ABSTRACT
BACKGROUND: Cutaneous B-cell lymphoma (CBCL) is part of dermatopathological routine diagnostics. However, in contrast to cutaneous T-cell lymphomas, there are only a few studies on the prevalence and possible clinical impact of lymphatic vessel involvement. Therefore, this pilot study aimed to quantify the prevalence of lymphovascular involvement in CBCL and to assess the association between lymphovascular involvement and recurrence. METHODS: Thirty-nine patients from two tertiary care hospitals diagnosed with CBCL were retrospectively identified and their biopsies were histopathologically examined for the presence of lymphatic vessel involvement using H&E stain, and CD20 and D2-40 immunohistochemistry. Clinical data were retrieved from our digital documentation files. RESULTS: Thirty patients were included in the evaluation (nPCFCL = 15, nPCMZL = 10, and nPCLBCL = 5). Lymphovascular involvement occurred in all three types of lymphoma and was present in 14/30 specimens. The presence of lymphatic involvement did not show a significant impact on recurrence rate (p = 0.150). CONCLUSIONS: This immunohistochemical pilot study shows that lymphovascular involvement is a relatively frequent finding in primary CBCL. Although no definitive conclusion can be drawn from our findings because of the small sample size, there were no strong signs of tendencies for recurrence in either group. Future studies with larger sample size are warranted to assess the possible clinical implications.
Subject(s)
Lymphatic Vessels , Lymphoma, B-Cell , Skin Neoplasms , Humans , Skin Neoplasms/pathology , Retrospective Studies , Pilot Projects , Lymphoma, B-Cell/pathology , Lymphatic Vessels/pathologyABSTRACT
Metabolic reprogramming mediated by hypoxia-inducible factors and its downstream targets plays a crucial role in many human malignancies. Excessive proliferation of tumor cells under hypoxic conditions leads to metabolic reprogramming and altered gene expression enabling tumors to adapt to their hypoxic environment. Here we analyzed the metabolic signatures of primary cutaneous melanomas with positive and negative sentinel node status in order to evaluate potential differences in their metabolic signature. We found a positive correlation of the expression of glucose transporter 1 (GLUT-1) with tumor thickness and ulceration in all melanomas with subgroup analyses as well as in the subgroup with a negative sentinel node. Furthermore, the expression of vascular endothelial growth factor (VEGF) was positively correlated with the presence of ulceration in melanomas with positive sentinel node.
Subject(s)
Melanoma , Sentinel Lymph Node , Skin Neoplasms , Cell Hypoxia , Humans , Lymph Nodes/pathology , Melanoma/genetics , Melanoma/pathology , Sentinel Lymph Node/metabolism , Sentinel Lymph Node/pathology , Sentinel Lymph Node Biopsy , Skin Neoplasms/pathology , Vascular Endothelial Growth Factor AABSTRACT
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects patients' quality of life (QoL). OBJECTIVE: To investigate changes in QoL in patients with HS after wide local excision (WLE) and to examine the level of pain, rate of postoperative complications, recurrences, and the time to complete wound closure. METHODS: Fifty-five patients were enrolled in this prospective study. All patients underwent WLE of HS, followed by secondary wound healing. Dermatologic Life Quality Questionnaire, pain, and wound size were measured 1 day, 3 weeks, 3 months, and 6 months after surgery. RESULTS: Dermatologic Life Quality Questionnaire and pain scores (mean ± SD) improved significantly (both p < .001) from 14.5 ± 7.3 and 3.7 ± 2.8 at baseline to 5.8 ± 6.9 and 0.8 ± 1.7, 6 months postoperatively, respectively. Wounds were closed completely by secondary intention after 4.4 ± 2.8 months. Sixteen patients (29.1%) experienced postoperative complications, local recurrences in the treated sites were observed in 11 patients (20%), and new lesions in untreated sites were observed in 5 cases (9.1%). CONCLUSION: Wide local excision significantly improves patients' QoL and pain, and, given its low rate of recurrence and complications, should be considered as a first-line therapy, especially in patients with higher Hurley stages.
