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Mengeot L, Jachiet M, Bourrat E, Mahé A, Cambau E, Bernard E, Pasqualini C, Chamouine A, Truong J, Dumaine C, Bertolotti A, Franco J. Effective management of severe chronic erythema nodosum leprosum in adolescent patient using ustekinumab and apremilast: A case report. J Eur Acad Dermatol Venereol 2024; 38:e244-e246. [PMID: 37795664 DOI: 10.1111/jdv.19552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Affiliation(s)
- Laura Mengeot
- Pediatric Department, Centre Hospitalier de Mayotte, Mamoudzou, France
- Inserm CIC1410, Department of Infectious Disease - Dermatology, University Hospital La Réunion, Saint Pierre, La Réunion, France
| | - Marie Jachiet
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuelle Bourrat
- Department of Dermatology, Reference Center for Rare Skin Diseases MAGEC, St. Louis Hospital, Paris, France
- General Pediatrics, Infectious Disease and Internal Medicine Department, Hospital Robert Debre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Antoine Mahé
- Department of Dermatology, Hospital Pasteur, Colmar, France
| | - Emmanuelle Cambau
- Associate Laboratory of the National Reference Center for Mycobacteria and Antimycobacterial Resistance, Mycobacteriology Laboratory, APHP-Hospital Bichat, Paris, France
- Inserm, Université Paris Cité, IAME UMR1137, Paris, France
| | - Elise Bernard
- Pediatric Department, Centre Hospitalier de Mayotte, Mamoudzou, France
| | | | | | - Jeanne Truong
- General Pediatrics, Infectious Disease and Internal Medicine Department, Hospital Robert Debre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Dumaine
- General Pediatrics, Infectious Disease and Internal Medicine Department, Hospital Robert Debre, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Antoine Bertolotti
- Inserm CIC1410, Department of Infectious Disease - Dermatology, University Hospital La Réunion, Saint Pierre, La Réunion, France
| | - Justine Franco
- Pediatric Department, Centre Hospitalier de Mayotte, Mamoudzou, France
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2
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Wu PC, Hung YT, Chen CB. Eruption of Subcutaneous Nodules in a Patient With Abdominal Pain and Arthralgia. Gastroenterology 2024; 166:e5-e8. [PMID: 37619640 DOI: 10.1053/j.gastro.2023.08.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/06/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Po-Chien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Teng Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Dermatology and Aesthetic Medicine Center, Jen Ai Hospital, Taichung, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
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3
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Aubignat M, Smail A. Skin lesions. Rev Med Interne 2023; 44:619-620. [PMID: 37414675 DOI: 10.1016/j.revmed.2023.06.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/11/2023] [Indexed: 07/08/2023]
Affiliation(s)
- M Aubignat
- Department of Neurology and Movement Disorders, Amiens-Picardie University Hospital, CHU d'Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France.
| | - A Smail
- Department of Internal Medicine, Amiens-Picardie University Hospital, CHU d'Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France
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4
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Ahuja R, Garg S, Barwad A, Subbiah A, Gupta V. Recurrent erythema nodosum leprosum leading to secondary renal amyloidosis and nephrotic syndrome in an Indian patient with lepromatous leprosy. Int J Dermatol 2023; 62:e514-e517. [PMID: 37066445 DOI: 10.1111/ijd.16693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/14/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Rhea Ahuja
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Shivangi Garg
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Adarsh Barwad
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Arunkumar Subbiah
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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5
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Shajil C, Sathishkumar D, Babu JS, Babu R, Kumar S. Spontaneous crateriform indentation in a child. Pediatr Dermatol 2023; 40:715-717. [PMID: 37440194 DOI: 10.1111/pde.15241] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 12/19/2022] [Indexed: 07/14/2023]
Affiliation(s)
- Chandana Shajil
- Departments of Dermatology, Christian Medical College and Hospital, Vellore, India
| | | | - Jyoti Sureka Babu
- Departments of Radiology, Christian Medical College and Hospital, Vellore, India
| | - Ramesh Babu
- Departments of Pathology, Christian Medical College and Hospital, Vellore, India
| | - Sathish Kumar
- Pediatric Rheumatology Unit, Department of Pediatrics, Christian Medical College and Hospital, Vellore, India
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6
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Yendo TM, Pante CDC, Miyamoto D. Pseudomonas aeruginosa as an uncommon agent of infectious panniculitis. An Bras Dermatol 2022; 97:326-331. [PMID: 35272923 PMCID: PMC9133242 DOI: 10.1016/j.abd.2020.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/23/2020] [Accepted: 09/27/2020] [Indexed: 11/25/2022] Open
Abstract
Pseudomonas aeruginosa is a Gram-negative bacillus that frequently causes septicemia, abscesses and infections in skin wounds. Panniculitis caused by this microorganism is unusual and there are few well-documented cases, none of them in a patient with systemic lupus erythematosus. The present report describes an immunosuppressed patient with systemic lupus erythematosus who developed panniculitis caused by Pseudomonas aeruginosa, with a review of the literature on this rare presentation.
