1
|
Affiliation(s)
| | - Emily G. Tocco
- University of Virginia School of Medicine, Charlottesville, Virginia
| | | |
Collapse
|
2
|
Zheng H, Qiu L, Liu C, Tian C. Advances in classification and treatment of primary cutaneous lymphomas. Ann Hematol 2025; 104:2143-2157. [PMID: 40131416 PMCID: PMC12052749 DOI: 10.1007/s00277-025-06311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Accepted: 03/08/2025] [Indexed: 03/27/2025]
Abstract
Primary cutaneous lymphomas (PCLs) are a heterogeneous group of extranodal non-Hodgkin lymphomas, characterized with skin involvement as the primary or predominant manifestation. While early-stage PCLs typically have a favorable prognosis, managing patients with aggressive progression or advaced stages remains a challenge. Recent advancements in molecular biology and sophisticated clinical laboratory tests have significantly improved the classification and management of PCLs, which provide more targeted and effective treatment strategies for patients. This review summarizes the latest classification schemes and therapeutic options for PCLs, with a focus on the latest developments and future directions in the field.
Collapse
Affiliation(s)
- Hong Zheng
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Lihua Qiu
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
| | - Chang Liu
- Pulmonary Medicine, Molecular Cell Biology and Immunology, Amsterdam Institute for Infection and Immunity, Cancer Immunology, Cancer Center Amsterdam, Cancer Biology and Immunology, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Chen Tian
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.
| |
Collapse
|
3
|
Marques-Piubelli ML, Navarrete J, Ledesma DA, Hudgens CW, Lazcano RN, Alani A, Huen A, Duvic M, Nagarajan P, Aung PP, Wistuba II, Curry JL, Miranda RN, Torres-Cabala CA. Differential Upregulation of Th1/Th17-Associated Proteins and PD-L1 in Granulomatous Mycosis Fungoides. Cells 2024; 13:419. [PMID: 38474383 PMCID: PMC10931377 DOI: 10.3390/cells13050419] [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] [Received: 12/20/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Granulomatous Mycosis Fungoides (GMF) is a rare form of mycosis fungoides (MF) characterized by a granulomatous infiltrate associated with the neoplastic lymphoid population and is considered to have a worse prognosis compared with regular MF. The upregulation of the T helper (Th) axis, especially Th17, plays an important role in the pathogenesis of several inflammatory/infectious granulomatous cutaneous diseases, but its role in GMF is still not elucidated to date. In this study, we evaluated the immunohistochemical expression of Th1 (Tbet), Th2 (GATA-3), Th17 (RORγT), T regulatory (Foxp3), and immune checkpoint (IC) (PD-1 and PD-L1) markers in a cohort of patients with GMF and MF with large cell transformation (MFLCT). Skin biopsies from 49 patients (28 GMF and 21 MFLCT) were studied. Patients with GMF were associated with early clinical stage (p = 0.036) and lower levels of lactate dehydrogenase (p = 0.042). An increased percentage of cells positive for Tbet (p = 0.017), RORγT (p = 0.001), and PD-L1 (p = 0.011) was also observed among the GMF specimens, while a stronger PD-1 intensity was detected in cases of MFLCT. In this cohort, LCT, RORγT < 10%, Foxp3 < 10%, age, and advanced stage were associated with worse overall survival (OS) in univariate analysis. GMF demonstrated Th1 (cellular response) and Th17 (autoimmunity) phenotype, seen in early MF and granulomatous processes, respectively, which may be related to the histopathological appearance and biological behavior of GMF. Further studies involving larger series of cases and more sensitive techniques are warranted.
Collapse
Affiliation(s)
- Mario L. Marques-Piubelli
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
| | - Jesus Navarrete
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
| | - Debora A. Ledesma
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
| | - Courtney W. Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
| | - Rossana N. Lazcano
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
| | - Ali Alani
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
| | - Auris Huen
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Madeleine Duvic
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Priyadharsini Nagarajan
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
| | - Phyu P. Aung
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
| | - Ignacio I. Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
| | - Jonathan L. Curry
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Roberto N. Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Carlos A. Torres-Cabala
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (D.A.L.); (J.L.C.)
- Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (J.N.)
