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Alberti-Violetti S, Avallone G, Colonna C, Tavoletti G, Venegoni L, Merlo V, Cambiaghi S, Marzano AV, Berti E, Cavalli R. Paediatric cutaneous lymphomas including rare subtypes: A 40-year experience at a tertiary referral centre. J Eur Acad Dermatol Venereol 2024. [PMID: 38650545 DOI: 10.1111/jdv.20028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Primary cutaneous lymphomas are neoplasms of the immune system with a distinct tropism for the skin and an absence of extracutaneous manifestations at the time of diagnosis. Studies focusing on cutaneous lymphomas in children and adolescents remain scarce and often do not encompass the rare subtypes. OBJECTIVES To address this knowledge gap by describing the clinical, histological and molecular characteristics of a large group of paediatric patients affected by primary cutaneous lymphoma. We also provided the Paediatric Primary Cutaneous Lymphoma Atlas that illustrates the clinicopathological spectrum of observed presentations, in the hope of supporting other physicians in the diagnostic process. METHODS Retrospective chart review of paediatric patients diagnosed with primary cutaneous lymphomas between 1980 and 2022 at the Paediatric Dermatology Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan. RESULTS A total of 101 patients (58 males, 43 females) met the inclusion criteria. The most common subtypes were lymphomatoid papulosis (n = 48) and mycosis fungoides (n = 31). These were followed by primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorders (n = 7), primary cutaneous anaplastic large-cell lymphomas (n = 5), primary cutaneous marginal zone B-cell lymphomas (n = 3), primary cutaneous follicle centre lymphomas (n = 2), subcutaneous panniculitis-like T-cell lymphomas (n = 2), primary cutaneous peripheral T-cell lymphoma not otherwise specified (n = 1), primary cutaneous precursor B-lymphoblastic lymphoma (n = 1) and Sézary syndrome (n = 1). Clinical follow-up data covering a median of 70.8 months (range 1-324) were available for 74 patients, of whom three died due to cutaneous lymphoma. CONCLUSIONS Our findings shed light on the peculiar aspects and long-term outcomes of paediatric cutaneous lymphomas, particularly emphasizing their distinctive features in comparison to their adult counterparts and exploring the less common subtypes. Further larger-scale studies are warranted to better characterize these entities and to achieve a more rapid and accurate diagnosis.
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Affiliation(s)
- Silvia Alberti-Violetti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Cristiana Colonna
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Tavoletti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Luigia Venegoni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Valentina Merlo
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Cambiaghi
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Riccardo Cavalli
- Pediatric Dermatology Unit, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Richter J, Oschlies I, Kock K, Wüseke T, Haag J, Koch K, Klapper W. CD27/CD70 pathway activation in primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. J Pathol 2024; 262:189-197. [PMID: 37933684 DOI: 10.1002/path.6222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
Primary cutaneous CD4+ small or medium T-cell lymphoproliferative disorder (PCSM-LPD) is a clonal T-cell proliferation disease confined to the skin. PCSM-LPD shares expression of T follicular helper (Tfh) cell markers with various mature T-cell lymphomas. However, the benign presentation of PCSM-LPD contrasts the clinical behavior of other Tfh-lymphomas. The aim of our study was to delineate the molecular similarities and differences between PCSM-LPD and other Tfh-derived lymphomas to explain the clinical behavior and unravel possible pathological mechanisms. We performed targeted next-generation sequencing of 19 genes recurrently mutated in T-cell neoplasms in n = 17 PCSM-LPD with high and in n = 21 PCSM-LPD with low tumor cell content. Furthermore, gene expression profiling was used to identify genes potentially expressed in the PD1-positive (PD1+) neoplastic cells. Expression of some of these genes was confirmed in situ using multistain immunofluorescence. We found that PCSM-LPD rarely harbored mutations recurrently detected in other T-cell neoplasms. PCSM-LPD is characterized by the invariable expression of the T-cell-receptor-associated LCK protein. CD70 and its ligand CD27 are co-expressed on PD1+ PCSM-LPD cells, suggestive of autoactivation of the CD70 pathway. In conclusion, PCSM-LPD differs from disseminated lymphomas of Tfh origin by their mutation profile. Activation of CD70 signaling also found in cutaneous T-cell lymphoma represents a potential driver of neoplastic proliferation of this benign neoplasia of Tfh. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Julia Richter
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Ilske Oschlies
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Katharina Kock
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Thomas Wüseke
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jochen Haag
- Department of Pathology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Karoline Koch
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Kiel, Germany
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Fenu EM, Milman T, Penne R, Navarro FE, Yang G, Bagg A. Primary cutaneous T-follicular helper lymphoma. EJHaem 2023; 4:1176-1178. [PMID: 38024630 PMCID: PMC10660100 DOI: 10.1002/jha2.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Elena M. Fenu
- Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Tatyana Milman
- Department of OphthalmologyWills Eye Hospital and Jefferson University HospitalPhiladelphiaPennsylvaniaUSA
| | - Robert Penne
- Department of OphthalmologyWills Eye Hospital and Jefferson University HospitalPhiladelphiaPennsylvaniaUSA
| | - Farah El‐Sharkawy Navarro
- Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Guang Yang
- Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Adam Bagg