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Affiliation(s)
- Tatiana Mina Yendo
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Cristina de Castro Pante
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Denise Miyamoto
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
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7
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Alzoabi N, Alqahtani J, Algamdi B, Almutairi M, Alratroot J, Alkhaldi S, Alqahtani S, Alakloby O. Atypical Presentation of Erythema Nodosum Following Pfizer-BioNTech COVID-19 Vaccine. Med Arch 2022; 76:72-74. [PMID: 35422564 PMCID: PMC8978813 DOI: 10.5455/medarh.2022.76.72-74] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/21/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Nasser Alzoabi
- Department of Dermatology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Jamal Alqahtani
- Department of Dermatology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Bader Algamdi
- Department of Dermatology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Almutairi
- Medical Intern College of Medicine, King Faisal University, Alhasa, Saudi Arabia
| | - Jumana Alratroot
- Department of Pathology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Saud Alkhaldi
- Medical Intern, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Shatha Alqahtani
- Medical Intern, College of Medicine, Najran university, Najran, Saudi Arabia
| | - Omar Alakloby
- Department of Dermatology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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Minutoli F, Parisi S, Laudicella R, Pergolizzi S, Baldari S. 18F-FDG PET/CT Imaging of Immune Checkpoint Inhibitor-Related "Retroperitoneal Panniculitis". Clin Nucl Med 2022; 47:e39-e40. [PMID: 34269732 DOI: 10.1097/rlu.0000000000003806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 71-year-old woman was operated on for undifferentiated lung adenocarcinoma. Four months after surgery, she developed bone and adrenal metastases. She underwent palliative radiation therapy of left scapula and right iliac bone. Thereafter, she started immune checkpoint inhibitor (ICI) therapy with anti-PD-1 antibodies achieving complete tumor response. Twenty months later, a follow-up 18F-FDG PET/CT confirmed tumor response and revealed high radiotracer accumulation in correspondence of retroperitoneal and subcutaneous fat opacities. The contiguous fasciae were mildly thickened. The temporal relation with ICI therapy together with tumor response and corticosteroids therapy effectiveness led to conclude for ICI-related adverse events.
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Affiliation(s)
- Fabio Minutoli
- From the Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina, Italy
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Ono S, Yoshimoto K, Nishimura N, Yoneima R, Kawashima H, Kobayashi T, Tai Y, Miyamoto M, Tsushima E, Yada N, Nishio K. Complete Resolution of a Case of TAFRO Syndrome Accompanied by Mediastinal Panniculitis, Adrenal Lesion, and Liver Damage with Hyperbilirubinemia. Intern Med 2021; 60:1303-1309. [PMID: 33191324 PMCID: PMC8112990 DOI: 10.2169/internalmedicine.5850-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
TAFRO syndrome is a systemic inflammatory, lymphoproliferative disorder, but the pathophysiology of the disease is unknown. It is typically characterized by thrombocytopenia, anasarca, a fever, reticulin fibrosis, renal dysfunction, and organomegaly. However, other manifestations have been also reported. We encountered a 43-year-old man with TAFRO syndrome who showed mediastinal panniculitis, liver damage, and adrenal lesions in addition to the core signs. He achieved complete remission with combination therapy of corticosteroids, tocilizumab, and cyclosporin, and remission was maintained even after drug discontinuation at 15 months. Atypical manifestations and complete remission of TAFRO syndrome were remarkable features of our case.