Subject(s)
Hidradenitis Suppurativa/complications , Hidradenitis Suppurativa/surgery , Postoperative Complications/epidemiology , Quality of Life , Adult , Female , Humans , Male , Middle Aged , Pain, Postoperative/epidemiology , Prospective Studies , Recurrence , Time Factors , Wound Healing , Young AdultABSTRACT
This study analysed the expression of vascular endothelial growth factor-A (VEGF), VEGFR-2, and VEGFR-3 in primary cutaneous melanomas with positive and negative sentinel node status (SLN) (a total of 58 specimens divided into 2 groups of 29 for each status). The specimens were collected from the pathological archive of the department of Dermatology, Venereology and Allergology of the University Medical Center Heidelberg. A quantification score was developed for protein expression, by considering the percentage of positive melanoma cells (0: 0%, 1: up to 1%, 2: 2-10%, 3: 11-50%, and 4: > 50%) in relation to the intensity of staining (0: negative, 1: low, 2: medium, 3: strong). Tumoural VEGFR-3 expression (mean ± standard deviation) in SLN+ tumours (9.62 ± 3.09) was significantly stronger than in SLN- tumours (6.13 ± 3.87; p < 0.001). A binary logistic regression model proved VEGFR-3 expression and tumour thickness to be significant independent predictors of SLN. These data provide evidence that VEGFR-3 expression may play a critical role in the pathogenesis of malignant melanoma and that its investigation may help to improve the selection of patients with primary cutaneous melanoma for sentinel node biopsy.
Subject(s)
Melanoma , Skin Neoplasms , Vascular Endothelial Growth Factor Receptor-3 , Humans , Lymphatic Metastasis , Prognosis , Sentinel Lymph Node Biopsy , Skin Neoplasms/surgery , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-3/metabolismABSTRACT
To shed more light on the pathogenesis of sebaceous carcinoma, we analysed the expression of proteins related to angiogenesis in 18 ocular and 22 extraocular sebaceous carcinomas using a broad panel of immunohistochemical markers. To quantify the expression of D2-40, vascular endothelial growth factor, vascular endothelial growth factor receptor-2 and -3, we calculated a quantification score by considering the percentage of positive tumour cells (0=0%, 1=up to 1%, 2=2-10%, 3=11-50%, and 4=>50%) in relation to the staining intensity (0=negative, 1=low, 2=medium, and 3=strong). Additionally, lymphatic microvessel density in the D2-40 stained sections was counted. Vascular endothelial growth factor receptor-3 (quantification score 9.42 ± 2.94) was significantly more strongly expressed than vascular endothelial growth factor receptor-2 (quantification score 2.15 ± 2.42, p < 0.001). Furthermore, epidermal vascular endothelial growth factor expression was negatively correlated with the intratumoural lymphatic vessel density, and the ratio of small lymphatics to large lymphatics was much higher in intratumoural tissue than in paratumoural tissue and in intraindividual control tissue, suggesting a lymphangiogenetic potential of sebaceous carcinoma.
Subject(s)
Adenocarcinoma, Sebaceous/pathology , Biomarkers, Tumor/metabolism , Neovascularization, Pathologic/pathology , Sebaceous Gland Neoplasms/pathology , Vascular Endothelial Growth Factor A/metabolism , Vascular Endothelial Growth Factor C/metabolism , Adenocarcinoma, Sebaceous/metabolism , Adult , Aged , Aged, 80 and over , Biopsy, Needle , Cohort Studies , Eye/pathology , Female , Humans , Immunohistochemistry , Male , Middle Aged , Prognosis , Retrospective Studies , Sebaceous Gland Neoplasms/physiopathologyABSTRACT
Necrolytic migratory erythema (NEM) is associated with glucagonoma, an endocrine malignancy of the pancreas. It is a rare and a likely underrecognized paraneoplastic dermatitis. A 38-year-old woman presented to our clinic with a 3-year history of reocurring pruritic skin rashes with increasing intensity. The skin lesions presented with active annular borders, central scaling, and postinflammatory hyperpigmentation, but also with erosions, pustules, and crusted lesions. Multiple skin biopsies were taken. The workup of the patient revealed a tumor localized in the head of the pancreas, and glucagon serum levels were elevated. Clues to the diagnosis of NEM were the waxing and waning of serpiginous erythemas with active borders localized on extremities, intertriginous areas, and face. On histopathology, dyskeratosis in all layers of the epidermis were an early feature of NEM, and long-standing lesions typically showed psoriasiform hyperplasia with pallor and necrosis of upper epidermal layers. Clinicians and histopathologists need to be aware of the wide spectrum of skin manifestations in glucagonoma. Early diagnosis of the tumor is crucial for patients.
