Asunto(s)
Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutáneo Primario de Células Grandes , Trastornos Linfoproliferativos , Enfermedades de la Piel , Neoplasias Cutáneas , Humanos , Metotrexato/efectos adversos , Linfoma Anaplásico Cutáneo Primario de Células Grandes/inducido químicamente , Linfoma Anaplásico Cutáneo Primario de Células Grandes/diagnóstico , Linfoma Anaplásico Cutáneo Primario de Células Grandes/tratamiento farmacológico , Neoplasias Cutáneas/inducido químicamente , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológico , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/tratamiento farmacológico , Trastornos Linfoproliferativos/inducido químicamente , Trastornos Linfoproliferativos/diagnóstico , Trastornos Linfoproliferativos/patologíaRESUMEN
Sweet syndrome (SS) is an uncommon inflammatory disease that involves painful skin, edematous, red papules, plaques, or nodules often accompanied by fever and leukocytosis. SS has three subtypes, including classical, malignant-tumor associated, and drug-induced SS (DISS). Patients with DISS have clear histories of recent drug exposure. The incidence of SS is high in hematological malignancy but rare in lymphomas. Glucocorticoid treatment is the recommended treatment for all subtypes of SS. This case study describes a male patient who had a history of sALCL(Systemic anaplastic large cell lymphoma) and was treated with multiple cycles of monoclonal-antibody (mAb) therapy. They also received the G-CSF injection at the site where skin lesions later developed. They met the diagnosis criteria for DISS, which was considered to be caused by the G-CSF injection. In addition, BV(Brentuximab vedotin) administration might predispose them to DISS. This case illustrates the first reported SS during the lymphoma treatment, with rare clinical presentations of local crater-like suppurative skin lesions. This case expands the available literature on SS and hematologic neoplasms and reminds clinicians to promptly recognize and diagnose SS to minimize patient morbidity and long-term sequelae.
Asunto(s)
Fístula , Inmunoconjugados , Linfoma Anaplásico de Células Grandes , Síndrome de Sweet , Humanos , Masculino , Inmunoconjugados/uso terapéutico , Síndrome de Sweet/inducido químicamente , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/tratamiento farmacológico , Brentuximab Vedotina/uso terapéutico , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/tratamiento farmacológico , Linfoma Anaplásico de Células Grandes/patología , Fiebre/tratamiento farmacológico , Factor Estimulante de Colonias de GranulocitosRESUMEN
Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive non-Hodgkin lymphomas, the majority of which have high relapse rates following standard therapy. Despite use of consolidative stem cell transplant (SCT) following frontline therapy, there remains no consensus on its utility. The double-blind randomized phase 3 ECHELON-2 study (#NCT01777152; clinicaltrials.gov) demonstrated improved progression-free survival (PFS) and overall survival with frontline brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP). Herein, we conducted an exploratory subgroups analysis of the impact of consolidative SCT on PFS in patients with previously untreated CD30+ PTCL (ALK- anaplastic large cell lymphoma [ALCL] and non-ALCL) who were in complete response (CR) after frontline treatment with A+CHP or cyclophosphamide, doxorubicin, vincristine, and prednisone. Median PFS follow-up was 47.57 months. The PFS hazard ratio was 0.36, equating to a 64% reduction in the risk of a PFS event in patients who underwent SCT. The median PFS in patients who underwent SCT was not reached, vs 55.66 months in patients who did not undergo SCT. PFS results favored the use of SCT in both ALK- ALCL and non-ALCL subgroups. These data support the consideration of consolidative SCT in patients with CD30+PTCL who achieve CR following treatment with A+CHP.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Linfoma Anaplásico de Células Grandes , Brentuximab Vedotina , Ciclofosfamida/efectos adversos , Doxorrubicina/efectos adversos , Humanos , Antígeno Ki-1 , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/terapia , Recurrencia Local de Neoplasia , Prednisona/efectos adversos , Vincristina/efectos adversosRESUMEN
Since the dawn of breast implantation back in the sixties, five generations of breast implants have tried to provide the most natural-looking results while striving to eliminate the risk of unpleasant ruptures or capsular contractures. National Health regulators (i.e. the FDA in USA and ANSM in France) have had an "after the facts" reaction, which led to a so-called "dirty war" among producers in the form of a 1992 Silicone's Moratorium (after suspicions of associated cancer or immune-related disorders) all this under the rigid oversight of a FDA director, who seemed more sensible to media scandal than scientific data. After more than a decade of consistent scientific evidence, the interdiction was finally ended in France in 2001 and in the USA in 2006, however the scandals resurfaced again in 2011 after a proven fraud on the "PIP - affair" and most recently with "breast implant associated - anaplastic large cell lymphoma", an extremely serious and rare pathology, treated only by surgical means, until further research. We describe also a chronology on the way the FDA finally recognized this dramatic complication.