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Affiliation(s)
- Shiro Ono
- Department of General Medicine, Nara Medical University, Japan
| | | | | | - Ryo Yoneima
- Department of General Medicine, Nara Medical University, Japan
| | | | | | - Yoshiaki Tai
- Department of General Medicine, Nara Medical University, Japan
| | - Makiko Miyamoto
- Department of General Medicine, Nara Medical University, Japan
| | - Emiko Tsushima
- Department of General Medicine, Nara Medical University, Japan
| | - Noritaka Yada
- Department of General Medicine, Nara Medical University, Japan
| | - Kenji Nishio
- Department of General Medicine, Nara Medical University, Japan
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10
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Egorova ON, Belov BS, Glukhova SI, Radenska-Lopovok SG. [ Panniculitis in modern rheumatology]. TERAPEVT ARKH 2020; 92:33-38. [PMID: 32598773] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Indexed: 06/11/2023]
Abstract
AIM To study clinical and laboratory features of panniculitis (Pn) in modern rheumatology. MATERIALS AND METHODS The study included 690 patients with Pn (615 women and 75 men, average age 39.410.26) with the prevailing referral diagnosis of Erythema nodosum (59.2%), Pn (27.5%), Rheumatic disease Rd (9%), other diseases (4.4%),who had been on outpatient and/or inpatient treatment for 10 years. All patients were examined according to our diagnostic algorithm: general clinical, immunological and histological examinations, computed tomography of the chest organs, tuberculin tests. RESULTS Pn with Rd was diagnosed in 140 patients (118 women and 22 men, average age 40.2114.87), average disease duration 31.06 [0.1; 541] months. In most cases (49%) patients had idiopathic lobular Pn which belongs to the group of systematic lesions of connective tissue (M35.6), as well as systemic lupus erythematosus and Behcet disease (13% each), rheumatoid arthritis (8%), dermatomyositis (6.4%), etc. Matching of the referral and final diagnoses was 35% in case of Rd. Among the examined patients prevailed those with a moderate (51.07%) degree of activity of the underlying disease. Within the study group Pn was represented by all forms, but mainly by nodular form (64.02%). Mesenteric form was characteristic only for idiopathic lobular Pn. The main features of Pn associated with Rd were identified. In modern clinical practice the type of Pn and the activity of the underlying disease determine the approaches to treatment.
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Affiliation(s)
| | - B S Belov
- Nasonova Research Institute of Rheumatology
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11
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Weng RH, Wang LL, Xia Y, Li CR, Yang J. [A case of cytophagic histiocytic panniculitis]. Zhonghua Er Ke Za Zhi 2020; 58:53-55. [PMID: 31905478 DOI: 10.3760/cma.j.issn.0578-1310.2020.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- R H Weng
- Department of Rheumatology and Immunology, Shenzhen Children's Hospital, Shenzhen 518035, China
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12
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Mishra S, Garg S, Mahajan R, Patil A, Bhatia P, Sharma V. Azathioprine induced pancreatitis, polyarthritis and panniculitis (PPP) syndrome in a patient with Crohn's disease. Acta Gastroenterol Belg 2020; 83:87-89. [PMID: 32233278] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Azathioprine and 6-mercaptopurine have been widely used for maintenance of remission in patients with inflammatory bowel disease. The use of thiopurines is associated with multiple adverse effects including dose dependent cytopenias or idiosyncratic reaction. We report about a case of azathioprine related pancreatitis associated with polyarthralgia and panniculitis. Pancreatitis, polyarthritis and panniculitis (PPP) syndrome is an uncommon phenomenon which may accompany a number of pancreatic diseases including acute or chronic pancreatitis or pancreatic malignancy. To the best of our knowledge, this is the first report of Azathioprine related PPP syndrome.
