51
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Hristov AC, Tejasvi T, Wilcox RA. Cutaneous T-cell lymphomas: 2021 update on diagnosis, risk-stratification, and management. Am J Hematol 2021; 96:1313-1328. [PMID: 34297414 PMCID: PMC8486344 DOI: 10.1002/ajh.26299] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/08/2022]
Abstract
DISEASE OVERVIEW Cutaneous T-cell lymphomas are a heterogenous group of T-cell neoplasms involving the skin, the majority of which may be classified as Mycosis Fungoides (MF) or Sézary Syndrome (SS). DIAGNOSIS The diagnosis of MF or SS requires the integration of clinical and histopathologic data. RISK-ADAPTED THERAPY TNMB (tumor, node, metastasis, blood) staging remains the most important prognostic factor in MF/SS and forms the basis for a "risk-adapted," multi-disciplinary approach to treatment. For patients with disease limited to the skin, expectant management or skin-directed therapies is preferred, as both disease-specific and overall survival for these patients is favorable. In contrast, patients with advanced-stage disease with significant nodal, visceral or blood involvement are generally approached with systemic therapies, including biologic-response modifiers, histone deacetylase inhibitors, or antibody-based strategies, in an escalating fashion. In highly-selected patients, allogeneic stem-cell transplantation may be considered, as this may be curative in some patients.
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52
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Jia Y, Pei D, Yang X, Min W, Song L. A Rare Case of Cutaneous Intravascular NK/T-Cell Lymphoma. Clin Lab 2021; 67. [PMID: 34258975 DOI: 10.7754/clin.lab.2020.201110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Cutaneous intravascular NK/T cell lymphoma (CIVNKTC) is a rare form of extranodal non-Hodgkin's lymphoma with its unique histological and immunophenotypic characteristics. METHODS We report a case presenting with an over 2-month history of nodules on the extremities and trunk with intermittent fever. Skin biopsy was taken from the patient and a histopathological examination was made from the material. RESULTS The histopathological examination showed some expanding vessels filled with atypical lymphoid cells in the dermis and subcutaneous tissue. The tumor cells had large nuclei and one or two small nucleoli, with the expression of CD3, cytotoxic protein, and Epstein-Barr virus (EBV)-encoded messenger RNAs (EBER), and without the expression of tumor cytokeratin (CK), CD20, CD79A, CD4, and CD8. After being diagnosed as CIVNKTC and treated with a CHOP regimen 6 times, the patient died of this disease 1 year later. CONCLUSIONS The clinical course is dangerous and the prognosis is extremely poor.
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Abstract
The cutaneous lymphomas are malignancies of T-cell and B-cell lymphocytes in which the skin is the primary organ of involvement. The cutaneous T-cell lymphomas include variants that can mimic the presentation of common skin diseases or arthropod bites. Mycosis fungoides, the most common cutaneous T-cell lymphoma, usually presents as fixed asymptomatic patches or plaques in sun-protected areas. The cutaneous B-cell lymphomas have fewer variants that often present as papules or nodules that can mimic nonmelanoma skin cancers. Some therapies for cutaneous lymphoma have unique side effects such as central hypothyroidism, hyperlipidemia, and peripheral neuropathy.
