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Preparation and evaluation of ibrutinib lipid-based formulations. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Soufi A, Nokta AA, Alshehabi Z, Alhussein F. The occurrence of sarcoidosis after treatment of nodal marginal B-cell zone lymphoma in a 56-year-old male: A case report from Syria. Ann Med Surg (Lond) 2022; 80:104128. [PMID: 35855879 PMCID: PMC9287776 DOI: 10.1016/j.amsu.2022.104128] [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: 04/12/2022] [Revised: 07/01/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Sarcoidosis is a chronic systematic inflammatory disorder of unknown etiology. Marginal zone lymphoma is a well-varied family of lymphomas that makes up to 10% of the overall non-Hodgkin's lymphomas. The relationship between sarcoidosis and multiple diseases was mentioned repeatedly in the literature, whereas the relationship between sarcoidosis and marginal zone lymphoma was found rare. This case presents a 56-years-old man who was diagnosed with sarcoidosis after treatment of marginal zone lymphoma. Case presentation A 56-year-old male presented to Tishreen University Hospital (TUH) Gastrointestinal department with abdominal pain, vomiting, loss of apetite, fever, and unintentional weight loss. Computerized tomography scan of the chest and abdomen, in addition to the excisional biopsy of the cervical nodes, were both highly suggestive of marginal zone lymphoma. After completing a course of chemotherapy, the patient returned with generalized abdominal discomfort, anorexia, and fatigue. Computerized tomography illustrated enlarged mediastinal lymph nodes in the chest and the abdomen. Microscopic examination of an abdominal lymph node revealed granulomatous lymphadenitis with sarcoidosis. Thereafter, the patient was managed with nonsteroidal anti-inflammatory drugs and corticosteroids. Conclusion We describe the occurrence of sarcoidosis after the treatment of marginal zone lymphoma. In most cases, sarcoidosis precedes lymphomas. This case emphasizes the evidence on the possible relationship between lymphomas and sarcoidosis, and attention should be sought towards any new manifestations throughout the follow-up of patients diagnosed with lymphomas toward sarcoidosis as part of our differential diagnosis. The relationship between sarcoidosis and marginal zone lymphoma was found rare in the literature. MZL comes in second place as the most frequent subtype of indolent B cell non-Hodgkin's lymphoma. In most cases Sarcoidosis procedes Lymphomas. We describe the occurance of Sarcoidosis after the treatment of Marginal Zone Lymphoma. sarcoidosis should be a part of our differential diagnosis when following-up patients with lymphomas.
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Silva L, Alpoim M, Ribeiro A, Caiano Gil P, Lopes Caçola R. Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C. Cureus 2021; 13:e18667. [PMID: 34786250 PMCID: PMC8579832 DOI: 10.7759/cureus.18667] [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] [Accepted: 10/11/2021] [Indexed: 11/22/2022] Open
Abstract
Splenic marginal zone lymphoma (SMZL) accounts for only 1-2.7% of all lymphomas. Almost all patients have bone marrow (BM) involvement but only one-third has liver involvement. The higher prevalence of hepatitis C virus (HCV) infection in these patients has led to the hypothesis of viral involvement in lymphomagenesis. In this report, we present a case of a 48-year-old woman, with cured hepatitis C, presenting with fever, weight loss, nausea, abdominal pain, and jaundice. She had leucocytosis with lymphocytosis, a progressively worsening cytocholestasis, and hepatosplenomegaly. Liver biopsy, immunophenotyping, and BM biopsy were performed, resulting in the diagnosis of SMZL. The patient started chemotherapy (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone) with an initial good response, but later progression to high-grade lymphoma and was recommended to undergo salvage chemotherapy followed by auto-transplant. Despite the unusual liver involvement, we should consider hepatic infiltration by lymphomas, such as SMZL, especially in patients with a history of HCV infection.