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|
4
|
Shafi S, Henning A, Chung CG. Mucinous spongiosis as a clue to atypical mycosis fungoides. J Cutan Pathol 2023; 50:1027-1029. [PMID: 37759389 DOI: 10.1111/cup.14530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023]
Affiliation(s)
- Saba Shafi
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ania Henning
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Catherine G Chung
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| |
Collapse
|
5
|
Mondal D, Shinde S, Paul S, Thakur S, Velu GSK, Tiwari AK, Dixit V, Amit A, Vishvakarma NK, Shukla D. Diagnostic significance of dysregulated miRNAs in T-cell malignancies and their metabolic roles. Front Oncol 2023; 13:1230273. [PMID: 37637043 PMCID: PMC10448964 DOI: 10.3389/fonc.2023.1230273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/17/2023] [Indexed: 08/29/2023] Open
Abstract
T-cell malignancy is a broad term used for a diverse group of disease subtypes representing dysfunctional malignant T cells transformed at various stages of their clonal evolution. Despite having similar clinical manifestations, these disease groups have different disease progressions and diagnostic parameters. The effective diagnosis and prognosis of such a diverse disease group demands testing of molecular entities that capture footprints of the disease physiology in its entirety. MicroRNAs (miRNAs) are a group of noncoding RNA molecules that regulate the expression of genes and, while doing so, leave behind specific miRNA signatures corresponding to cellular expression status in an altered stage of a disease. Using miRNAs as a diagnostic tool is justified, as they can effectively distinguish expressional diversity between various tumors and within subtypes of T-cell malignancies. As global attention for cancer diagnosis shifts toward liquid biopsy, diagnosis using miRNAs is more relevant in blood cancers than in solid tumors. We also lay forward the diagnostic significance of miRNAs that are indicative of subtype, progression, severity, therapy response, and relapse. This review discusses the potential use and the role of miRNAs, miRNA signatures, or classifiers in the diagnosis of major groups of T-cell malignancies like T-cell acute lymphoblastic lymphoma (T-ALL), peripheral T-cell lymphoma (PTCL), extranodal NK/T-cell lymphoma (ENKTCL), and cutaneous T-cell lymphoma (CTCL). The review also briefly discusses major diagnostic miRNAs having prominent metabolic roles in these malignancies to highlight their importance among other dysregulated miRNAs.
Collapse
Affiliation(s)
- Deepankar Mondal
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | - Sapnita Shinde
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | - Souvik Paul
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Suresh Thakur
- Centre for Excellence in Genomics, Trivitron Healthcare Pvt. Ltd., Chennai, India
| | - GSK Velu
- Centre for Excellence in Genomics, Trivitron Healthcare Pvt. Ltd., Chennai, India
| | - Atul Kumar Tiwari
- Department of Zoology, Dr. Bhawan Singh Porte Government College, Pendra, Chhattisgarh, India
| | - Vineeta Dixit
- Department of Botany, Sri Satguru Jagjit Singh Namdhari College, Gharwa, Jharkhand, India
| | - Ajay Amit
- Department of Forensic Sciences, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| | | | - Dhananjay Shukla
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India
| |
Collapse
|
6
|
Goyal A, Casillo C, Narayanan D, Pinkus GS, Russell-Goldman E. Initial Diagnosis of Classic Hodgkin Lymphoma With Skin Biopsy: A Rare Case and Review of Diagnostic Considerations. Am J Dermatopathol 2023; 45:577-581. [PMID: 37462207 DOI: 10.1097/dad.0000000000002472] [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: 07/20/2023]
Abstract
ABSTRACT Classic Hodgkin lymphoma (CHL) is a B-cell-derived lymphoma that classically displays a bimodal age distribution. CHL typically involves the mediastinum, lymph nodes, and other visceral organs. CHL is characterized histologically by the presence of a relatively paucicellular neoplastic cell population composed of large atypical cells (including Hodgkin and Reed-Sternberg forms) in a reactive mixed inflammatory background, often with prominent necrosis. CHL rarely occurs in the skin, and the associated mixed inflammatory infiltrate or necrotic appearance can create diagnostic uncertainty. Herein, we report the case of a 31-year-old man presenting with a painful dendritic rash of the anterior chest wall with axillary lymphadenopathy. After multiple nondiagnostic biopsies that revealed largely necrotic material, a chest wall skin biopsy was obtained. The skin biopsy was diagnostic of CHL, based on the presence of large atypical dermal cells, including Hodgkin and Reed-Sternberg forms, which expressed CD15, CD30 and Fascin, in a typical mixed inflammatory and necrotic background. Through the lens of this case, we discuss the characteristics and mechanisms of skin involvement of CHL, and the histopathologic and immunohistochemical pitfalls when considering the rare diagnosis of CHL in the skin.