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MESH Headings
- Aged
- Aged, 80 and over
- Animals
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents, Immunological/adverse effects
- Arthropods
- Bexarotene/adverse effects
- Bites and Stings/diagnosis
- Brentuximab Vedotin/adverse effects
- Diagnosis, Differential
- Humans
- Hyperlipidemias/chemically induced
- Hypothyroidism/chemically induced
- Lymphoma, Primary Cutaneous Anaplastic Large Cell/diagnosis
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/therapy
- Lymphomatoid Papulosis/diagnosis
- Mycosis Fungoides/diagnosis
- Peripheral Nervous System Diseases/chemically induced
- Prognosis
- Sezary Syndrome/diagnosis
- Skin Diseases/diagnosis
- Skin Diseases/pathology
- Skin Neoplasms/pathology
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54
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Beer J, Hadeler E, Nouri K. The Potential for Teledermatology in Managing and Diagnosing Patients With Cutaneous Lymphomas. J Drugs Dermatol 2021; 19:1125. [PMID: 33196742 DOI: 10.36849/jdd.2020.5682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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55
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Torres-Cabala CA, Huen A, Iyer SP, Miranda RN. Gamma/Delta Phenotype in Primary Cutaneous T-cell Lymphomas and Lymphoid Proliferations: Challenges for Diagnosis and Classification. Surg Pathol Clin 2021; 14:177-194. [PMID: 34023099 DOI: 10.1016/j.path.2021.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Primary cutaneous T-cell lymphomas pose a diagnostic challenge for dermatopathologists, hematopathologists, and general surgical pathologists. Recognition of gamma/delta phenotype in cutaneous T proliferations has been enhanced by the availability of antibodies against TCRgamma and delta for immunohistochemistry. Thus, reporting gamma/delta phenotype in a cutaneous T-cell lymphoid proliferation may indicate a significant change in therapy and a challenge for dermatologists and oncologists who treat these patients. Herein, we discuss primary cutaneous gamma/delta T-cell lymphoma, its differential diagnosis, and other skin lymphoid proliferations that may show gamma/delta phenotype. Awareness of the occurrence of gamma/delta phenotype in both T-cell lymphomas and benign lymphoid proliferations involving skin is crucial for a better interpretation of histopathologic findings. Integration of clinical presentation, morphology, immunoprofile, and molecular findings is key for a correct diagnosis and appropriate therapy of lesions displaying gamma/delta T-cell phenotype.
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56
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López Aventín D, Gallardo F, Colomo L, Moragón E, Vela MC, Duran Jordà X, Bellosillo B, Pujol RM. Diagnostic Value of Genotypic Analysis in Primary Cutaneous Lymphomas using Standardized BIOMED-2 Polymerase Chain Reaction Protocols: Experience in Daily Clinical Practice. Acta Derm Venereol 2021; 101:adv00460. [PMID: 33954802 PMCID: PMC9367047 DOI: 10.2340/00015555-3828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BIOMED-2 Concerted Action BMH4-CT98-3936 (BIOMED-2) PCR protocols are an important diagnostic tool in the evaluation of cutaneous lymphomas. The aim of this study was to assess the diagnostic value of the genotyping results obtained by these techniques in daily clinical practice. A total of 360 paraffin-embedded skin samples were retrospectively reviewed from 114 cutaneous T-cell lymphomas and 35 cutaneous B-cell lymphomas. A total of 249 biopsies from 180 patients with benign lymphoid infiltrates served as controls. T-cell receptor and immunoglobulin gene rearrangements were assessed using the BIOMED-2 method. A combined T-cell receptor gamma and beta assay approach reliably distinguished cutaneous T-cell lymphomas from benign skin T-cell infiltrates (sensitivity 89.4%; specificity 81.5%). Analysis of complete immunoglobulin heavy chain rearrangements also differentiated cutaneous B-cell lymphomas from benign B-cell infiltrates (sensitivity 85.7%; specificity 82.4%). In conclusion, the full BIOMED-2 protocol is a useful aid combined with clinical, histological and immunophenotypical findings for assessment of lymphoid clonality in skin lymphoid proliferations.
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57
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Abstract
Primary cutaneous lymphomas are defined as a heterogenic group of T- and B-cell non-Hodgkin lymphomas that present initially in the skin. Patients with primary cutaneous lymphomas are at a higher risk for developing complications in case of infection with the novel coronavirus severe acute respiratory syndrome coronavirus 2. The coronavirus disease 2019 (COVID-19) pandemic has affected the established diagnostic approach, staging, and therapeutic guidelines in patients with primary cutaneous lymphomas. In the light of the current global health crisis, management of primary cutaneous lymphomas needs to be adjusted. The key to achieving this is to balance the optimal control of the lymphoma, with a minimal increase of the personal risk for COVID-19 exposure and complications.
