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McCloskey D, Semeere A, Ayanga R, Laker-Oketta M, Lukande R, Semakadde M, Kanyesigye M, Wenger M, LeBoit P, McCalmont T, Maurer T, Gardner A, Boza J, Cesarman E, Martin J, Erickson D. LAMP-enabled diagnosis of Kaposi's sarcoma for sub-Saharan Africa. Sci Adv 2023; 9:eadc8913. [PMID: 36638178 DOI: 10.1126/sciadv.adc8913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Kaposi's sarcoma (KS) is an endothelial cancer caused by the Kaposi's sarcoma-associated herpesvirus (KSHV) and is one of the most common cancers in sub-Saharan Africa. In limited-resource settings, traditional pathology infrastructure is often insufficient for timely diagnosis, leading to frequent diagnoses at advanced-stage disease where survival is poor. In this study, we investigate molecular diagnosis of KS performed in a point-of-care device to circumvent the limited infrastructure for traditional diagnosis. Using 506 mucocutaneous biopsies collected from patients at three HIV clinics in Uganda, we achieved 97% sensitivity, 92% specificity, and 96% accuracy compared to gold standard U.S.-based pathology. The results presented in this manuscript show that LAMP-based quantification of KSHV DNA extracted from KS-suspected biopsies has the potential to serve as a successful diagnostic for the disease and that diagnosis may be accurately achieved using a point-of-care device, reducing the barriers to obtaining KS diagnosis while increasing diagnostic accuracy.
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Affiliation(s)
- Duncan McCloskey
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14850, USA
| | - Aggrey Semeere
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Racheal Ayanga
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Miriam Laker-Oketta
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Lukande
- Pathology Department, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Micheal Kanyesigye
- Immune Suppression Syndrome Clinic, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Megan Wenger
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Philip LeBoit
- Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Timothy McCalmont
- Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
- Golden State Dermatology Dermatopathology, Walnut Creek, CA 94598, USA
| | - Toby Maurer
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Andrea Gardner
- Pathology and Laboratory Medicine, Weill Cornell Medical College; New York, NY, 10021, USA
| | - Juan Boza
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14850, USA
| | - Ethel Cesarman
- Pathology and Laboratory Medicine, Weill Cornell Medical College; New York, NY, 10021, USA
| | - Jeffrey Martin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - David Erickson
- Sibley School of Mechanical and Aerospace Engineering, Cornell University; Ithaca, NY, 14850, USA
- Division of Nutritional Science, Cornell University, Ithaca, NY 14850, USA
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2
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Chen JY, Keiser E, LeBoit P, Yeh I, Wei ML. A rare case of axillary keratoacanthoma arising in hidradenitis suppurativa. JAAD Case Rep 2022; 21:49-51. [PMID: 35146101 PMCID: PMC8818802 DOI: 10.1016/j.jdcr.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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3
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Robertson SJ, Orme L, Teixeira R, Shamassi M, Newell F, Patch AM, Yeh I, Gard G, Wilmott J, Jackett L, LeBoit P, Fellowes A, MacArthur G, Fox S, Hayward NK, Bastian B, Scolyer R, Waddell N, Penington A, Shackleton M. Evaluation of Crizotinib Treatment in a Patient With Unresectable GOPC-ROS1 Fusion Agminated Spitz Nevi. JAMA Dermatol 2021; 157:836-841. [PMID: 34076666 DOI: 10.1001/jamadermatol.2021.0025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Spitz nevi are benign melanocytic neoplasms that classically present in childhood. Isolated Spitz nevi have been associated with oncogenic gene fusions in approximately 50% of cases. The rare agminated variant of Spitz nevi, thought to arise from cutaneous genetic mosaicism, is characterized by development of clusters of multiple lesions in a segmental distribution, which can complicate surgical removal. Somatic single-nucleotide variants in the HRAS oncogene have been described in agminated Spitz nevi, most of which were associated with an underlying nevus spilus. The use of targeted medical therapy for agminated Spitz nevi is not well understood. Observations A girl aged 30 months presented with facial agminated Spitz nevi that recurred rapidly and extensively after surgery. Owing to the morbidity of further surgery, referral was made to a molecular tumor board. The patient's archival nevus tissue was submitted for extended immunohistochemical analysis and genetic sequencing. Strong ROS1 protein expression was identified by immunohistochemistry. Consistent with this, analysis of whole-genome sequencing data revealed GOPC-ROS1 fusions. These results indicated likely benefit from the oral tyrosine kinase inhibitor crizotinib, which was administered at a dosage of 280 mg/m2 twice daily. An excellent response was observed in all lesions within 5 weeks, with complete flattening after 20 weeks. Conclusions and Relevance Given the response following crizotinib treatment observed in this case, the kinase fusion was believed to be functionally consequential in the patient's agminated Spitz nevi and likely the driver mutational event for growth of her nevi. The repurposing of crizotinib for GOPC-ROS1 Spitz nevi defines a new treatment option for these lesions, particularly in cases for which surgery is relatively contraindicated.