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Affiliation(s)
- S Mishra
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Garg
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Mahajan
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - A Patil
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Bhatia
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Sharma
- Department of Gastroenterology, Internal Medicine, Dermatology, Clinical Pharmacology and Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Wen PF, Zhou QT, Wan C, Liu XY, Xie Y, Li F, Wang L. [Clinical Comparative Analysis of Lupus Panniculitis and Subcutaneous Panniculitis-like T-cell Lymphoma]. Sichuan Da Xue Xue Bao Yi Xue Ban 2019; 50:930-934. [PMID: 31880127] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the similarities and differences in clinical pathological features and gene rearrangement of lupus erythematosus profundus(LEP) and subcutaneous panniculitis-like T-cell lymphoma(SPTL). METHODS We compared the clinical presentations, histopathology, immunophenotypical features and T-cell receptor (TCR) gene rearrangement findings of 9 cases of LEP and SPTL. RESULTS For clinical features, most patients of LEP occurred on head and face without systemic symptoms. LEP patients responded well to hydroxycholorquine treatment with good prognosis. Most patients of SPTL tended to lower extremities involvement and accompanied with systemic symptoms, the patients with disseminated lesions or hemophagocytic syndrome(HPS) showed poorer prognosis. For histopathology, LEP patients showed dense inflammatory infiltrate in the dermis consisting predominantly of lymphocytes with less numbers of plasma cells. However, the dermis was spared in SPTL, and rimming of adipocytes and erythrophagocytosis was observed in SPTL. Lymphocytes of LEP expressing CD4+/CD8+, as well as clusters of CD20+. CD138-positive cells and scatter of CD123-positive cells were also observed in LEP. Tumor cells of SPTL were CD4-/CD8+, βF1+, CD138- and CD123-. The expression of TIA-1 or GrB was more favor in SPTL. Monoclonal T-cell receptor-γ gene rearrangement was found in 89% of SPTL patients while negative for LEP. CONCLUSION Base on different clinical and pathological features, it is easy to distinguish LEP from SPTL. However, a minority of lesions in LEP localize at subcutaneous tissue, which may turn to immunophenotypical and TCR gene rearrangement test for diagnosis.
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Affiliation(s)
- Peng-Fei Wen
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qin-Tian Zhou
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Dermatology, the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China
| | - Chuan Wan
- Department of Dermatology, Dermatology Hospital of Jiangxi Province, Nanchang 330001, China
| | - Xiao-Yu Liu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yao Xie
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fan Li
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lin Wang
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu 610041, China
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Ong SY, Phipps C, Kaur H, Tan L, Lee YS. Pralatrexate Induces Long-Term Remission in Relapsed Subcutaneous Panniculitis-Like T-Cell Lymphoma. Ann Acad Med Singap 2019; 48:298-300. [PMID: 31737895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
MESH Headings
- Adult
- Aminopterin/analogs & derivatives
- Aminopterin/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Cisplatin/administration & dosage
- Cyclophosphamide
- Deoxycytidine/administration & dosage
- Deoxycytidine/analogs & derivatives
- Dexamethasone/administration & dosage
- Doxorubicin
- Folic Acid Antagonists/therapeutic use
- Humans
- Lymphohistiocytosis, Hemophagocytic/etiology
- Lymphohistiocytosis, Hemophagocytic/pathology
- Lymphoma, T-Cell, Peripheral/complications
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Neoplasm Recurrence, Local/drug therapy
- Panniculitis
- Prednisone
- Remission Induction
- Subcutaneous Fat, Abdominal/pathology
- Vincristine
- Gemcitabine
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Affiliation(s)
- Shin Yeu Ong
- Department of Haematology, Singapore General Hospital, Singapore
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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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Affiliation(s)
- C van der Weyden
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - C McCormack
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Australia
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
| | - S Lade
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Department of Anatomical Pathology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - R W Johnstone
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - H M Prince
- Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Oncology, Sir Peter MacCallum, The University of Melbourne, Parkville, Australia
- Epworth Healthcare, Melbourne, Australia