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Affiliation(s)
- Leonor Silva
- Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Mafalda Alpoim
- Hematology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Ana Ribeiro
- Pathology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Pedro Caiano Gil
- Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
| | - Rute Lopes Caçola
- Internal Medicine, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT
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Rituximab Monotherapy for Compressive Optic Neuropathy With Giant Ocular Adnexal Mucosa-Associated Lymphoid Tissue lymphoma. Ophthalmic Plast Reconstr Surg 2021; 37:S132-S133. [PMID: 32826825 DOI: 10.1097/iop.0000000000001803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A rare case of compressive optic neuropathy due to giant mucosa-associated lymphoid tissue lymphoma in the orbit was presented. A 87-year-old woman was aware of a slow progressive left ocular proptosis for 10 years and presented after becoming aware of a sudden progression of the proptosis accompanying visual disturbance over the previous 2 months. Orbital imaging and a biopsy of the tumor revealed a mucosa-associated lymphoid tissue lymphoma occupying her left orbit compressing and stretching the left optic nerve. Considering her age and the additional adverse effects of external beam radiation therapy to her damaged optic nerve, rituximab monotherapy was utilized. The intervention resulted in almost complete regression without any serious adverse effect, with left eye best-corrected visual acuity improving from 12/200 to 16/20. Rituximab monotherapy can be one of the first-choice treatment options for mucosa-associated lymphoid tissue lymphoma, especially in cases with the critical damage in the optic nerve.
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Thu MB, Htun NN, Soe KHH, Steinberg A, McKinley G, Varma M, Yoe J. Regression of Marginal Zone Lymphoma After Praziquantel Therapy in a Patient With Remote Schistosoma haematobium Infection. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2021; 21:e353-e355. [PMID: 33509726 DOI: 10.1016/j.clml.2020.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/27/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Myint B Thu
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY
| | - Nyein N Htun
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY
| | - Khin H H Soe
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY
| | - Amir Steinberg
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY
| | - George McKinley
- Department of Infectious Diseases, Mount Sinai Health System, New York, NY
| | - Mala Varma
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY
| | - Joseph Yoe
- Department of Hematology-Oncology, Mount Sinai Health System, New York, NY.
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Lumish M, Falchi L, Imber BS, Scordo M, von Keudell G, Joffe E. How we treat mature B-cell neoplasms (indolent B-cell lymphomas). J Hematol Oncol 2021; 14:5. [PMID: 33407745 PMCID: PMC7789477 DOI: 10.1186/s13045-020-01018-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/02/2020] [Indexed: 12/30/2022] Open
Abstract
Mature B cell neoplasms, previously indolent non-Hodgkin lymphomas (iNHLs), are a heterogeneous group of malignancies sharing similar disease courses and treatment paradigms. Most patients with iNHL have an excellent prognosis, and in many, treatment can be deferred for years. However, some patients will have an accelerated course and may experience transformation into aggressive lymphomas. In this review, we focus on management concepts shared across iNHLs, as well as histology-specific strategies. We address open questions in the field, including the influence of genomics and molecular pathway alterations on treatment decisions. In addition, we review the management of uncommon clinical entities including nodular lymphocyte-predominant Hodgkin lymphoma, hairy cell leukemia, splenic lymphoma and primary lymphoma of extranodal sites. Finally, we include a perspective on novel targeted therapies, antibodies, antibody-drug conjugates, bispecific T cell engagers and chimeric antigen receptor T cell therapy.
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Affiliation(s)
- Melissa Lumish
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA
| | - Lorenzo Falchi
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA
| | - Brandon S Imber
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA
| | - Michael Scordo
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA
| | - Gottfried von Keudell
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA
| | - Erel Joffe
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, SR-441B, New York, NY, 10065, USA.
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Türkkan G, Alkan A, Paydaş S, Tanrıverdi Ö, Karakaş Y, Karadurmuş N, Sakin A, Temiz S, Arpacı E, Akın M, Menekşe S, Şen CA, Barışta İ. Demographical and Clinical Features of Marginal Zone Lymphomas: A Retrospective Study of Turkish Oncology Group (TOG). Indian J Hematol Blood Transfus 2020; 36:640-645. [PMID: 33100705 DOI: 10.1007/s12288-020-01257-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/28/2020] [Indexed: 11/28/2022] Open
Abstract
Marginal zone lymphomas (MZLs) are rare and indolent subtypes of non-Hodgkin lymphomas, and their clinical behaviours are heterogeneous. The aim of this study was to evaluate the clinical and prognostic characteristics of MZL. In this multicentre retrospective study, we analyzed demographical, clinical and prognostic features of 64 MZL patients. The median age was 54.0 and 78.1% of the patients had extra-nodal disease at presentation. Most of the patients were treated with chemotherapy. The 5 years and 10 years overall survival (OS) rates were 74.5% and 62.1%, respectively. The analysis of factors associated with OS showed that ECOG performance score was an important prognostic factor, with 133.0 months (95% CI 49.3-216.5) versus 18.0 months (95% CI 12.1-23.7) for ECOG 0-1 and 2-3, respectively (p = 0.011). Prognosis of MZL is favorable and ECOG performance score was found associated with OS. Further detailed studies with large patient numbers are needed to clarify the clinical features and treatment management of MZLs.