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Affiliation(s)
- Susan J Robertson
- Department of Dermatology, The Royal Children's Hospital, The Royal Melbourne Hospital and Monash Medical Centre, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Lisa Orme
- Department of Oncology, The Royal Children's Hospital, Melbourne, Australia.,Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Rodrigo Teixeira
- Department of Plastic Surgery, The Royal Children's Hospital, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Maryam Shamassi
- Department of Anatomical Pathology, The Royal Children's Hospital, Melbourne, Australia
| | - Felicity Newell
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Ann-Marie Patch
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Iwei Yeh
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | - Grace Gard
- Department of Medical Oncology, Alfred Health, Melbourne, Australia
| | - James Wilmott
- Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Louise Jackett
- Melanoma Institute Australia, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Camperdown, Australia
| | - Philip LeBoit
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | | | | | - Stephen Fox
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicholas K Hayward
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Boris Bastian
- Helen Diller Family Comprehensive Cancer Center, Departments of Dermatology and Pathology, University of California, San Francisco
| | - Richard Scolyer
- Melanoma Institute Australia, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Camperdown, Australia
| | - Nicola Waddell
- Department of Genetics and Computational Biology, QIMR (Queensland Institute of Medical Research) Berghofer Medical Research Institute, Brisbane, Australia
| | - Anthony Penington
- Murdoch Children's Research Institute, Melbourne, Australia.,Department of Plastic Surgery, The Royal Children's Hospital, Melbourne, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Mark Shackleton
- Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Medical Oncology, Alfred Health, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
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Yu W, North J, Neuhaus I, LeBoit P, Wei M. 1265 Quantitative modeling to predict margin involvement for melanoma in situ excisions. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Tee M, Lang U, Durieux E, Jorapur A, Shain A, Haddad V, Pissaloux D, Chen X, Cerroni L, Judson R, LeBoit P, McCalmont T, Bastian B, de la Fouchardiere A. 148 Combined activation of MAP kinase and beta-catenin signaling define deep penetrating nevi. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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6
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Amerson E, Woodruff CM, Forrestel A, Wenger M, McCalmont T, LeBoit P, Maurer T, Laker-Oketta M, Muyindike W, Bwana M, Buziba N, Busakhala N, Wools-Kaloustian K, Martin J. Accuracy of Clinical Suspicion and Pathologic Diagnosis of Kaposi Sarcoma in East Africa. J Acquir Immune Defic Syndr 2016; 71:295-301. [PMID: 26452066 PMCID: PMC4770348 DOI: 10.1097/qai.0000000000000862] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/08/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND HIV-associated Kaposi sarcoma (KS) is one of the most common malignancies in sub-Saharan Africa. The diagnosis is often based on clinical suspicion, without histopathologic confirmation. When biopsies are performed, the accuracy of interpretation by local pathologists is poorly understood. We assessed the accuracy of clinical suspicion and pathologic diagnosis of KS in 2 East African countries. METHODS At 2 large HIV care sites in Uganda and Kenya, we evaluated consecutive biopsies performed from October 2008 to January 2013 on HIV-infected adults with clinically suspected KS. Biopsies were interpreted by both local African pathologists and a group of US-based dermatopathologists from a high volume medical center. For the purpose of this analysis, the US-based dermatopathologist interpretation was used as the gold standard. Positive predictive value was used to characterize accuracy of local African clinical suspicion of KS, and concordance, sensitivity, and specificity were used to characterize accuracy of local pathologic diagnosis. RESULTS Among 1106 biopsies, the positive predictive value of clinical suspicion of KS was 77% (95% confidence interval: 74% to 79%). When KS was not histopathologically diagnosed, clinically banal conditions were found in 35%, medically significant disorders which required different therapy in 59% and life-threatening diseases in 6%. Concordance between African pathologists and US-based dermatopathologists was 69% (95% confidence interval: 66% to 72%). Sensitivity and specificity of African pathologic diagnoses were 68% and 89%, respectively. CONCLUSIONS Among East African HIV-infected patients, we found suboptimal positive predictive value of clinical suspicion of KS and specific, but not sensitive, histopathologic interpretation. The findings call for abandonment of isolated clinical diagnosis of KS in the region and augmentation of local dermatopathologic services.
