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Wednesday, January 30, 2013

Positron Emission Tomography Revealed Diffuse Involvement of the Lower Legs and Occult Extracutaneous Lesions in Subcutaneous Panniculitis-Like T-cell Lymphoma.

Positron Emission Tomography Revealed Diffuse Involvement of the Lower Legs and Occult Extracutaneous Lesions in Subcutaneous Panniculitis-Like T-cell Lymphoma.

Jan 2013 


From the *Department of Hematology, †Department of Diagnostic Imaging and Nuclear Medicine, ‡Department of Surgical Pathology, and §Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan.



Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a very rare type of cutaneous lymphoma that localizes primarily in the subcutaneous adipose tissue without palpable involvement of the lymph nodes. Most often, it presents as multiple, painless, subcutaneous nodules on the extremities and trunk. In this study, we describe an unusual case of SPTCL that mimicked phlegmonous inflammation; PET/CT revealed massive diffuse involvement of the lower legs, low-grade nodal active disease, and occult involvement of the intra-abdominal visceral fat. A repeat PET/CT study after CHOP chemotherapy revealed complete resolution of abnormal FDG uptake in the initially involved sites.

Monday, January 21, 2013

Composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient.

Composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient.

Jan  2013


Department of Pathology, Tulane University, New Orleans, LA, USA 70112.


Composite lymphoma of T-cell and B-cell type is uncommon, and the one occurring primarily on skin is extremely rare. Herein, we report a unique case of composite lymphoma of mycosis fungoides and cutaneous small B-cell lymphoma in a 73-year-old male patient. The patient presented with multiple erythematous patches, plaques, and nodules on the upper arms, scalp, and trunk. Four punch biopsies of arm and scalp lesions demonstrated lymphoid infiltrate in superficial to deep dermis with a characteristic zone distribution of T-cell and B-cell components. T cells were distributed in papillary and perifollicular dermis and displayed a larger size with convoluted nuclei, whereas B cells were small sized, assuming nodular infiltrate in mid-deep dermis with coexpression of CD5. Molecular test detected clonal rearrangement of both TCRG and IGH/K genes with identical amplicons for each gene in all 4 biopsies. Clinical staging revealed no extracutaneous lesions. A multidisplinary approach is emphasized to establish a definitive diagnosis.

Sunday, January 13, 2013

New Insights into Associated Co-morbidities in Patients with Cutaneous T-cell Lymphoma (Mycosis Fungoides).

New Insights into Associated Co-morbidities in Patients with Cutaneous T-cell Lymphoma (Mycosis Fungoides).

Jan 2013


Department of Dermatology, Rabin Medical Center, Petah Tiqva, 49100, Peath Tiqva, Israel.


Studies of associated cancer in patients with mycosis fungoides (MF) have focused primarily on secondary cancers in North American and European populations. This study investigated the association between MF and malignancies, anxiety and depression in the Israeli population. Data on Israeli patients with MF and age- and gender-matched controls were collected from a database of population- based cohort (683 patients; 1,700 controls) and an institution- based cohort (343 patients; 846 controls) and analysed by univariate and multivariate methods. MF was significantly associated with Hodgkin's lymphoma in both cohorts (multivariate odds ratio (OR) 7.83, univariate OR ∞, respectively); acute leukaemia (multivariate OR 10.1, first cohort) and lung cancer (multivariate OR 10.15, second cohort). MF was significantly associated with anxiety and depression (multivariate OR 1.59, OR 1.51, respectively in first cohort). The current study provides support to the associations between MF and other cancers: Hodgkin's lymphoma, acute leukaemia and lung cancer. The study also em-phasizes the association between MF and anxiety and depression.

Serum-soluble Herpes Virus Entry Mediator Levels Reflect Disease Severity and Th2 Environment in Cutaneous T-cell Lymphoma

Serum-soluble Herpes Virus Entry Mediator Levels Reflect Disease Severity and Th2 Environment in Cutaneous T-cell Lymphoma

Tomomitsu Miyagaki, Makoto Sugaya*, Hiraku Suga, Hanako Ohmatsu, Hideki Fujita, Yoshihide Asano, Yayoi Tada, Takafumi
Kadono and Shinichi Sato
Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. *E-mail:

Activated T cells express LIGHT, an acronyme for lymphotoxin-like, exhibits inducible expression, and competes with HSV glycoprotein D for herpesvirus entry mediator (HVEM) a receptor expressed by T lymphocytes (1). LIGHT binds to 3 distinct receptors: HVEM, lymphotoxin β receptor, and decoy receptor 3 (2). Of these, HVEM is expressed by many cell types (1). LIGHT-HVEM interactions activate T cells and natural killer (NK) cells to produce T helper type (Th) 1 cytokines (3–7).

Many patients with cutaneous T-cell lymphoma (CTCL) in the advanced stages have eosinophilia and high levels of immunoglobulin E, suggesting that Th2 is dominant in these patients (8, 9).