- Department of Pathology and Laboratory MedicineHospital of the University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Knaneh J, Hodak E, Fedida-Metula S, Edri A, Eren R, Yoffe Y, Amitay-Laish I, Prag Naveh H, Lubin I, Porgador A, Moyal L. mAb14, a Monoclonal Antibody against Cell Surface PCNA: A Potential Tool for Sezary Syndrome Diagnosis and Targeted Immunotherapy. Cancers (Basel) 2023; 15:4421. [PMID: 37686697 PMCID: PMC10486495 DOI: 10.3390/cancers15174421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common types of primary cutaneous T-cell lymphoma (CTCL). Proliferating cell nuclear antigen (PCNA) is expressed on the cell surface of cancer cells (csPCNA), but not on normal cells. It functions as an immune checkpoint ligand by interacting with natural killer (NK) cells through the NK inhibitory receptor NKp44, leading to the inhibition of NK cytotoxicity. A monoclonal antibody (mAb14) was established to detect csPCNA on cancer cells and block their interaction with NKp44. In this study, three CTCL cell lines and peripheral blood mononuclear cells (PBMCs) from patients with SS and healthy donors were analyzed for csPCNA using mAb14, compared to monoclonal antibody PC10, against nuclear PCNA (nPCNA). The following assays were used: immunostaining, imaging flow cytometry, flow cytometry, cell sorting, cell cycle analysis, ELISA, and the NK-cell cytotoxic assay. mAb14 successfully detected PCNA on the membrane and in the cytoplasm of viable CTCL cell lines associated with the G2/M phase. In the Sézary PBMCs, csPCNA was expressed on lymphoma cells that had an atypical morphology and not on normal cells. Furthermore, it was not expressed on PBMCs from healthy donors. In the co-culture of peripheral blood NK (pNK) cells with CTCL lines, mAb14 increased the secretion of IFN-γ, indicating the reactivation of pNK activity. However, mAb14 did not enhance the cytotoxic activity of pNK cells against CTCL cell lines. The unique expression of csPCNA detected by mAb14 suggests that csPCNA and mAb14 may serve as a potential biomarker and tool, respectively, for detecting malignant cells in SS and possibly other CTCL variants.
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Affiliation(s)
- Jamal Knaneh
- Laboratory for Molecular Dermatology, Felsenstein Medical Research Center, Tel Aviv 6997801, Israel; (J.K.); (E.H.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.A.-L.); (H.P.N.)
| | - Emmilia Hodak
- Laboratory for Molecular Dermatology, Felsenstein Medical Research Center, Tel Aviv 6997801, Israel; (J.K.); (E.H.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.A.-L.); (H.P.N.)
- Davidoff Cancer Center, Rabin Medical Center, Petach Tikva 4941492, Israel
| | | | - Avishay Edri
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410101, Israel; (A.E.); (A.P.)
| | - Rachel Eren
- PiNK Biopharma Ltd., Ness Ziona 7403648, Israel; (S.F.-M.); (Y.Y.)
| | - Yael Yoffe
- PiNK Biopharma Ltd., Ness Ziona 7403648, Israel; (S.F.-M.); (Y.Y.)
| | - Iris Amitay-Laish
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.A.-L.); (H.P.N.)
- Division of Dermatology, Rabin Medical Center, Petach Tikva 4941492, Israel
| | - Hadas Prag Naveh
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.A.-L.); (H.P.N.)
- Division of Dermatology, Rabin Medical Center, Petach Tikva 4941492, Israel
| | - Ido Lubin
- Core Facility, Felsenstein Medical Research Center, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Angel Porgador
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410101, Israel; (A.E.); (A.P.)
- National Institute for Biotechnology in the Negev, Ben Gurion University of the Negev, Beer Sheva 8410101, Israel
| | - Lilach Moyal
- Laboratory for Molecular Dermatology, Felsenstein Medical Research Center, Tel Aviv 6997801, Israel; (J.K.); (E.H.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (I.A.-L.); (H.P.N.)
- Davidoff Cancer Center, Rabin Medical Center, Petach Tikva 4941492, Israel
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Oishi N, Feldman AL. Current Concepts in Nodal Peripheral T-Cell Lymphomas. Surg Pathol Clin 2023; 16:267-285. [PMID: 37149360 DOI: 10.1016/j.path.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
This review summarizes the current understanding of mature T-cell neoplasms predominantly involving lymph nodes, including ALK-positive and ALK-negative anaplastic large cell lymphomas, nodal T-follicular helper cell lymphoma, Epstein-Barr virus-positive nodal T/NK-cell lymphoma, and peripheral T-cell lymphoma (PTCL), not otherwise specified. These PTCLs are clinically, pathologically, and genetically heterogeneous, and the diagnosis is made by a combination of clinical information, morphology, immunophenotype, viral positivity, and genetic abnormalities. This review summarizes the pathologic features of common nodal PTCLs, highlighting updates in the fifth edition of the World Health Organization classification and the 2022 International Consensus Classification.
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Hristov AC, Tejasvi T, Wilcox RA. Cutaneous T-cell lymphomas: 2023 update on diagnosis, risk-stratification, and management. Am J Hematol 2023; 98:193-209. [PMID: 36226409 PMCID: PMC9772153 DOI: 10.1002/ajh.26760] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 02/04/2023]
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," multidisciplinary 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 the 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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Affiliation(s)
- Alexandra C. Hristov
- Departments of Pathology and Dermatology, 2800 Plymouth Road, Building 35, Ann Arbor, MI 48109-2800
| | - Trilokraj Tejasvi
- Department of Dermatology, 1910 Taubman Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Ryan A. Wilcox
- Correspondence to: Ryan Wilcox, MD, PhD, Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan Rogel Cancer Center, 1500 E. Medical Center Drive, Room 4310 CC, Ann Arbor, MI 48109-5948, Phone: (734) 615-9799, Fax: (734) 936-7376,
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Kempf W. Follicular T helper cells and cutaneous T-cell lymphomas. Br J Dermatol 2022; 187:841-842. [PMID: 36045612 DOI: 10.1111/bjd.21839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, and Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
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