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Lymphoma
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Rodney J Hicks
Lymphoma is the commonest primary testicular tumour in men over 60, but accounts for only 5% of all testicular neoplasms and 1%–2% of NHL (109). The vast majority are DLBCL. Testicular involvement is commoner in ARL, involving younger men often with Burkitt-like or plasmablastic lymphoma. At presentation, 20%–30% have systemic disease. There is an association with CNS and cutaneous lymphoma. The outcome appears poorer than other DLBCL of equivalent stage, probably because of the tendency for CNS relapse.
Dermatological manifestations of malignancies and dermatological emergencies due to malignancy
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Evidence of skin lesions within 6 months of diagnosis of the primary lymphoma is associated with a poor prognosis. Usually a secondary cutaneous lymphoma portends a poorer prognosis with an estimated 5-year survival rate around 30%. Early diagnosis is therefore of paramount importance. The treatment is mostly with single-agent to multiagent chemotherapy depending on the cell type and staging of the primary disease. The dermatologist's role is mainly to identify a cutaneous lymphoma and look for primaries elsewhere and help determine whether this is a primary or secondary skin manifestation.
Lymphomas and pseudolymphomas
Published in Aimilios Lallas, Enzo Errichetti, Dimitrios Ioannides, Dermoscopy in General Dermatology, 2018
Zoe Apalla, Aimilios Lallas, Enzo Errichetti
Cutaneous pseudolymphoma seems to resemble cutaneous lymphoma, both clinically and dermoscopically. There are only few reports referring to the dermoscopic characteristics of pseudolymphomas. In particular, one instance of pseudolymphomatous folliculitis dermoscopy revealed linear arborizing vessels with small perifollicular and follicular yellowish spots and follicular red dots (Figure 10.15B),19 while in a case of lymphocytoma cutis, white reticular lines on a pinkish background together with a few fine linear vessels crossing the reticular lines composed the dermoscopic pattern (Figure 10.16B).20 In the authors’ experience, the main dermoscopic feature of both T-cell and B-cell pseudolymphomas (nodular lesions) is represented by diffuse or focal orangish or salmon-colored areas (due to the aforementioned “mass effect”) (Figures 10.17B–10.19B), similarly to what is visible in clinically nodular PCLs. Vascular pattern may be variable, with linear-irregular and branching vessels being the most common morphologies (Figures 10.17B–10.19B). Whitish areas may also be seen, but they are less common and quite unspecific.
Radiation Therapy for Primary Cutaneous Gamma Delta Lymphoma Prior to Stem Cell Transplantation
Published in Cancer Investigation, 2023
Yufan F. Wu, Lawrie Skinner, Jonathan Lewis, Michael S. Khodadoust, Youn H. Kim, Bernice Y. Kwong, Wen-Kai Weng, Richard T. Hoppe, Quaovi Sodji, Caressa Hui, Noah Kastelowitz, Sebastian Fernandez-Pol, Susan M. Hiniker
In a systematic review of 46 cases of the abscopal effect, it was found that patients received a median radiation dose of 31 Gy, with a median time to notice of abscopal effect of 2 months (6). Similar to our treatment of a primary cutaneous site leading to regression at a visceral site, De la Cruz et al. (8) reported on a 71 year-old man with previously resected melanoma with metastases to the lungs, mediastinal lymph nodes, and subcutaneous nodules in the right temporal scalp. He declined systemic therapy and was treated with 30 Gy in 10 fractions to the right temporal scalp lesions. Four months after, he had complete resolution of his untreated lung lesions and significant regression of the mediastinal lymph nodes, which was sustained for 2.5 years. Another similar case of cutaneous lymphoma with progression after radiotherapy was described by Isobe et al. (9) A 65 year-old woman with cutaneous involvement of NK cell lymphoma in the periocular region was initially treated with CHOP and involved field radiotherapy to 40 Gy. Nine months later, she developed biopsy-proven progression in a submandibular lymph node, with pathology revealing significantly increased infiltrating T-cells and increased CD8:CD4 ratio. The node regressed without treatment 2 months later, and the patient had no evidence of disease after 5 years of follow-up. Based on the pathologic findings, the authors hypothesized that the initial radiation treatment led to modulation of the immune system which subsequently recognized and infiltrated the site of progression.
Accidental discovery of metastasized basal cell carcinoma
Published in Acta Chirurgica Belgica, 2022
Hanne Verberght, Thomas Schok, Siebe Wouda, Frits Aarts
Skin lesions can have various distinct diagnoses such as SCC, angiosarcoma, cutaneous lymphoma, and melanoma. An SCC develops in the same way as does a BCC after a sunburn. SCC usually progresses more quickly and metastasizes more often, initially to the lymph nodes. Angiosarcoma is a skin cancer originating from the blood or lymph vessels and occurring most commonly in the head and neck regions. In addition, angiosarcomas are characterized by aggressive growth, and metastasis is common, resulting in a high mortality rate. The slow course and the location of the lesion in this patient make it less likely to be an angiosarcoma. Another possible diagnosis is cutaneous lymphoma, which can appear as an eczematous rash for years and subsequently develop into an ulcerative tumor. It originates from lymph nodes in the skin and develops slowly and often locally. The fact that the lesion in our patient developed after sunburn makes it less likely to be a cutaneous lymphoma. Melanoma is one of the top three most commonly skin cancers, followed by SCC and BCC. It presents as both pigmented and unpigmented melanoma. However, in this case, the diagnosis of melanoma was unlikely, considering the very slow evolution of the lesion.
Investigative drugs for the treatment of cutaneous T-cell lymphomas (CTCL): an update
Published in Expert Opinion on Investigational Drugs, 2019
Egle Ramelyte, Reinhard Dummer, Emmanuella Guenova
In recent years, general oncology has immensely profit from the successful development of therapies targeting immune checkpoint molecules and using the strength of the patient’s own immune system to combat malignancy. This trend of research is of interest in cutaneous lymphoma too, especially given the fact that the first two successfully established and approved therapies, for this indication, extracorporeal photopheresis, and interferon-alpha 2a, rely on immunomodulation as a main mode action. In the context of checkpoint blockade, however, being a disease of immune cells, lymphoma poses difficulty to define a good target for treatment (Figure 1). Immunotherapies, targeting T cells and showing high response rates in solid tumors, cannot be directly applied in all lymphomas [94]. Molecules, shared by healthy and malignant cells have different effects, as seen in PD-1 pathway (see above, also [82]), however, stimulating the immune system has clearly shown positive effects in CTCL, as seen with TLR agonists [25,26].