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58
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Lazaridou I, Ram-Wolff C, Bouaziz JD, Bégon E, Battistella M, Rivet J, Jachiet M, Bagot M, de Masson A. Dupilumab Treatment in Two Patients with Cutaneous T-cell Lymphomas. Acta Derm Venereol 2020; 100:adv00271. [PMID: 32556342 PMCID: PMC9234988 DOI: 10.2340/00015555-3576] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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59
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Delaleu J, Maubec E, Rodrigues F, Lévy A, Szablewski V, Laroche L, Dereure O. Methotrexate-induced Primary Cutaneous Diffuse Large B-cell Lymphoma in Patients with Erythrodermic Cutaneous T-cell Lymphoma. Acta Derm Venereol 2020; 100:adv00226. [PMID: 32516423 PMCID: PMC9207630 DOI: 10.2340/00015555-3554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
MESH Headings
- Epstein-Barr Virus Infections
- Humans
- Lymphoma, Large B-Cell, Diffuse/chemically induced
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, T-Cell, Cutaneous/chemically induced
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/drug therapy
- Methotrexate/adverse effects
- Mycosis Fungoides
- Skin Neoplasms/drug therapy
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60
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Stähr K, Lang S, Mattheis S. [Primary cutaneous CD4+ small to medium-sized T-cell lymphoma in an adolescent patient]. HNO 2020; 68:695-697. [PMID: 32728760 DOI: 10.1007/s00106-020-00912-2] [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] [Indexed: 11/29/2022]
Abstract
A rare finding of primary cutaneous CD4+ small to medium-sized T‑cell lymphoma (SMPTCL) in a fifteen-year-old patient is reported. This is a rare tumor entity for which there is currently no standardized treatment recommendation. At the interdisciplinary tumor board, the decision was made to resect the tumor and reconstruct the defect with a nasolabial advancement flap in a two-stage process. Follow-up examinations, currently over 3 years, have shown the patient to be free of recurrences.
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61
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Ramachandran V, Park KE, Shah JR, Duvic M. Diagnosis of cutaneous T-cell lymphoma by insurance type before and after the Affordable Care Act: a national database study. Dermatol Online J 2019; 25:13030/qt5n4481mk. [PMID: 32045145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023] Open
Abstract
The Affordable Care Act (ACT) was implemented to increase health care access and reduce the uninsured in the age group between pediatric and Medicare populations (18-64). The association of the ACA with insurance type upon diagnosis (uninsured, Medicaid, non-Medicaid) has been investigated for otolaryngologic, gynecologic, and the top five non-skin malignancies. Such studies for cutaneous malignancies are lacking. We conducted a retrospective analysis of the prospective National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer database to assess the impact of the ACA on new diagnoses of cutaneous T-cell lymphoma (CTCL) by insurance type. Unlike prior studies of other malignancies, we did not observe significant differences between rate of diagnosis of CTCL by insurance type before and after full implementation of the ACA in all states, expansion states, and non-expansion states. Skin cancers do not have screening guidelines and CTCL is an uncommon malignancy, both of which may contribute to these findings. However, Medicaid-expansion states were much closer to reducing the percentage of newly diagnosed uninsured patients with CTCL than non-expansion states. As such, it may be prudent to investigate intrinsic socioeconomic barriers to care in Medicaid patients to improve their access to care to decrease the uninsured population and improve outcomes.
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62
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MESH Headings
- Aged
- Biopsy
- Bone Marrow/pathology
- Codon, Nonsense
- Cytokines/metabolism
- Diagnosis, Differential
- Exanthema/etiology
- Fatal Outcome
- Fever/etiology
- Humans
- Lymphohistiocytosis, Hemophagocytic/diagnosis
- Lymphohistiocytosis, Hemophagocytic/etiology
- Lymphohistiocytosis, Hemophagocytic/metabolism
- Lymphoma, T-Cell, Cutaneous/complications
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/genetics
- Male
- Pancytopenia/etiology
- Skin/pathology
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63
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Wang B, Zheng J, Wang HW. Granulomatous slack skin: case report with electron microscopic features. Dermatol Online J 2019; 25:13030/qt6f26b8c4. [PMID: 31450274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 06/10/2023] Open
Abstract
Granulomatous slack skin (GSS) is a rare subtype of mycosis fungoides. It usually presents as slowly evolving, erythematous, slack plaques that usually involve folds of lax skin. Herein, we report a case of GSS and we show electron microscopy examination. Atypical T cells with convoluted and cerebriform nuclei, lymphophagocytosis, and elastophagocytosis are key features of GSS under electron microscopy.