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Affiliation(s)
- Erin Amerson
- Department of Dermatology, University of California-San Francisco, San Francisco, CA
| | | | - Amy Forrestel
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA
| | - Megan Wenger
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA
| | - Timothy McCalmont
- Department of Dermatology, University of California-San Francisco, San Francisco, CA
- Department of Pathology and Laboratory Medicine, University of California-San Francisco, San Francisco, CA
| | - Philip LeBoit
- Department of Dermatology, University of California-San Francisco, San Francisco, CA
- Department of Pathology and Laboratory Medicine, University of California-San Francisco, San Francisco, CA
| | - Toby Maurer
- Department of Dermatology, University of California-San Francisco, San Francisco, CA
| | - Miriam Laker-Oketta
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA
- Infectious Disease Institute, Makerere University, Kampala, Uganda
| | - Winnie Muyindike
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mwebesa Bwana
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Nathan Buziba
- Department of Pathology, Moi University School of Medicine, Eldoret, Kenya
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Naftali Busakhala
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Department of Hematology and Oncology, Moi Teaching and Referral Hospital, Eldoret, Kenya; and
| | - Kara Wools-Kaloustian
- Department of Hematology and Oncology, Moi Teaching and Referral Hospital, Eldoret, Kenya; and
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Jeffrey Martin
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA
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7
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Semeere A, Wenger M, Busakhala N, Buziba N, Bwana M, Muyindike W, Amerson E, Maurer T, McCalmont T, LeBoit P, Musick B, Yiannoutsos C, Lukande R, Castelnuovo B, Laker-Oketta M, Kambugu A, Glidden D, Wools-Kaloustian K, Martin J. A prospective ascertainment of cancer incidence in sub-Saharan Africa: The case of Kaposi sarcoma. Cancer Med 2016; 5:914-28. [PMID: 26823008 PMCID: PMC4864821 DOI: 10.1002/cam4.618] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/12/2015] [Accepted: 11/08/2015] [Indexed: 01/03/2023] Open
Abstract
In resource‐limited areas, such as sub‐Saharan Africa, problems in accurate cancer case ascertainment and enumeration of the at‐risk population make it difficult to estimate cancer incidence. We took advantage of a large well‐enumerated healthcare system to estimate the incidence of Kaposi sarcoma (KS), a cancer which has become prominent in the HIV era and whose incidence may be changing with the rollout of antiretroviral therapy (ART). To achieve this, we evaluated HIV‐infected adults receiving care between 2007 and 2012 at any of three medical centers in Kenya and Uganda that participate in the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium. Through IeDEA, clinicians received training in KS recognition and biopsy equipment. We found that the overall prevalence of KS among 102,945 HIV‐infected adults upon clinic enrollment was 1.4%; it declined over time at the largest site. Among 140,552 patients followed for 319,632 person‐years, the age‐standardized incidence rate was 334/100,000 person‐years (95% CI: 314–354/100,000 person‐years). Incidence decreased over time and was lower in women, persons on ART, and those with higher CD4 counts. The incidence rate among patients on ART with a CD4 count >350 cells/mm3 was 32/100,000 person‐years (95% CI: 14–70/100,000 person‐years). Despite reductions over time coincident with the expansion of ART, KS incidence among HIV‐infected adults in East Africa equals or exceeds the most common cancers in resource‐replete settings. In resource‐limited settings, strategic efforts to improve cancer diagnosis in combination with already well‐enumerated at‐risk denominators can make healthcare systems attractive platforms for estimating cancer incidence.