Collapse
Affiliation(s)
- Amrita Goyal
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | | | - Damodaran Narayanan
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
- Department of Diagnostic Medicine, Dell Medical School, University of Texas at Austin, Austin, TX
| | | | | |
Collapse
|
7
|
Roy T, Boateng ST, Uddin MB, Banang-Mbeumi S, Yadav RK, Bock CR, Folahan JT, Siwe-Noundou X, Walker AL, King JA, Buerger C, Huang S, Chamcheu JC. The PI3K-Akt-mTOR and Associated Signaling Pathways as Molecular Drivers of Immune-Mediated Inflammatory Skin Diseases: Update on Therapeutic Strategy Using Natural and Synthetic Compounds. Cells 2023; 12:1671. [PMID: 37371141 PMCID: PMC10297376 DOI: 10.3390/cells12121671] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
The dysregulated phosphatidylinositol-3-kinase (PI3K)-Akt-mammalian target of rapamycin (mTOR) signaling pathway has been implicated in various immune-mediated inflammatory and hyperproliferative dermatoses such as acne, atopic dermatitis, alopecia, psoriasis, wounds, and vitiligo, and is associated with poor treatment outcomes. Improved comprehension of the consequences of the dysregulated PI3K/Akt/mTOR pathway in patients with inflammatory dermatoses has resulted in the development of novel therapeutic approaches. Nonetheless, more studies are necessary to validate the regulatory role of this pathway and to create more effective preventive and treatment methods for a wide range of inflammatory skin diseases. Several studies have revealed that certain natural products and synthetic compounds can obstruct the expression/activity of PI3K/Akt/mTOR, underscoring their potential in managing common and persistent skin inflammatory disorders. This review summarizes recent advances in understanding the role of the activated PI3K/Akt/mTOR pathway and associated components in immune-mediated inflammatory dermatoses and discusses the potential of bioactive natural products, synthetic scaffolds, and biologic agents in their prevention and treatment. However, further research is necessary to validate the regulatory role of this pathway and develop more effective therapies for inflammatory skin disorders.
Collapse
Affiliation(s)
- Tithi Roy
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Samuel T. Boateng
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Mohammad B. Uddin
- Department of Toxicology and Cancer Biology, Center for Research on Environmental Diseases, College of Medicine, University of Kentucky, Lexington, KY 40536, USA;
| | - Sergette Banang-Mbeumi
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Division for Research and Innovation, POHOFI Inc., Madison, WI 53744, USA
- School of Nursing and Allied Health Sciences, Louisiana Delta Community College, Monroe, LA 71203, USA
| | - Rajesh K. Yadav
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Chelsea R. Bock
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Joy T. Folahan
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Xavier Siwe-Noundou
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, P.O. Box 218, Pretoria 0208, South Africa;
| | - Anthony L. Walker
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
| | - Judy A. King
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
- College of Medicine, Belmont University, 900 Belmont Boulevard, Nashville, TN 37212, USA
| | - Claudia Buerger
- Department of Dermatology, Venerology and Allergology, Clinic of the Goethe University, 60590 Frankfurt am Main, Germany;
| | - Shile Huang
- Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA;
- Department of Hematology and Oncology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA
- Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA
| | - Jean Christopher Chamcheu
- School of Basic Pharmaceutical and Toxicological Sciences, College of Pharmacy, University of Louisiana at Monroe, Monroe, LA 71209, USA; (T.R.); (S.T.B.); (S.B.-M.); (R.K.Y.); (C.R.B.); (J.T.F.); (A.L.W.)