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64
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Carias E, DeLorenzo M, Owston M, Gonzalez O, Kumar S, Dick EJ. Cutaneous epitheliotropic lymphoma in a baboon (Papio spp.): A case report and a brief literature review. J Med Primatol 2019; 48:192-196. [PMID: 30941777 PMCID: PMC6716516 DOI: 10.1111/jmp.12410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/10/2019] [Indexed: 11/28/2022]
Abstract
Cutaneous epitheliotropic lymphoma (CEL) has not been reported in non-human primates. We report the first case of CEL in a 9-year-old baboon. The phenotype of the neoplastic cells in this baboon is similar to CEL in humans (CD3+, CD4+, CD8-) and different from dogs (CD3+, CD4-, CD8+).
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65
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McCaughey CD, Amarnani A, Longley BJ, Bennett DD, Wood GS. Erythema gyratum Repens-like eruption in Sézary syndrome: evidence for the role of a dermatophyte. Cutis 2019; 103:357-360. [PMID: 31348450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Erythema gyratum repens (EGR) is a rare and poorly understood dermatosis. The relationship of superficial dermatophytic infection to EGR-like eruptions in mycosis fungoides (MF) is unclear. We present a case of an EGR-like eruption in a patient with Sézary syndrome (SS). Histopathologic examination revealed both a superficial dermatophyte (Trichophyton rubrum) and cutaneous T-cell lymphoma (CTCL) in biopsies of the skin, regardless of whether those biopsies showed EGR-like lesions or erythroderma clinically. On 2 occasions, treatment of the superficial dermatophytic infection led to resolution of the EGR-like eruption and associated pruritus but not to resolution of the erythroderma. This case supports a role for dermatophytic superinfection in an EGR-like eruption in SS. Further investigation is necessary to fully understand the impact of dermatophytic infection in this clinical setting.
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66
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Heymann WR. The Challenge of Identifying Identical Twins: Advances in Differentiating Lupus Erythematosus Panniculitis from Subcutaneous Panniculitis-Like T-Cell Lymphoma. Skinmed 2019; 17:115-116. [PMID: 31145063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
MESH Headings
- Diagnosis, Differential
- Humans
- Immunohistochemistry
- Ki-67 Antigen/metabolism
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/metabolism
- Lymphoma, T-Cell, Cutaneous/pathology
- Panniculitis, Lupus Erythematosus/diagnosis
- Panniculitis, Lupus Erythematosus/metabolism
- Panniculitis, Lupus Erythematosus/pathology
- Proto-Oncogene Proteins c-myc/metabolism
- Skin Neoplasms/diagnosis
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
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67
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Tung JK, Korman JB, Yasuda MR. Indurated purple plaques on the scalp. Dermatol Online J 2019; 25:13030/qt93s821d7. [PMID: 31220903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 06/09/2023] Open
Abstract
Cutaneous epithelioid angiosarcoma is a rare neoplasm of vascular endothelial cell origin that can mimic a cutaneous lymphoma, metastatic carcinoma, or Kaposi sarcoma. It is one of the most malignant cutaneous tumors and early diagnosis is essential, as the tumor metastasizes quickly. We describe a 75-year-old man who presented with three tender, indurated violaceous plaques on his scalp. Biopsy revealed a poorly circumscribed infiltrate extending into the subcutaneous fat, composed of atypical epithelioid cells lining vascular spaces. We provide a brief review of the clinical presentation, histopathologic features, differential diagnosis, and management of this rare tumor.
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68
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Xavier Júnior JCC, Ocanha-Xavier JP. Cutaneous T-cell lymphomas in the revised 4th edition of World Health Organization classification of tumors of hematopoietic and lymphoid tissues (2017). An Bras Dermatol 2019; 93:871-873. [PMID: 30484532 PMCID: PMC6256223 DOI: 10.1590/abd1806-4841.20188057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/26/2018] [Indexed: 11/22/2022] Open
Abstract
Recently, the World Health Organization published the revised 4th edition of its classification of tumors of hematopoietic and lymphoid tissues. The present paper is a concise comparative review of the main primary cutaneous T-cell hematopoietic tumors, with emphasis on their immunohistochemical profiles.