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Affiliation(s)
- Aggrey Semeere
- Infectious Diseases Institute, Makerere University, Kampala, Uganda.,University of California, San Francisco, CA, USA
| | - Megan Wenger
- University of California, San Francisco, CA, USA
| | | | | | - Mwebesa Bwana
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Erin Amerson
- University of California, San Francisco, CA, USA
| | - Toby Maurer
- University of California, San Francisco, CA, USA
| | | | | | | | | | - Robert Lukande
- Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Miriam Laker-Oketta
- Infectious Diseases Institute, Makerere University, Kampala, Uganda.,University of California, San Francisco, CA, USA
| | - Andrew Kambugu
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
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8
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Affiliation(s)
- Jeffrey P North
- Departments of Pathology and Dermatology, University of California, San Francisco, San Francisco, CA, USA
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9
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Amerson E, Buziba N, Wabinga H, Wenger M, Bwana M, Muyindike W, Kyakwera C, Laker M, Mbidde E, Yiannoutsos C, Wools-Kaloustian K, Musick B, LeBoit P, McCalmont T, Ruben B, Volberding P, Maurer T, Martin J. Diagnosing Kaposi’s Sarcoma (KS) in East Africa: how accurate are clinicians and pathologists? Infect Agent Cancer 2012. [PMCID: PMC3330044 DOI: 10.1186/1750-9378-7-s1-p6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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10
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Martin J, Wenger M, Busakhala N, Buziba N, Bwana M, Muyindike W, Mbabazi R, Amerson E, Yiannoutsos C, Musick B, LeBoit P, McCalmont T, Ruben B, Maurer T, Wools-Kaloustian K. Prospective evaluation of the impact of potent antiretroviral therapy on the incidence of Kaposi’s Sarcoma in East Africa: findings from the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium. Infect Agent Cancer 2012. [PMCID: PMC3330081 DOI: 10.1186/1750-9378-7-s1-o19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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11
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Affiliation(s)
- Jeffrey P. North
- Departments of Pathology and Dermatology; University of California, San Francisco; San Francisco; CA
| | - Timothy H. McCalmont
- Departments of Pathology and Dermatology; University of California, San Francisco; San Francisco; CA
| | - Philip LeBoit
- Departments of Pathology and Dermatology; University of California, San Francisco; San Francisco; CA
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12
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Abstract
A rare case of a spindle cell (sarcomatoid) B-cell lymphoma is described. The patient, a 48-year-old male, presented with a several month history of an enlarging lesion on the scalp. Although there have been a few recent reports of cutaneous sarcomatoid lymphomas, this case is especially unusual because it presented as a scarlike plaque rather than a tumor and microscopically exhibited a prominent myxoid matrix. Given these features, the lesion was initially interpreted as an atypical fibromucinosis. The differential diagnosis included fibromucinous lesion consistent with variant of lichen myxedematosus, spindle cell carcinoma, spindle cell melanoma, atypical fibroxanthoma, and atypical smooth muscle tumors. Initial immunoperoxidase studies demonstrated negative staining for CD68, factor XIIIa, CD57, cytokeratin(AE1/AE3), S100, EMA, and vimentin, essentially ruling out the previously mentioned neoplasms. Subsequently, strong positive staining for LCA(CD45RB) and CD20 was demonstrated characteristic of a B-cell lymphoma. The patient underwent local radiotherapy with complete resolution. Although all variants of cutaneous sarcomatoid B-cell lymphomas are rare, it is imperative to consider them in the differential diagnosis of otherwise difficult to categorize spindle cell proliferations. This includes neoplasms and, based on the current case, fibromucinoses as well.