We reported recently that low HVEM expression on dermal fibroblasts in lesional skin of advanced CTCL attenuates the expression of Th1 chemokines, which may contribute to a shift to a Th2-dominant microenvironment (10). However, little is known about the soluble

form of HVEM (sHVEM) and its ligand, LIGHT, in CTCL. The aim of this study was to measure sHVEM and LIGHT levels in the sera of patients with CTCL.

working link not available

Medical Journals

Sunday, January 6, 2013

Treatment of advanced cutaneous T-cell lymphomas with non-pegylated liposomal doxorubicin - Consensus of thelymphoma group of the Working Group Dermatologic Oncology.

Treatment of advanced cutaneous T-cell lymphomas with non-pegylated liposomal doxorubicin - Consensus of the lymphoma group of the Working Group Dermatologic Oncology.

Jan 2013


Department of Dermatlogy, Helios Clinic Krefeld, Germany Department of Dermatology and Venereology, University of Graz, Austria Department of Dermatolgogy, Venereology and Allergology, Charité- University Medicine Berlin, Germany Department of Dermatology, University Clinic Zurich, Switzerland Department of Dermatolgoy, Municipal Clinic Ludwigshaven, Germany Department of Dermatology, University of Mannheim, Germany Department of Dermatology and Venereology, University of Cologne, Germany Department of Dermatology, University of Kiel, Germany Department of Dermatolgy, Johannes Wesling Clinic Minden, Germany.


Background: Systemic treatment with pegylated liposomal doxorubicin is an established second-line treatment of advancedcutaneous T-cell lymphoma. Pegylated liposomal doxorubicin (PLD) is currently unavailable, therefore, clinical studies investigating the efficacy of non-pegylated liposomal formula (NPLD) have been analyzed. 

Methods: Since clinical trials comparing PLD and NPLD in CTCL do not exist, the clinical use of NPLD including safety and efficiency profile in other types of non-Hodgkin lymphoma were analyzed. 

Results: Clinical trials show a comparable efficacy of NPLD and PLD in non-Hodgkin lymphoma. The dosage of NPLD used in the treatment of systemic lymphoma within polychemotherapy regimens was 50 mg/m(2) every three weeks. Overall response was 75-95 %, including a complete remission rate of 65-80 % and 2- and 3-year overall survival rates of 55-75 %. These data indicate that the non-pegylated formula of doxorubicin has a similar antitumor effect as the pegylated one but shows reduced cardiotoxicity. The palmoplantar erythrodysesthesia frequently observed in PLD has not been observed with the use of the NPLD. 

Conclusions: The clinical use of NPLD in the treatment of CTCL is reasonable. In analogy to the clinical trials of NPLD in non-Hodgkin lymphoma a dosage of 50 mg/m(2) every three weeks is recommended for the treatment of CTCL.

Primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal.

Primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal.

Dec 2012


Department of Otorhinolaryngology, Hospital de São Marcos, Sete Fontes, S. Victor 4701-243 Braga, Portugal.


Primary cutaneous T-cell lymphoma is rare. Cutaneous lymphoma is defined as primary when there is an absence of nodal or systemic disease during the first 6 months following diagnosis. We report what we believe to be the first documented case of a primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal. The patient was an elderly woman who presented with progressively worsening right otalgia and hypoacusis. Otoscopy revealed an erythematic, ulcerative, nonbleeding, localized lesion in the anterosuperior area of the external auditory canal. The patient underwent an excisional biopsy, and after the diagnosis was established, she underwent 22 sessions of radiotherapy. During follow-up, she exhibited no evidence of recurrence.

Tuesday, January 1, 2013

Dermatopathology Update.

Dermatopathology Update.

Dec 2012

[Article in English, Spanish]


Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol, Badalona, España; Departamento de Ciencias Morfológicas, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address:


This past year has seen a wealth of new developments in dermatopathology that appear to herald the dawning of a new era. Advances in molecular biology and the simplification of techniques have put molecular tests within reach of routine clinical practice and led to a radical change in our approach to lesions such as melanoma; in the future, the genetic characterization of these lesions will be an essential requirement for establishing diagnosis, prognosis, and therapy. 

Technological innovations have also reached dermatology departments: the introduction of ultrasound scans has propitiated the use of fine-needle aspiration cytology, which allows samples to be stained and studied immediately, thereby facilitating diagnosis of superficial and lymph-node lesions, and allowing staging of tumors such as melanoma. Targeted cancer therapies have led to the introduction of more sensitive and specific systems for identifying new targets, have reawakened interest in forgotten diseases such as aggressive basal cell carcinoma, and have led to dermatological reactions that, together with those caused by biologic drugs, we are just beginning to recognize. Consolidated techniques such as immunohistochemistry continue to advance with the addition of new antibodies that contribute considerably to improved diagnosis.

New clinicopathologic diseases have also been described or characterized this year, including 2 new types of melanoma, and progress has been made in our knowledge of other diseases, such as primary cutaneous CD4(+) small/medium-sized pleomorphic T-cell lymphoma. These topics, together with new developments in adnexal tumors, alopecia, and other lesions, will be discussed in this review.