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69
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Abstract
There are a number of rare T-cell lymphoma subtypes that may be encountered in clinical practice. In recent years, improved immunohistochemical techniques and molecular tumor profiling have permitted refinement of some of the diagnostic categories in this group, as well as the recognition of distinct conditions not previously well elucidated. In this chapter, we cover the diagnostic and clinical features of some of the more common of these conditions, including subcutaneous panniculitis-like T-cell lymphoma, cutaneous gamma-delta T-cell lymphoma, enteropathy-associated T-cell lymphoma, monomorphic epitheliotropic intestinal T-cell lymphoma, primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma, CD4-positive small/medium T-cell lymphoproliferative disorder, and acral CD8-positive T-cell lymphoma. Given the rarity of these conditions, optimal treatments approaches are not always well established, not least as data from large-scale clinical trials are lacking. In this chapter, we aim to provide a summation of current thinking around best treatment, as well as highlighting some controversies in the management of these diagnoses.
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70
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Horwitz SM. A new target in CTCL: treating the skin, blood, and lymph nodes. CLINICAL ADVANCES IN HEMATOLOGY & ONCOLOGY : H&O 2019; 17:40-43. [PMID: 30843897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
MESH Headings
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Clinical Decision-Making
- Clinical Trials as Topic
- Disease Management
- Humans
- Lymph Nodes/pathology
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/mortality
- Lymphoma, T-Cell, Cutaneous/therapy
- Prognosis
- Skin/pathology
- Treatment Outcome
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71
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Hbibi M, Benmiloud S, Rahmouni S, Tadmouri I, Abourazzak S, Chaouki S, Souilmi FZ, Idrissi ML, Hida M. [Macrophage activation syndrome revealing subcutaneous T-cell lymphoma in a 16-year old adolescent]. Pan Afr Med J 2018; 31:74. [PMID: 31007821 PMCID: PMC6457733 DOI: 10.11604/pamj.2018.31.74.14686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 09/18/2018] [Indexed: 11/25/2022] Open
Abstract
Macrophage activation syndrome (MAS) is a multisystemic disorder resulting from an over-activation of the immune system leading to a more or less diffuse macrophagic infiltration into the tussues. Clinical signs including fever, hepatosplenomegaly, adenopathy are associated with abnormal values in laboratory test results (bi or pancytopenia, hepatic cytolysis, elevated LDH levels, coagulopathy) and hemophagocytosis. In children, it can be primary or secondary to several disorders. We report the case of a 16-year old patient admitted to the Department of Pediatrics with febrile leukopenia associated with impaired general condition and circular erythematous lesions spread to the lower limbs. The diagnosis of macrophage activation syndrome was retained based on clinical signs, laboratory test results and cytological results. Skin biopsy of these lesions showed subcutaneous panniculitis-like T-cell lymphoma. The purpose of this study is to insists on the peculiarities of this clinical case given the rarity of this type of subcutaneous T-cell lymphoma, much more in this age group. We want to highlight the importance of suspecting subcutaneous T-cell lymphoma in patients with MAS associated with subcutaneous erythematous lesions because this could be life threatening.
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72
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Willemze R, Hodak E, Zinzani PL, Specht L, Ladetto M. Primary cutaneous lymphomas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018; 29:iv30-iv40. [PMID: 29878045 DOI: 10.1093/annonc/mdy133] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
MESH Headings
- Administration, Cutaneous
- Aftercare/methods
- Aftercare/standards
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/standards
- Biomarkers, Tumor/genetics
- CD79 Antigens/genetics
- Chemoradiotherapy/methods
- Dermatologic Surgical Procedures/methods
- Dermatologic Surgical Procedures/standards
- Europe
- Humans
- Incidence
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/epidemiology
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/epidemiology
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Medical Oncology/methods
- Medical Oncology/standards
- Myeloid Differentiation Factor 88/genetics
- Neoplasm Staging
- Ointments
- Precision Medicine/methods
- Precision Medicine/standards
- Skin/drug effects
- Skin/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Societies, Medical/standards
- Survivorship
- Treatment Outcome
- Ultraviolet Therapy/methods
- Ultraviolet Therapy/standards
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73
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Abstract
RATIONALE Hydroa vacciniforme (HV)-like T-cell lymphoma is a rare malignancy in childhood associated with Epstein-Barr virus infection. PATIENT CONCERNS A 6-year old girl presented with complaint of 3-year history of recurrent skin lesions, 3 months of fever accompanied by cough for 8 days. DIAGNOSES Skin biopsy revealed a HV-like lymphoma presentation and positive signals of EBER were detected by in situ hybridization. TCR-γ gene monoclonal rearrangement was present. A HV-like cutaneous T-cell lymphoma was diagnosed. INTERVENTIONS The girl was treated with cyclosporine and CHOP. OUTCOMES The girl's condition had been stable for 6 months. LESSONS Our case highlights the necessity for taking the HV-like lymphoma as a differential diagnosis especially when a patient manifests as recurrent skin lesions accompanied by systemic involvement.