- Department of Pathology and Translational Pathobiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA;
| |
Collapse
|
8
|
Hodak E, Geskin L, Guenova E, Ortiz-Romero PL, Willemze R, Zheng J, Cowan R, Foss F, Mangas C, Querfeld C. Real-Life Barriers to Diagnosis of Early Mycosis Fungoides: An International Expert Panel Discussion. Am J Clin Dermatol 2023; 24:5-14. [PMID: 36399227 PMCID: PMC9673193 DOI: 10.1007/s40257-022-00732-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/19/2022]
Abstract
Mycosis fungoides (MF) is a rare, primary cutaneous T-cell lymphoma that is challenging to diagnose due to its heterogeneous clinical presentation and complex histology. The subtlety of the initial clinical appearance of MF can result in diagnostic delays and hesitancy to refer suspected cases to specialist clinics. An unmet need remains for greater awareness and education. Therefore, an international expert panel of dermatologists, oncologists, hematologists, and dermatopathologists convened to discuss and identify barriers to early and accurate MF diagnosis that could guide clinicians toward making a correct diagnosis. Confirmation of MF requires accurate assessment of symptoms and clinical signs, and subsequent correlation with dermatopathological findings. This review summarizes the expert panel's guidance, based on the literature and real-life experience, for dermatologists to help include MF in their list of differential diagnoses, along with simple clinical and histopathologic checklists that may help clinicians to suspect and identify potential MF lesions and reduce diagnostic delays.
Collapse
Affiliation(s)
- Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, Tel Aviv University, 39 Jabotinsky Street, Petah Tiqva, 49100, Tel Aviv, Israel.
| | - Larisa Geskin
- Columbia University Medical Center, Columbia University, New York, NY, USA
| | - Emmanuella Guenova
- University Hospital Lausanne (CHUV) and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Pablo L Ortiz-Romero
- Department of Dermatology, Hospital 12 de Octubre, Institute i+12, CIBERONC, Medical School, University Complutense, Madrid, Spain
| | - Rein Willemze
- Leiden University Medical Center, Leiden, The Netherlands
| | - Jie Zheng
- Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Richard Cowan
- Christie Hospital, The Christie School of Oncology, Manchester, UK
| | - Francine Foss
- Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Cristina Mangas
- Dermatology Department and Institute of Oncology of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Christiane Querfeld
- Division of Dermatology and Department of Pathology, City of Hope National Medical Center and Beckman Research Institute, Duarte, CA, USA
| |
Collapse
|
9
|
Liu F, Li X, Ma JC, Wang L, Shi Z. Poikilodermatous and Ichthyosiform Patches all over the Body and Dark-brown Nodules on the Legs: A Quiz. Acta Derm Venereol 2022; 102:adv00759. [DOI: 10.2340/actadv.v102.2504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Quiz)
Collapse
|
10
|
Haque WS, Alam S, Kabir H, Chowdhury AA. Unilesional mycosis fungoides: a case report and review of literature. IMC JOURNAL OF MEDICAL SCIENCE 2021. [DOI: 10.55010/imcjms.16.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Mycosis fungoides (MF) is the commonest primary cutaneous T-cell lymphoma (CTCL). Classically MF is presented clinically as multilesional disease but occurrence of solitary lesion, though quite rare, is on the record. This rare variant of MF is clinically and histopathologically indistinguishable from classic MF. Due to the rarity of the presentation the clinician may miss the diagnosis and the pathologist may also be in diagnostic dilemma specially if not clinically oriented. Here we describe a case of unilesional/solitary MF (UMF) in a 59 years old male who was initially clinically diagnosed as inflammatory dermatosis and was treated accordingly without any appreciable clinical response for over 4 years. Unresponsiveness to empirical treatment led to biopsy which finally proved it to be UMF. The clinical, light microscopic and immunohistochemical features of UMF are briefly reviewed to create awareness among the clinicians and pathologists about this rare variant of MF.
