RESUMO
Only 40 cases of primary cutaneous gamma/delta T-cell lymphoma (GD-TCL) have been described. GD-TCL was included as a provisional entity in the WHO-EORTC classification of cutaneous lymphomas in 2005. GD-TCL often failed to respond to polychemotherapy and radiation therapy and have a poor prognosis with a mean survival of only 15 months. We present a patient treated with surgery, immunomodulatory therapy, and polychemotherapy. He then received hematopoietic stem cell transplantation and has been in complete remission since. Allogeneic stem cell transplantation appears to be a promising therapeutic option for aggressive and generally fatal lymphomas like GD-TCL.
Assuntos
Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Transplante de Células-Tronco , Adulto , Humanos , Linfoma Cutâneo de Células T/genética , Masculino , Receptores de Antígenos de Linfócitos T gama-delta/genética , Neoplasias Cutâneas/genética , Resultado do TratamentoRESUMO
BACKGROUND: Necrobiotic xanthogranuloma (NXG) is a rare histiocytic disorder of unknown origin. OBJECTIVE: We conducted an investigation of skin biopsy specimens from 7 patients with NXG for the presence of Borrelia by focus-floating microscopy. METHODS: Focus-floating microscopy is a recently described, modified immunohistochemical technique in which the sections of a slide are simultaneously scanned both horizontally and vertically. Focus-floating microscopy is more sensitive for the detection of micro-organisms than polymerase chain reaction. RESULTS: Borrelia could be detected as single, paired, or clusters of spirochetes in 6 cases of NXG whereas two cases investigated with a Borrelia-specific polymerase chain reaction (23s-RNA) remained negative. LIMITATIONS: Limited biopsy material in each patient prohibited a more detailed study of the life history of cutaneous lesions in NXG. CONCLUSIONS: The detection of this micro-organism in NXG points to a specific involvement of B burgdorferi or other similar strains in the development of or as a trigger of this disease.
Assuntos
Borrelia burgdorferi/isolamento & purificação , Granuloma/microbiologia , Transtornos Necrobióticos/microbiologia , Xantomatose/microbiologia , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Microscopia/métodos , Pessoa de Meia-IdadeRESUMO
Circumscribed palmar or plantar hypokeratosis is a new entity recently described by Perez et al in 2002. It seems to be underdiagnosed or clinically it is often misdiagnosed as Bowen's disease or porokeratosis. Obviously the number of case reports of circumscribed palmar or plantar hypokeratosis has increased since the first publication by Perez et al.The histopathological hallmarks of this condition are a stair-like configuration with an abrupt thinning of the stratum corneum from uninvolved to involved skin with a central hypokeratotic area. There are no atypical keratinocytes or cornoid lamellation. We describe two new patients with circumscribed palmar hypokeratosis. In one case there were additional histopathological features including the loss of granular cell layer in the center of the lesion and an overlying compact thin parakeratotic layer.