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Affiliation(s)
- Görkem Türkkan
- Department of Radiation Oncology, Muğla Sıtkı Koçman University Medical Faculty, Muğla, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Muğla Sıtkı Koçman University Medical Faculty, Muğla, Turkey
| | - Semra Paydaş
- Department of Medical Oncology, Çukurova University Medical Faculty, Adana, Turkey
| | - Özgür Tanrıverdi
- Department of Medical Oncology, Muğla Sıtkı Koçman University Medical Faculty, Muğla, Turkey
| | - Yusuf Karakaş
- Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey
| | - Nuri Karadurmuş
- Department of Medical Oncology, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Süleyman Temiz
- Department of Medical Oncology, Kocaeli Acıbadem Hospital, Kocaeli, Turkey
| | - Erkan Arpacı
- Department of Medical Oncology, Bülent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Mustafa Akın
- Department of Radiation Oncology, Balıkesir State Hospital, Balıkesir, Turkey
| | - Serkan Menekşe
- Department of Medical Oncology, Bağcılar Training and Research Hospital, Istanbul, Turkey
| | - Cenk Ahmet Şen
- Department of Radiation Oncology, Medical Park Izmir Hospital, Izmir, Turkey
| | - İbrahim Barışta
- Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey
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Dreessen L, Maréchal N, Verheyden M, De Becker A, Jochmans K, Vanderhasselt T, Bravenboer B, Beyer I. Leptomeningeal metastasis in a marginal zone lymphoma, presenting as a delirium: case report. BMC Geriatr 2020; 20:213. [PMID: 32552693 PMCID: PMC7298837 DOI: 10.1186/s12877-020-01608-6] [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: 01/16/2020] [Accepted: 06/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background Hematologic malignancies can spread to the central nervous system (CNS), either as focal lesions or as leptomeningeal disease. Marginal zone lymphoma (MZL) is a low-grade non-Hodgkin lymphoma and generally presents as an indolent disease. This case report illustrates an unexpected diagnosis of leptomeningeal metastasis in an MZL, presenting as a delirium without B symptoms, pronounced hematologic progression or abnormalities on cerebral imaging. Case presentation An 80-year-old patient with a medical history of monoclonal B-cell lymphocytosis (MBL) with a clone indicative for an MZL, presented to the emergency and the geriatric departments with a recent cognitive deterioration and behavioral changes. MMSE score was 18/30. After excluding the most common etiologies through classical work-up including a normal head magnetic resonance imaging, a lumbar puncture was performed. In the cerebrospinal fluid an elevated protein level and increased lymphocyte count were identified, whereas beta-amyloid and tau protein levels were normal. Immunophenotyping of the lymphocytes confirmed CNS invasion by the MZL clone. Staging revealed mild splenomegaly. Prednisolone, intrathecal and systemic chemotherapy were initiated, leading to quick cognitive improvement with a final MMSE score of 28/30. Conclusions To the best of our knowledge a delirium in an older patient due to leptomeningeal disease in MZL has never been described. To date, rare reports of CNS invasion by MZL describe focal intracranial lesions. After exclusion of common etiologies, physicians should remain vigilant when confronted with a patient with history of MBL presenting neurological symptoms. This case illustrates the importance of low threshold for lumbar punctures in this population, also for those patients with normal imaging studies.