IMC J Med Sci 2022; 16(1): 006
*Correspondence: Wasim Selimul Haque, Head, Department of Histopathology and Cytopathology, Jaber Al-Ahmed Armed Forces Hospital, Kuwait Armed, Forces, Subhan Cantonment, Kuwait. Email: audrirodelawasim@gmail.com
Collapse
Affiliation(s)
- Wasim Selimul Haque
- Department of Histopathology and Cytopathology, Jaber Al-Ahmed Armed Forces Hospital, Subhan Cantonment, Kuwait
| | - Shakibul Alam
- Department of Dermatology, Jaber Al-Ahmed Armed Forces Hospital, Subhan Cantonment, Kuwait
| | - Humayun Kabir
- Department of Dermatology, Jaber Al-Ahmed Armed Forces Hospital, Subhan Cantonment, Kuwait
| | - Al-Amin Chowdhury
- Department of Surgery, Jaber Al-Ahmed Armed Forces Hospital, Subhan Cantonment, Kuwait
| |
Collapse
|
11
|
Stahly S, Manway M, Lin CC, Sukpraprut-Braaten S. Pagetoid Reticulosis: A Rare Dermatologic Malignancy Presenting in a Middle-Aged Female. Cureus 2021; 13:e18524. [PMID: 34754679 PMCID: PMC8569836 DOI: 10.7759/cureus.18524] [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: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
Pagetoid reticulosis is a rare form of cutaneous T cell lymphoma, a malignancy of T lymphocytes, that invades the skin leading to a multitude of dermatologic manifestations. Pagetoid reticulosis commonly presents as a localized slow-growing or indolently manifesting hyperkeratotic patch/plaque on the extremities that is confined to the epidermis. Diagnosis is confirmed via a skin biopsy of the affected area followed by a cytologic examination. Treatment typically entails topical corticosteroids, alkylating agents, and retinoids. With disseminated disease, a multidisciplinary approach involving chemotherapy and radiation is necessary. To raise awareness about pagetoid reticulosis, its diagnosis, and management, we report a case localized to the left forehead and earlobe of a 57-year-old female.
Collapse
Affiliation(s)
| | - Mitch Manway
- Dermatology, HonorHealth/Affiliated Dermatology, Scottsdale, USA
| | - Christine C Lin
- Dermatology, HonorHealth/Affiliated Dermatology, Scottsdale, USA
| | | |
Collapse
|
12
|
Travaglino A, Russo D, Varricchio S, Pignatiello S, Baldo A, Picardi M, Pane F, Mascolo M. Prognostic Significance of CD30 in Transformed Mycosis Fungoides. Am J Clin Pathol 2021; 156:350-355. [PMID: 33769436 DOI: 10.1093/ajcp/aqaa261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Several studies suggested that CD30 expression is a favorable prognostic marker in transformed mycosis fungoides (tMF). However, evidence in this field is still unclear. This systematic review and meta-analysis aimed to evaluate the prognostic significance of CD30 in tMF. METHODS Electronic databases were searched from their inception to June 2020 for all studies assessing the prognostic value of CD30 in tMF. Pooled hazard ratio (HR) for death was calculated; a P value less than .05 was considered significant. Inconsistency index (I2) was used to assess statistical heterogeneity among studies. RESULTS Seven studies with 323 patients were included. CD30 expression in tMF was significantly associated with a decreased hazard of death both on univariate (HR, 0.459; 95% confidence interval [CI], 0.319-0.660; P < .001) and multivariate analysis (HR, 0.503; 95% CI, 0.345-0.734; P < .001), and the statistical heterogeneity among studies was null in all analyses (I2 = 0%). CONCLUSIONS tMF cases with CD30 expression in large cells have a hazard of death two times lower than CD30-negative cases.
Collapse
Affiliation(s)
- Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Sara Pignatiello
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| | - Antonello Baldo
- Department of Clinical Medicine and Surgery, Dermatology Section Naples, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II,” Naples, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples “Federico II,” Naples, Italy
| | - Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section Naples, Italy
| |
Collapse
|
13
|
Swoboda R, Kaminska-Winciorek G, Wesolowski M, Dulik K, Giebel S. Granulomatous slack skin variant of mycosis fungoides: Clinical and dermoscopic follow-up of a very rare entity. Dermatol Ther 2021; 34:e14822. [PMID: 33527657 DOI: 10.1111/dth.14822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/07/2021] [Accepted: 01/21/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Ryszard Swoboda
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Grazyna Kaminska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Marcin Wesolowski
- The Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Katarzyna Dulik
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Sebastian Giebel
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| |
Collapse
|
14
|
LaPolla JJ, DiDomenico LA, Brodell RT, Casteel ML. Woringer-Kolopp Disease of the Foot: A Case Report. J Am Podiatr Med Assoc 2020; 110:449535. [PMID: 33301589 DOI: 10.7547/18-029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Woringer-Kolopp disease is a rare variant of mycosis fungoides, a type of cutaneous T-cell lymphoma. Described is a case of a small annular plaque on the foot diagnosed histologically as Woringer-Kolopp disease and treated successfully with topical and intralesional steroids. In addition, a brief review of the literature and treatment options is provided.