Asunto(s)
Implantes de Mama/historia , Neoplasias de la Mama/inducido químicamente , Neoplasias de la Mama/historia , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/historia , Siliconas/historia , Implantes de Mama/efectos adversos , Femenino , Francia , Fraude/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Factores de Riesgo , Siliconas/efectos adversos , Estados Unidos , United States Food and Drug Administration/historiaAsunto(s)
Clorhidrato de Fingolimod/efectos adversos , Inmunosupresores/efectos adversos , Linfoma Anaplásico de Células Grandes/inducido químicamente , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Neoplasias Cutáneas/inducido químicamente , Biopsia , Femenino , Humanos , Antígeno Ki-1/metabolismo , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/patología , Persona de Mediana Edad , Receptores de Lisoesfingolípidos/antagonistas & inhibidores , Receptores de Lisoesfingolípidos/metabolismo , Piel/citología , Piel/efectos de los fármacos , Piel/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Linfocitos T/efectos de los fármacos , Linfocitos T/metabolismoRESUMEN
Capsular contracture, which is the pathologic development of fibrous capsules around implants, is a major complication of reconstructive and aesthetic breast surgeries. Capsular contracture can cause implant failure with breast hardening, deformity, and severe pain. The exact mechanisms underlying this complication remain unclear. In addition, anaplastic large cell lymphoma is now widely recognized as a very rare disease associated with breast implants. Foreign body reactions are an inevitable common denominator of capsular contracture. A number of studies have focused on the associated immune responses and their regulation. The present article provides an overview of the currently available techniques, including novel nano/microtechniques, to reduce silicone implant-induced contracture and associated foreign body responses.
Asunto(s)
Implantes de Mama/efectos adversos , Contractura Capsular en Implantes/prevención & control , Linfoma Anaplásico de Células Grandes/prevención & control , Geles de Silicona/efectos adversos , Animales , Materiales Biomiméticos/uso terapéutico , Femenino , Reacción a Cuerpo Extraño/inducido químicamente , Reacción a Cuerpo Extraño/inmunología , Reacción a Cuerpo Extraño/prevención & control , Humanos , Contractura Capsular en Implantes/inducido químicamente , Contractura Capsular en Implantes/inmunología , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/inmunología , NanotecnologíaRESUMEN
BACKGROUND: Previous reports of cutaneous neoplastic lesions secondary to Fingolimod treatment among multiple sclerosis patients. OBJECTIVE: Reporting a case of cutaneous large cell lymphoma in a multiple sclerosis patient during Fingolimod treatment. METHOD: Case study. RESULT: Our patient developed CD30+ cutaneous large cell lymphoma two years after initiation of Fingolimod treatment and her symptoms regressed following the cessation of treatment. CONCLUSION: This report indicates that cutaneous lymphoid neoplasms should be considered a possible side effect among patients receiving Fingolimod.
