaughan
- Division of Hematology and Oncology, Department of Medicine, University of Virginia Medical Center, Charlottesville, VA
| | | | - Alejandro A Gru
- Department of Pathology, University of Virginia Medical Center, Charlottesville, VA
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Davick JJ, Mutgi KAJ, Wanat KA, Link BK, Liu V. Disseminated CD8-positive, CD30-positive cutaneous lymphoproliferative eruption with overlapping features of mycosis fungoides and primary cutaneous anaplastic large cell lymphoma following remote solitary lesional presentation. J Cutan Pathol 2017; 44:703-712. [DOI: 10.1111/cup.12961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 03/31/2017] [Accepted: 05/08/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Jonathan J. Davick
- Department of Pathology; University of Virginia; Charlottesville Virginia
| | - Krishna A. J. Mutgi
- Department of Dermatology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Karolyn A. Wanat
- Department of Dermatology; University of Iowa Hospitals and Clinics; Iowa City Iowa
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Brian K. Link
- Department of Medicine, Division of Hematology-Oncology; University of Iowa Hospitals and Clinics; Iowa City Iowa
| | - Vincent Liu
- Department of Dermatology; University of Iowa Hospitals and Clinics; Iowa City Iowa
- Department of Pathology; University of Iowa Hospitals and Clinics; Iowa City Iowa
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