Collapse
|
15
|
Jayasinghe DR, Dissanayake K, de Silva MVC. Comparison between the histopathological and immunophenotypical features of hypopigmented and nonhypopigmented mycosis fungoides: A retrospective study. J Cutan Pathol 2020; 48:486-494. [PMID: 32965737 DOI: 10.1111/cup.13882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/16/2020] [Accepted: 09/19/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Mycosis fungoides (MF), the commonest primary cutaneous T-cell lymphoma, has classic and variant types which include hypopigmented MF (HMF). Previous studies have identified distinct clinicopathological profiles in HMF. This study aims to objectively compare the clinicopathological features of HMF with non-HMF lesions in order to characterize salient features of HMF. METHODS This cross-sectional, retrospective study analyzed biopsy specimens of 87 patients with MF. HMF and non-HMF groups were compared using clinical data, immunophenotypic features and scores given for six histopathological features: dermal infiltrate, basilar and superficially extending epidermotropism, Pautrier microabscesses and dermal and epidermotropic lymphocytic atypia. RESULTS Seventy-six patients had HMF. Presentation in females (59.21%; p = .04) and patch stage (88.16%; p = .01) in HMF were significant, and HMF presented at a younger mean age when compared to non-HMF. Both groups had equal intensity of epidermotropism, with HMF showing milder dermal infiltrates and significantly less dermal atypia. Pautrier microabscesses were significantly commoner in non-HMF (LR 10.76; p < .01). 94.74% of HMF were CD4-/CD8+. CONCLUSION HMF presents at a lower age and earlier stage with female predominance compared to non-HMF. Because of milder dermal infiltrates, less dermal atypia, and Pautrier microabscesses, the diagnosis of HMF requires correlation with clinical features and careful assessment of epidermotropic cells.
Collapse
Affiliation(s)
| | - Karuna Dissanayake
- Department of Pathology, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | |
Collapse
|
16
|
Mascolo M, Travaglino A, Varricchio S, Russo D, Sabattini E, Agostinelli C, Bertuzzi C, Baldo A, Pileri A, Picardi M, Pane F, Staibano S. Role of chromatin assembly factor-1/p60 and poly [ADP-ribose] polymerase 1 in mycosis fungoides. Virchows Arch 2020; 478:961-968. [PMID: 33098490 PMCID: PMC8099834 DOI: 10.1007/s00428-020-02952-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 10/14/2020] [Indexed: 12/18/2022]
Abstract
Mycosis fungoides (MF) represents the most common type of cutaneous lymphoma. In the majority of patients, the disease has a slow evolution and a protracted course; however, a subset of patients shows poor oncologic outcomes. Unfortunately, there are no reliable prognostic markers for MF, and the currently available treatments are only effective in a minority of patients. This study aimed to evaluate the expression and clinical significance of PARP-1 and CAF-1/p60 in MF. Sixty-four MF representatives of the different stages of disease were assessed by immunohistochemistry for PARP-1 and CAF-1/p60. The association of PARP-1 and CAF-1/p60 with the MF stage and outcome was assessed by using Fisher’s exact test and Kaplan-Meier survival analysis with the Log-rank test; a p value < 0.05 was considered significant. PARP-1 was overexpressed in 57.9% of MF and was significantly associated with a MF stage > II (p = 0.034) but not with the risk of death (p = 0.237). CAF-1/p60 was overexpressed in 26.8% of MF and was significantly associated with decreased overall survival (p < 0.001) but not with the MF stage (p = 1). A significant association was found between PARP-1 overexpression and CAF-1/p60 overexpression (p = 0.0025). Simultaneous overexpression of PARP-1 and CAF-1/p60 was significantly associated with decreased overall survival (p < 0.001), although less strongly than CAF-1/p60 alone (χ2 = 14.916 vs 21.729, respectively). In MF, PARP-1 is overexpressed in advanced stages, while CAF-1/p60 is overexpressed in the cases with shorter overall survival, appearing as a significant prognostic marker. A role for PARP-1 inhibitors and anti-CAF-1/p60 targeted therapy may be reasonably hypothesized in MF.