Asunto(s)
Clorhidrato de Fingolimod/efectos adversos , Inmunosupresores/efectos adversos , Linfoma Anaplásico de Células Grandes/inducido químicamente , Esclerosis Múltiple/tratamiento farmacológico , Adulto , Femenino , HumanosRESUMEN
BACKGROUND: The appearance of solid tumors und lymphomas during treatment with fingolimod was observed in studies and has been described in case reports. OBJECTIVE: To report a case of primary cutaneous CD30(+) anaplastic large-cell T-cell lymphoma during treatment of multiple sclerosis (MS) with fingolimod. METHODS: Case study. RESULTS: Our patient developed a lymphoma a few weeks after initialization of therapy with fingolimod; 5 weeks after discontinuation of treatment the lesions resolved. CONCLUSION: Causality of fingolimod is indicated by the fact that the skin lesions appeared after commencement of treatment and resolved after discontinuation of therapy. This case serves as a reminder of the potential side effects of fingolimod.
Asunto(s)
Clorhidrato de Fingolimod/efectos adversos , Inmunosupresores/efectos adversos , Antígeno Ki-1 , Linfoma Anaplásico de Células Grandes/inducido químicamente , Esclerosis Múltiple/tratamiento farmacológico , Neoplasias Cutáneas/inducido químicamente , Femenino , Humanos , Persona de Mediana EdadRESUMEN
BACKGROUND: ALK-negative anaplastic large cell lymphoma associated with breast implant (i-ALCL) has been recently recognized as a distinct entity. Among 43 830 lymphomas registered in the French Lymphopath network since 2010, 300 breast lymphomas comprising 25 peripheral T-cell lymphomas (PTCL) were reviewed. Among PTCL, ALK-negative ALCL was the most frequent and all of them were associated with breast implants. PATIENTS AND METHODS: Since 2010, all i-ALCL cases were collected from different institutions through Lymphopath. Immuno-morphologic features, molecular data and clinical outcome of 19 i-ALCLs have been retrospectively analyzed. RESULTS: The median age of the patients was 61 years and the median length between breast implant and i-ALCL was 9 years. Most implants were silicone-filled and textured. Implant removal was performed in 17 out of 19 patients with additional treatment based on mostly CHOP or CHOP-like chemotherapy regimens (n = 10/19) or irradiation (n = 1/19). CHOP alone or ABVD following radiation without implant removal have been given in two patients. The two clinical presentations, i.e. effusion and less frequently tumor mass correlated with distinct histopathologic features: in situ i-ALCL (anaplastic cell proliferation confined to the fibrous capsule) and infiltrative i-ALCL (pleomorphic cells massively infiltrating adjacent tissue with eosinophils and sometimes Reed-Sternberg-like cells mimicking Hodgkin lymphoma). Malignant cells were CD30-positive, showed a variable staining for EMA and were ALK negative. Most cases had a cytotoxic T-cell immunophenotype with variable T-cell antigen loss and pSTAT3 nuclear expression. T-cell receptor genes were clonally rearranged in 13 out of 13 tested cases. After 18 months of median follow-up, the 2-year overall survival for in situ and infiltrative i-ALCL was 100% and 52.5%, respectively. CONCLUSIONS: In situ i-ALCLs have an indolent clinical course and generally remain free of disease after implant removal. However, infiltrative i-ALCLs could have a more aggressive clinical course that might require additional therapy to implant removal.
Asunto(s)
Implantes de Mama/efectos adversos , Linfoma Anaplásico de Células Grandes/patología , Linfoma de Células T Periférico/patología , Siliconas/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Quinasa de Linfoma Anaplásico , Femenino , Enfermedad de Hodgkin/patología , Humanos , Inmunofenotipificación , Antígeno Ki-1/metabolismo , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/mortalidad , Linfoma de Células T Periférico/inducido químicamente , Linfoma de Células T Periférico/mortalidad , Persona de Mediana Edad , Proteínas Tirosina Quinasas Receptoras/metabolismo , Receptores de Antígenos de Linfocitos T/metabolismo , Estudios Retrospectivos , Factor de Transcripción STAT3/metabolismo , Linfocitos T Citotóxicos/inmunologíaRESUMEN
The association of malignancy with autoimmune rheumatic diseases has been a subject of investigation. It has been shown that there is increased risk of malignancies, mainly non-Hodgkin lymphoma, in patients with autoimmune disorders. There is scarcity of data about malignancy in juvenile idiopathic arthritis (JIA). We report the occurrence of anaplastic large cell lymphoma in a patient with systemic onset juvenile idiopathic arthritis treated with low dose methotrexate (MTX). A relationship between MTX treatment and the occurrence of lymphoma in autoimmune diseases has been suggested. The hypothesis that MTX has a role in the aetiology of lymphoproliferative disorders is supported by the observation of spontaneous remission of lymphoma in few cases on cessation of MTX therapy. However, systemic onset juvenile idiopathic arthritis patients receiving MTX must be periodically examined for the development of lymphoproliferative disorder especially if the disease is difficult to control or patient develop new symptoms on therapy.