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Affiliation(s)
- Lisa Dreessen
- Department of Geriatric Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - Nicolas Maréchal
- Department of Geriatric Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Michel Verheyden
- Department of Internal Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Ann De Becker
- Department of Hematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Kristin Jochmans
- Department of Hematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Tim Vanderhasselt
- Department of Radiology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Bert Bravenboer
- Department of Geriatric Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Ingo Beyer
- Department of Geriatric Medicine, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
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Burgess HJ, MacDonald Dickinson V, Kerr M, Bienzle D. Marginal zone lymphoma in a dog. Vet Clin Pathol 2020; 49:312-318. [PMID: 32524625 DOI: 10.1111/vcp.12874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/20/2022]
Abstract
A 13-year-old spayed female American Cocker Spaniel was presented for evaluation of a cough and weight loss. Physical exam revealed generalized lymphadenopathy. The patient was diagnosed with marginal zone lymphoma (MZL) on histopathology of an extirpated lymph node. This report demonstrates an unusual case of a pleomorphic neoplastic population documented on cytologic evaluation that had moncytoid features and peripheral blood involvement; a previously undocumented IgG1 monoclonal gammopathy was also an interesting feature of this canine MZL. The patient did not undergo chemotherapy for lymphoma and was euthanized over 4 years after the initial presentation.
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Affiliation(s)
- Hilary J Burgess
- Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Valerie MacDonald Dickinson
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Moira Kerr
- Prairie Diagnostic Services Inc., Saskatoon, SK, Canada
| | - Dorothee Bienzle
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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10
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Robinson JE, Greiner TC, Bouska AC, Iqbal J, Cutucache CE. Identification of a Splenic Marginal Zone Lymphoma Signature: Preliminary Findings With Diagnostic Potential. Front Oncol 2020; 10:640. [PMID: 32457837 PMCID: PMC7225304 DOI: 10.3389/fonc.2020.00640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/06/2020] [Indexed: 12/12/2022] Open
Abstract
Splenic marginal zone lymphoma (SMZL) is a rare, indolent non-Hodgkin's lymphoma that affects 0. 13 per 100,000 persons annually. Overall survival of SMZL is estimated to reach 8-11 years in most cases, but up to 30% of SMZL cases develop aggressive presentations resulting in greatly diminished time of survival. SMZL presents with a very heterogeneous molecular profile, making diagnosis problematic, and accurate prognosis even less likely. The study herein has identified a potential diagnostic gene expression signature with highly specific predictive utility, coined the SMZL-specific Gene Expression Signature (SSGES). Additionally, five of the most impactful markers identified within the SSGES were selected for a five-protein panel, for further evaluation among control and SMZL patient samples. These markers included EME2, ERCC5, SETBP1, USP24, and ZBTB32. When compared with control spleen and other B-cell lymphoma subtypes, significantly higher expression was noticed in SMZL samples when stained for EME2 and USP24. Additionally, ERCC5, SETBP1, USP24, and ZBTB32 staining displayed indications of prognostic value for SMZL patients. Delineation of the SSGES offers a unique SMZL signature that could provide diagnostic utility for a malignancy that has historically been difficult to identify, and the five-marker protein panel provides additional support for such findings. These results should be further investigated and validated in subsequent molecular investigations of SMZL so it may be potentially incorporated into standard oncology practice for improving the understanding and outlook for SMZL patients.
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Affiliation(s)
- Jacob E Robinson
- Department of Biology, University of Nebraska Omaha, Omaha, NE, United States
| | - Timothy C Greiner
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Alyssa C Bouska
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
| | - Javeed Iqbal
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States
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Gkalpakiotis S, Arenberger P, Sticova E, Karlova I, Arenbergerova M. Unusual Periungual Nodulocystic Lesions Leading to the Diagnosis of Extranodal Marginal Zone Lymphoma. Indian J Dermatol 2020; 65:83-84. [PMID: 32029955 PMCID: PMC6986125 DOI: 10.4103/ijd.ijd_485_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Spyridon Gkalpakiotis
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic. E-mail:
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic. E-mail:
| | - Eva Sticova
- Department of Pathology, Third Faculty of Medicine, Charles University and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Ivana Karlova
- Department of Internal Medicine - Haematology, Third Faculty of Medicine, Charles University and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Monika Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Faculty Hospital of Kralovske Vinohrady, Prague, Czech Republic. E-mail:
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