Collapse
Affiliation(s)
- Massimo Mascolo
- Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Antonio Travaglino
- Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Silvia Varricchio
- Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Daniela Russo
- Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| | - Elena Sabattini
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Claudio Agostinelli
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Clara Bertuzzi
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Antonello Baldo
- Department of Clinical Medicine and Surgery, Dermatology Section, University of Naples "Federico II", Naples, Italy
| | - Alessandro Pileri
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Marco Picardi
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Fabrizio Pane
- Department of Clinical Medicine and Surgery, Hematology Section, University of Naples "Federico II", Naples, Italy
| | - Stefania Staibano
- Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy
| |
Collapse
|
17
|
Pulitzer MP, Horna P, Almeida J. Sézary syndrome and mycosis fungoides: An overview, including the role of immunophenotyping. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:132-138. [PMID: 32516521 DOI: 10.1002/cyto.b.21888] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 01/11/2023]
Abstract
This review discusses the definition and major categories of cutaneous T-cell lymphoma, Sézary syndrome and mycosis fungoides, and the role of immunophenotyping in their diagnosis. The following key points are raised: (a) Sézary syndrome and mycosis fungoides cells most often have a characteristic CD3+ CD4+ CD7- and/or CD26- immunophenotype. (b) This immunophenotype is not specific, but can assist in the distinction from non-neoplastic T cells and other subtypes of mature T-cell neoplasm. (c) However, small subsets of normal and reactive T-cells can have an overlapping immunophenotype, and can be distinguished by evaluating for additional changes in antigen expression.
Collapse
Affiliation(s)
- Melissa P Pulitzer
- Department of Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, New York, USA
| | - Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Julia Almeida
- Cancer Research Center (IBMCC-CSIC/USAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, IBSAL and CIBERONC, Salamanca, Spain
| |
Collapse
|
18
|
Zhu M, Yu W, Wang P, Liu J, Li Z, Dai H, Xu AE. Reflectance confocal microscopy may be included as part of the diagnostic algorithm of early-stage mycosis fungoides. Skin Res Technol 2020; 26:591-598. [PMID: 31950528 DOI: 10.1111/srt.12840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/11/2019] [Accepted: 12/18/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Reflectance confocal microscopy (RCM), a noninvasive, real-time technique of computed tomography, has been widely used for pigmentary, inflammatory, and tumor diseases of the skin. AIM Our main purpose was to analyze the consistency between pathological and RCM characteristics of early-stage mycosis fungoides (MF) and the utility of RCM in the diagnosis of early-stage MF. METHODS According to the RCM features of MF in the early stage, the biopsy sites of 40 cases of suspected MF and 20 cases of chronic inflammatory skin diseases clinically were preliminarily located. Histopathologic and immunohistochemical examinations were performed to make a diagnosis based on the diagnostic algorithm proposed by the International Society for Cutaneous Lymphomas. RESULTS Among the 60 patients observed, there were 12 confirming cases of MF, 14 suspecting cases, 6 not completely excluding cases, and 28 eliminating cases according to the diagnostic algorithm, as well as characteristics of RCM were typical in 8 cases, suspected in 16 cases, not excluded in 3 cases, and excluded in 33 cases. The kappa value was 0.769 (P < .01), which means there is a strong consistency between the classification by RCM and the diagnosis algorithm. MF in patch stage and plaque stage (IA to IIB) has typical characteristics of RCM, respectively. CONCLUSIONS RCM can be used as an objective and convenient auxiliary means to diagnose early-stage MF and may be included as part of the diagnostic algorithm of early-stage MF.