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Affiliation(s)
- Savita Ries
- Department of Pathology, Memorial Medical Center of Long Beach, Long Beach, CA, USA.
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13
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Abstract
We report two pediatric cases of nephrogenic fibrosing dermopathy (NFD), first described in 2000. NFD is a condition in which individuals with renal dysfunction have development of extensive skin hardening and histopathologic evidence of a scleromyxedema-like condition.
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Affiliation(s)
- Farhana Jan
- Department of Dermatology, University of Cincinnati, Cincinnati, Ohio, USA
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14
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Mraz-Gernhard S, Natkunam Y, Hoppe RT, LeBoit P, Kohler S, Kim YH. Natural killer/natural killer-like T-cell lymphoma, CD56+, presenting in the skin: an increasingly recognized entity with an aggressive course. J Clin Oncol 2001; 19:2179-88. [PMID: 11304770 DOI: 10.1200/jco.2001.19.8.2179] [Citation(s) in RCA: 189] [Impact Index Per Article: 8.2] [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: 11/20/2022] Open
Abstract
PURPOSE To describe and identify the clinical and pathologic features of prognostic significance for natural killer (NK) and NK-like T-cell (NK/T-cell) lymphoma presenting in the skin. PATIENTS AND METHODS This study was a retrospective review of 30 patients with CD56+ lymphomas initially presenting with cutaneous lesions, with analysis of clinical and histopathologic parameters. RESULTS The median survival for all patients was 15 months. Those with extracutaneous manifestations at presentation (11 patients) had a shorter median survival of 7.6 months as compared with those without extracutaneous involvement (17 patients), who had a more favorable median survival of 44.9 months (P =.0001). Age, gender, extent of cutaneous involvement, and initial response to therapy had no statistically significant effect on survival. Seven patients (24%) had detectable Epstein-Barr virus (EBV) within neoplastic cells. The patients with tumor cells that coexpress CD30 (seven patients) have not yet reached a median survival after 35 months of follow-up as compared with those with CD30- tumor cells (20 patients), who had a median survival of 9.6 months (P <.02). Routine histopathologic characteristics had no prognostic significance nor did the presence of CD3epsilon, EBV, or multidrug resistance. CONCLUSION NK/T-cell lymphoma is an aggressive neoplasm; however, a subset with a more favorable outcome is identified in this study. The presence of extracutaneous disease at presentation is the most important clinical variable and portends a poor prognosis. The extent of initial skin involvement does not reliably predict outcome. Patients from the United States with NK/T-cell lymphoma presenting in the skin have a low incidence of demonstrable EBV in their tumor cells. Patients with coexpression of CD30 in CD56 lymphomas tend to have a more favorable outcome.
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Affiliation(s)
- S Mraz-Gernhard
- Departments of Dermatology, Pathology, and Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.
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15
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LeBoit P. Spitz nevus: a look back and a look ahead. Adv Dermatol 2001; 16:81-109; discussion 110. [PMID: 11094625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- P LeBoit
- Department of Pathology, University of California, San Francisco, USA
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