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Tao HH, Liu DH, Li XF. [A case report of anaplastic lymphoma kinase-negative anaplastic large-cell lymphoma characterized by skin panniculitis in children]. Zhonghua Er Ke Za Zhi 2017; 55:469-470. [PMID: 28592018 DOI: 10.3760/cma.j.issn.0578-1310.2017.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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17
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Borroni G, Tomasini CF. The "raison d'être" of a monograph on panniculitides. GIORN ITAL DERMAT V 2013; 148:313-314. [PMID: 23900154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- G Borroni
- Department of Clinical and Surgical Diagnostic and Pediatric Sciences, Dermatology Clinic, University of Pavia, IRCCS Fondazione Policlinico "San Matteo", Pavia, Italy
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18
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Shi Q, Zheng WJ, Li J, Lin Y, Zhou DB, Zhao Y. [Clinical analysis of subcutaneous panniculitis-like T cell lymphoma misdiagnosed as rheumatic diseases: 8 cases report.]. Zhonghua Nei Ke Za Zhi 2009; 48:1019-1022. [PMID: 20193520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the characteristics of subcutaneous panniculitis-like T cell lymphoma (SPTCL) in order to facilitate prompt identification and proper treatment of this rare and heterogeneous disease entity. METHODS For 8 patients who had been misdiagnosed as rheumatic diseases but eventually confirmed as SPTCL though pathology and immunohistochemistry, a retrospective chart review was made with regard to their clinical symptoms, laboratory test results, pathological features, responses to therapy as well as outcomes. RESULTS These 8 patients with a male to female ratio of 1:1 were initially misdiagnosed as a variety of rheumatic diseases such as erythema nodosa, nodular panniculitis, systemic vasculitis, etc. The period from the onset of symptoms to the confirmation of diagnosis as SPTCL was 28.6 months on average (range, 4 - 84 months). All the cases presented with multiple subcutaneous nodules, plaques or tumors which involved various anatomic sites including the head and neck, the trunk, and the extremities. Fever was the most frequently accompanying symptom (7/8), followed by lymphadenopathy (4/8), hepatomegaly (3/8), splenomegaly (3/8). Hemophagocytic phenomenon was seen in 3 cases. A total of 22 times of biopsy involving multiple anatomic sites were performed on these 8 cases with 2.75 times on average (range, 1 - 5 times). All cases demonstrated a dense lymphoid infiltrate with significant cellular heteromorphism located in the subcutaneous tissue. CD(3) was positive in the majority of the cases. Immunostaining for gammadeltaTCR was positive in one case. The anti-rheumatic therapy including steroids and immunosuppressants administered before the identification of SPTCL attained minimal therapeutic effect. In contrast, 6 cases gained partial response after chemotherapy except that the other 2 cases died of fatal pulmonary infiltration and subsequent infection. CONCLUSIONS SPTCL is a rare and heterogeneous entity which is unseldomly misdiagnosed as rheumatic disease. The anti-rheumatic therapy including steroids and immunosuppressants can attain minimal therapeutic effect. Early identification by means of histology and immunohistochemistry as well as immunostaining for PCR is critical for proper treatment.
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Affiliation(s)
- Qun Shi
- Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100032, China.
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Wan C, Xu C, Wang L, Li GD, Jiang W, Zhang WY, Tang Y, Kan B, Liu WP. [Diagnostic significance of immunophenotyping and detection of gene rearrangement in subcutaneous panniculitis-like T-cell lymphoma]. Zhonghua Bing Li Xue Za Zhi 2008; 37:390-394. [PMID: 19031718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To explore the diagnostic implication of immunophenotyping and gene rearrangement in subcutaneous panniculitis-like T-cell lymphoma (SPTL). METHODS According to the selection criteria of 2005 WHO-EORTC classification for cutaneous lymphomas, 20 SPTL patients were enrolled in this study. A 10-antibody panel was used for immunophenotyping and in addition, polymerase chain reaction for TCR gamma and IgH gene rearrangement and in situ hybridization for EBER1/2 were also employed. RESULTS There were 9 males and 11 female with a mean age of 29.5 years. Immunophenotypic study showed that all the patients expressed one to three T-cell associated antigens (CD2, CD3 or CD45RO), 18 patients were positive for beta F1, 18 for CD8, 20 for TIA-1 and 16 for granzyme B. None of the patients expressed CD4, CD20 and CD56. TCR gamma gene rearrangement was found in 16 of 20 cases (80.0%) and none for IgH gene rearrangement. The positive rate of EBER1/2 was 25.0% (5/20). CONCLUSIONS Since the majority of SPTL patients show clonal TCR gene rearrangements, correlations among clinical presentation, histological features, immunophenotype and gene rearrangement data are considered important in confirming a diagnosis of SPTL.