Collapse
Affiliation(s)
- Mengyan Zhu
- Department of Dermatology, The Third People's Hospital of Hangzhou Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Wenzhong Yu
- Department of Dermatology, The Third People's Hospital of Hangzhou Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Ping Wang
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, China
| | - Jiao Liu
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, China
| | - Zhao Li
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, China
| | - Hui Dai
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, China
| | - Ai-E Xu
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, China
| |
Collapse
|
19
|
Fatima S, Siddiqui S, Tariq MU, Ishtiaque H, Idrees R, Ahmed Z, Ahmed A. Mycosis Fungoides: A Clinicopathological Study of 60 Cases from a Tertiary Care Center. Indian J Dermatol 2020; 65:123-129. [PMID: 32180598 PMCID: PMC7059469 DOI: 10.4103/ijd.ijd_602_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Mycosis fungoides (MF) is the most common primary cutaneous lymphoma. It affects usually the covered areas of the body in elderly males in 6th and 7th decades of life. Atypical dermal lymphoid infiltrate is seen along with epidermotropism. Nuclei of neoplastic cells are convoluted. The neoplastic cells demonstrate positivity for CD3 (Pan T) immunohistochemical stain. Majority show increased CD4 to CD8 ratio. The present study was done to study the clinicopathological features, which might be of help in reaching a correct diagnosis in these cases. Materials and Methods: A retrospective descriptive study was conducted on 60 reported cases of MF. The retrieved slides were reviewed for clinical and histopathological features and immunohistochemical profile. Results: The ages ranged from 20–84 years, mean age was 47 years. Majority (75%) of patients were male. Trunk and extremities were the sites most commonly affected. There was significant inverse correlation between epidermal thickness and tumor stage (P = 0.02). Thickened epidermis was seen in patch stage and thickness reduced with progressing stage. The intensity of dermal infiltrate and cell size was also statistically significantly linked to stage progression (P < 0.001 each). In addition, proliferation index also correlated significantly with tumor stage (P = 0.002). Conclusion: Clinical information and histological features are equally important in the accurate diagnosis of MF. Papillary dermal fibrosis is a useful diagnostic clue. CD4:CD8 ratio is not increased in all cases; it may be decreased or remain unchanged.
Collapse
Affiliation(s)
- Saira Fatima
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sabeehuddin Siddiqui
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Usman Tariq
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Hira Ishtiaque
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Romana Idrees
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Zubair Ahmed
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Arsalan Ahmed
- Section of Histopathology, Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
20
|
|
21
|
Abstract
Non-Hodgkin's lymphoma (NHL) encompasses a diverse collection of systemic and primary cutaneous lymphomas. Cutaneous T-cell lymphomas (CTCLs) represent about 13% of all NHLs, which are further subdivided into a heterogeneous group with vastly different presentations and histologic features. Diagnosis requires integration of clinical, pathologic, and molecular features. Among CTCLs, mycosis fungoides and Sézary syndrome are the most prevalent. Treatment is aimed at limiting morbidity and halting disease progression. Hematopoietic stem cell transplantation is the only therapy with curative intent.
Collapse
Affiliation(s)
- Cecilia A Larocca
- Department of Dermatology, Center for Cutaneous Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA
| | - Nicole R LeBoeuf
- Department of Dermatology, Center for Cutaneous Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02215, USA.
| |
Collapse
|
22
|
Two cases of phenotypic switch of primary cutaneous T cell lymphoma after treatment with an aggressive course and review of the literature. Virchows Arch 2019; 475:637-648. [DOI: 10.1007/s00428-019-02599-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/07/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
|
23
|
Scleromyxedematous Changes in a Patient With Long-Standing Mycosis Fungoides Who Progressed to Sézary Syndrome. Am J Dermatopathol 2019; 41:e139-e143. [PMID: 31169525 DOI: 10.1097/dad.0000000000001464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mycosis fungoides (MF) variants with different clinicopathologic and immunohistochemical features have been well-delineated. We report a case of scleromyxedematous changes arising in a patient with long-standing MF who progressed to Sézary syndrome (SS) shortly afterward. Total-skin electron-beam radiation therapy resulted in an excellent response, controlling both the MF/SS and the scleromyxedematous lesions; however, the patient died few months later. Although mucin deposition has been described in association with MF/SS (mainly follicular mucinosis in folliculotropic MF), there are limited reports in the literature on dermal mucinosis and scleromyxedematous changes in MF/SS. The mechanism of this association and its prognostic implications requires further investigation.
Collapse
|