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74
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Porkert S, Lehner-Baumgartner E, Valencak J, Knobler R, Riedl E, Jonak C. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas. Acta Derm Venereol 2018; 98:240-245. [PMID: 29048099 DOI: 10.2340/00015555-2819] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Revised Illness Perception Questionnaire (IPQ-R) has been shown to assess illness perception reproducibly in primary cutaneous T-cell lymphomas (CTCL). Illness perception reflects patients' individual concepts of understanding and interpretation of the disease, influencing illness behaviour and health-related quality of life (HRQOL). This study investigated the clinical relevance of the relationships between illness perception, illness behaviour, and HRQOL in CTCL and cutaneous B-cell lymphomas (CBCL). A total of 92 patients completed the IPQ-R, the Scale for the Assessment of Illness Behavior (SAIB), and a skin-specific HRQOL tool (Skindex-29). Data on illness behaviour were not evidently related to illness perception, whereas illness perception was significantly associated with HRQOL. Both, IPQ-R and HRQOL results correlated with disease entity, stage, and socio-demographics. Only IPQ-R results provided practical information on patients' needs to train personal coping strategies. IPQ-R assessment in CTCL and CBCL might be a useful instrument to improve individual disease management.
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MESH Headings
- Adult
- Aged
- Cost of Illness
- Cross-Sectional Studies
- Female
- Health Knowledge, Attitudes, Practice
- Humans
- Illness Behavior
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/psychology
- Lymphoma, B-Cell/therapy
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/psychology
- Lymphoma, T-Cell, Cutaneous/therapy
- Male
- Middle Aged
- Patients/psychology
- Perception
- Predictive Value of Tests
- Prognosis
- Skin Neoplasms/diagnosis
- Skin Neoplasms/psychology
- Skin Neoplasms/therapy
- Surveys and Questionnaires
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75
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Oka T, Sugaya M, Takahashi N, Nakajima R, Otobe S, Kabasawa M, Suga H, Miyagaki T, Asano Y, Sato S. Increased Interleukin-19 Expression in Cutaneous T-cell Lymphoma and Atopic Dermatitis. Acta Derm Venereol 2017; 97:1172-1177. [PMID: 28597022 DOI: 10.2340/00015555-2723] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interleukin-19 (IL-19), a pro-inflammatory cytokine known to stimulate the production of T helper type 2 (Th2) cytokines, is induced by IL-17A and highly expressed in the lesional skin of psoriasis and atopic dermatitis (AD). This aim of this study was to investigate whether IL-19 is involved in cutaneous T-cell lym-phoma (CTCL) and AD. IL-19 levels were significantly higher in the sera of patients with AD and those with advanced-stage CTCL than in normal controls, correlating significantly with clinical disease markers. IL-19 mRNA levels in lesional skin of both diseases were significantly elevated. Immunohistochemical staining revealed that IL-19 was expressed in the epidermis of AD skin and CTCL skin. In vitro, IL-17A and IL-4 increased IL-19 mRNA expression in human keratinocytes. Thus, IL-19 was increased in the sera and skin of AD and CTCL. These results suggest that IL-19 is important for bridging Th17 to Th2 in these diseases.
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MESH Headings
- Adolescent
- Adult
- Aged
- Case-Control Studies
- Cells, Cultured
- Dermatitis, Atopic/blood
- Dermatitis, Atopic/diagnosis
- Dermatitis, Atopic/metabolism
- Epidermis/metabolism
- Epidermis/pathology
- Female
- Humans
- Interleukin-17/metabolism
- Interleukin-4/metabolism
- Interleukins/blood
- Interleukins/genetics
- Interleukins/metabolism
- Keratinocytes/metabolism
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/metabolism
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- Neoplasm Staging
- RNA, Messenger/genetics
- Skin Neoplasms/blood
- Skin Neoplasms/genetics
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Up-Regulation
- Young Adult
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