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MESH Headings
- Adolescent
- Adult
- Antigens, CD20/immunology
- CD56 Antigen/analysis
- CD56 Antigen/immunology
- Child
- Female
- Gene Rearrangement/genetics
- Humans
- Immunophenotyping/methods
- In Situ Hybridization
- Lymphoma, T-Cell/classification
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/genetics
- Lymphoma, T-Cell/immunology
- Lymphoma, T-Cell, Cutaneous/classification
- Lymphoma, T-Cell, Cutaneous/diagnosis
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/immunology
- Male
- Middle Aged
- Panniculitis
- RNA, Viral/immunology
- RNA, Viral/isolation & purification
- Skin Neoplasms/immunology
- Subcutaneous Tissue
- Young Adult
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Affiliation(s)
- Chuan Wan
- Department of Dermatovenereology, West China Hospital of Sichuan University, Chengdu 610041, China
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Mukai HY, Okoshi Y, Shimizu S, Katsura Y, Takei N, Hasegawa Y, Kojima H, Mori N, Nagasawa T. Successful treatment of a patient with subcutaneous panniculitis-like T-cell lymphoma with high-dose chemotherapy and total body irradiation. Eur J Haematol 2003; 70:413-6. [PMID: 12756026 DOI: 10.1034/j.1600-0609.2003.00058.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 24-yr-old man was referred for fever, right cheek swelling, subcutaneous tumor and liver dysfunction. Physical examination showed an elastic hard subcutaneous tumor on the right cheek, left axillary lymph node swelling and multiple small subcutaneous tumors in the trunk. Laboratory examinations showed elevated levels of transaminase, soluble interleukin-2 receptor and ferritin. Biopsy of the subcutaneous tumor showed proliferation of medium-sized cells with abundant clear cytoplasm and hyperchromatic nuclei among the subcutaneous fat tissues. These cells showed CD3+, CD4-, CD8+, CD56- and CD20- phenotype and possessed cytotoxic molecules such as granzyme B and T-cell intracellular antigen-1. Bone marrow aspiration showed proliferation of small numbers of abnormal lymphocytes with severe hemophagocytosis. He was thus diagnosed as having subcutaneous panniculitis-like T-cell lymphoma (SPTCL) and treated with dose-escalated CHOP regimen. After three courses of the chemotherapy, he was further treated with high-dose chemotherapy and total body irradiation (TBI) with autologous peripheral blood stem cell rescue. Thereafter, he has been in remission for more than 2 yr. We consider that SPTCL with hemophagocytosis is an extremely aggressive disease, and high-dose chemotherapy and TBI should be included for the choice of the treatment.
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Affiliation(s)
- Harumi Y Mukai
- Division of Hematology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Malaviya AN. Case 33-2002: a 28-year-old woman with ocular inflammation, fever, and headache. N Engl J Med 2003; 348:474-6; author reply 474-6. [PMID: 12557868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Tamburro JE, Esterly NB. Hypersensitivity syndromes. Adolesc Med 2001; 12:vii, 323-41. [PMID: 11404204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The hypersensitivity syndromes are a group of diseases in which the cutaneous vasculature is altered through immunologic or nonimmunologic mechanisms. These reactions range in severity from mild to life-threatening and can be triggered by drugs, infectious agents, foods, or environmental allergens. Although their causes may vary, the morphologic appearance of these entities may be similar making a clinical diagnosis a challenge.
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Affiliation(s)
- J E Tamburro
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee 53226-3595, USA
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Hung IJ, Kuo TT, Sun CF. Subcutaneous panniculitic T-cell lymphoma developing in a child with idiopathic myelofibrosis. J Pediatr Hematol Oncol 1999; 21:38-41. [PMID: 10029810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE Subcutaneous panniculitic T-cell lymphoma is reported in a child with idiopathic myelofibrosis. Both disease entities are rarely seen in children. PATIENT AND METHODS A girl aged 5 years and 9 months had pancytopenia and severe constitutional symptoms. Idiopathic myelofibrosis was subsequently diagnosed. RESULTS A transient response was achieved after treatment with a course of high-dose methylprednisolone therapy. However, proptosis and skin nodules developed during tapering of steroid therapy. A computed tomography scan of the orbit also revealed a mass lesion in the right lacrimal gland region. A skin biopsy specimen showed a subcutaneous panniculitic T-cell lymphoma. The clinical course was marked by high fever, profound pancytopenia, massive gastrointestinal bleeding, and severe, recurrent infections. Her condition rapidly deteriorated, and she died from polymicrobial sepsis 4 months after her initial examination. CONCLUSIONS Subcutaneous panniculitic T-cell lymphoma is a distinctive clinicopathologic entity that is rarely seen in children. The association of myelofibrosis and peripheral T-cell lymphoma as seen in this has been rarely reported.