Subject(s)
Glucagonoma/complications , Necrolytic Migratory Erythema/pathology , Pancreatic Neoplasms/complications , Paraneoplastic Syndromes/pathology , Skin/pathology , Adult , Biopsy , Fatal Outcome , Female , Glucagonoma/diagnostic imaging , Glucagonoma/surgery , Humans , Lymph Node Excision , Necrolytic Migratory Erythema/etiology , Pancreatectomy , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgery , Paraneoplastic Syndromes/etiology , Predictive Value of Tests , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Granuloma Annulare , Scleromyxedema , Humans , Scleromyxedema/diagnosis , Diagnosis, DifferentialABSTRACT
A 19-year-old man suffering from testicular choriocarcinoma presented to the dermatology department with a cutaneous metastasis on his head. This metastasis was the first sign of disease that led to medical consultation. Histopathology revealed cytotrophoblasts and syncytiotrophoblasts, the later expressing human chorionic gonadotropin antigen. Whole body computed tomography showed multiple metastases of the brain, lung, liver, bone, paraaortic lymph nodes and left uvea; the primary was found in the left testicle. Despite neurosurgical intervention and chemotherapy the patient died 9 days after the biopsy of the cutaneous metastasis. Cutaneous metastases of testicular choriocarcinoma are exceptionally rare, with fewer than a dozen cases reported in the English-language literature. The present case highlights that testicular choriocarcinoma metastatic to the skin should be included in the differential of cutaneous scalp tumors.
Subject(s)
Choriocarcinoma , Head and Neck Neoplasms , Skin Neoplasms , Testicular Neoplasms , Adult , Choriocarcinoma/drug therapy , Choriocarcinoma/metabolism , Choriocarcinoma/pathology , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/metabolism , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/secondary , Humans , Male , Neoplasm Metastasis , Skin Neoplasms/drug therapy , Skin Neoplasms/metabolism , Skin Neoplasms/pathology , Skin Neoplasms/secondary , Testicular Neoplasms/drug therapy , Testicular Neoplasms/metabolism , Testicular Neoplasms/pathologyABSTRACT
We present the case of a 35-year-old man who developed a follicular differentiated cutaneous carcinoma with an eosinophil-rich infiltrate and an aggressive clinical behavior. After an in-depth histopathological investigation the diagnosis of trichoblastic carcinoma was made. Over the course of the disease the patient developed a cutaneous in-transit metastasis as well as an axillary lymph node metastasis 18 months after the excision of the primary tumor on his back. Based on a literature review we discuss the different concepts behind the term "trichoblastic carcinoma" and we summarize the clinical and histological details of previously reported cases. Furthermore, we focus on the phenomenon of tumor-associated eosinophilia.
Subject(s)
Carcinoma/pathology , Hair Diseases/pathology , Hair Follicle/pathology , Skin Neoplasms/pathology , Adult , Humans , Male , Neoplasm Recurrence, Local/pathologySubject(s)
Alopecia/pathology , Eyebrows/pathology , Facial Dermatoses/pathology , Administration, Cutaneous , Adolescent , Adrenal Cortex Hormones/administration & dosage , Alopecia/drug therapy , Dermatologic Agents/administration & dosage , Facial Dermatoses/drug therapy , Female , Humans , Treatment OutcomeABSTRACT
Superficial angiomyxoma is a rare, benign neoplasm consisting of spindle-shaped fibroblasts in a myxoid, vascularized stroma. Diagnostic clarification is usually based on histology and immunohistochemistry and is of particular importance depending on the clinical presentation, as malignant tumors may also be considered in the differential diagnosis. Herewith, we present a patient with a solitary, superficial angiomyxoma of the sole of the foot. Although it often occurs as an independent entity, it is recommended to exclude syndromes such as Carney complex.