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Affiliation(s)
- I J Hung
- Division of Hematology/Oncology, Chang Gung Children's Hospital, Taipei, Taiwan
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Iwatsuki K, Harada H, Ohtsuka M, Han G, Kaneko F. Latent Epstein-Barr virus infection is frequently detected in subcutaneous lymphoma associated with hemophagocytosis but not in nonfatal cytophagic histiocytic panniculitis. Arch Dermatol 1997; 133:787-8. [PMID: 9197840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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RIDLEY CM. LIQUEFYING LIPOID NECROSIS (? LIQUEFYING PANNICULITIS). Proc R Soc Med 1965; 58:619-20. [PMID: 14341843 PMCID: PMC1898852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BOGOMOLETZ W. [RECURRENT NODULAR PANNICULITIS]. Schweiz Med Wochenschr 1965; 95:813-6. [PMID: 14305776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BELLONIAS E, RAFTOPOULOS J, COSTEAS F, BARTSOKAS C. MYOCARDIAL INVOLVEMENT IN WEBER-CHRISTIAN DISEASE: REPORT OF ONE CASE AND REVIEW OF LITERATURE. Vasc Dis 1965; 2:140-8. [PMID: 14315460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DUPERRAT B. [THE WEBER-CHRISTIAN SYNDROME]. Rev Prat 1965; 15:1121-32. [PMID: 14303791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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COUDERC P. [HYPODERMITIS]. Presse Med (1893) 1965; 73:785-9. [PMID: 14257166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DE GRACIANSKY P, PARAF A, RAUTUREAU J, TEXIER J. [RECURRING FEBRILE ACUTE NODULAR PANNICULITIS IN "ACINAR" CANCER OF THE PANCREAS. THE PROBLEM OF WEBER-CHRISTIAN DISEASE]. Bull Mem Soc Med Hop Paris 1965; 116:261-82. [PMID: 14306084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DVORAK R, SLAVIK J. [A CASE OF SPONTANEOUS PANNICULITIS OF THE WEBER-CHRISTIAN TYPE]. Vnitr Lek 1965; 11:157-61. [PMID: 14309933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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SWANN NH, LANDRY RM. MESENTERIC PANNICULTIS. Am Surg 1965; 31:21-2. [PMID: 14227206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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ZABELINSKII EK, SOKOLOV II. [A CASE OF PANNICULITIS (WEBER-CHRISTIAN DISEASE)]. Klin Med (Mosk) 1964; 42:132-3. [PMID: 14301816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DETRIE P. [RETRACTILE MESENTERITIS]. J Chir (Paris) 1964; 88:341-2. [PMID: 14230005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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MATSUO E, TAKAHASHI A, MIKAMI Y, KOIZUMI H, NAKAMURA S, YOKOI M, ISHIKAWA H. [HISTOPATHOLOGICAL DIAGNOSIS OF TUMORS (13). SKIN TUMORS AND SIMILAR LESIONS (I)]. Gan No Rinsho 1964; 10:712-8. [PMID: 14209135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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ASHMARIN II, LIKHACHEV IP. [WEBER-CHRISTIAN DISEASE WITH SUBCUTANEOUS CALCINOSIS]. Vestn Dermatol Venerol 1964; 38:73-5. [PMID: 14248118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
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SATO Y, WASHIO M, OMATA N, MAJIMA T, HIRASAWA Y, HAYAKAWA H, OGAWA I, ODAWA K, OGIMA I, AKAI A, ONISHI Y, KITAMURA S, OGURO C. [A CASE COMPLAINING OF RELAPSING FEVER AND SUBCUTANEOUS NODULES]. Newsl Int Coll Dent India Sect 1964; 78:284-92. [PMID: 14199487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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OPPERMANN A, PHILIPPE E, WEBER B. [BILATERAL PREMAMMARY LIPOPHAGIC GRANULOMA]. Ann Anat Pathol (Paris) 1964; 9:379-83. [PMID: 14242099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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LIEVRE JA, MAY V, BENICHOU C, CAMUS JP, MARCAIS J, LIEVRE JA. [DISSEMINATED STEATONECROSIS, STEATONECROTIC OSTEOLYSIS AND CANCER OF THE PANCREAS. DISCUSSION OF THE WEBER-CHRISTIAN SYNDROME]. Bull Mem Soc Med Hop Paris 1964; 115:755-71. [PMID: 14186897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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