Asunto(s)
Artritis Juvenil/tratamiento farmacológico , Inmunosupresores/efectos adversos , Linfoma Anaplásico de Células Grandes/inducido químicamente , Metotrexato/efectos adversos , Artritis Juvenil/diagnóstico , Biopsia , Resultado Fatal , Femenino , Humanos , Huésped Inmunocomprometido , Inmunosupresores/administración & dosificación , Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/inmunología , Metotrexato/administración & dosificación , Factores de Tiempo , Tomografía Computarizada por Rayos X , Adulto JovenAsunto(s)
Linfoma Anaplásico de Células Grandes/inducido químicamente , Papulosis Linfomatoide/inducido químicamente , Neoplasias Cutáneas/inducido químicamente , Tatuaje/efectos adversos , Colorantes/efectos adversos , Erupciones por Medicamentos/etiología , Femenino , Humanos , Compuestos de Mercurio/efectos adversos , Seudolinfoma/diagnóstico , Enfermedades de la Piel/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: The Allergan Style 410 implant is a textured, anatomic, highly cohesive silicone gel-filled breast implant. Despite its widespread use in both Europe and Canada, limited data exist regarding long-term outcomes. The purpose of this study was to investigate outcomes using the Style 410 implant for primary subglandular breast augmentation. METHODS: A retrospective chart review was performed to identify all patients who underwent primary subglandular breast augmentation through an inframammary incision with the Style 410 implant. Patient demographics and implant characteristics were documented. Complications were examined, along with reoperation rate. RESULTS: Between 2002 and 2011, 440 consecutive patients were identified, with 16.6 percent of patients experiencing a complication and 10.7 percent requiring reoperation. The most common complication was malrotation, experienced by 5.2 percent of patients; this was largely managed nonoperatively. Baker grade III or IV capsular contracture occurred in 1.8 percent of patients, and 1.4 percent of patients presented with late seroma. No cases of anaplastic large cell lymphoma were identified. The most frequent indication for reoperation was revision breast surgery for inadequate cosmetic result (3.6 percent of patients). Larger implant volume correlated with significantly higher complication rates; however, implant profile did not. CONCLUSIONS: The complication and reoperation rates with the Style 410 implant are consistent with those of other implants. This device may possess certain inherent advantages over other breast implants currently available; however, there are also several problems associated with textured anatomic implants that must be considered when deciding on the best approach to breast augmentation for a patient. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Asunto(s)
Implantación de Mama/efectos adversos , Implantación de Mama/métodos , Implantes de Mama , Diseño de Prótesis , Geles de Silicona/efectos adversos , Adolescente , Adulto , Factores de Edad , Bases de Datos Factuales , Femenino , Estudios de Seguimiento , Humanos , Contractura Capsular en Implantes/epidemiología , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/fisiopatología , Mamoplastia/efectos adversos , Mamoplastia/métodos , Persona de Mediana Edad , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/cirugía , Reoperación/métodos , Estudios Retrospectivos , Medición de Riesgo , Resultado del Tratamiento , Adulto JovenRESUMEN
The development of malignancies during therapy with biologics has been discussed controversially. A patient with extensive pityriasis rubra pilaris failed to respond to standard therapeutic approaches. While receiving immunomodulatory therapy, lastly with ustekinumab, the patient developed a CD30(+) anaplastic large cell lymphoma.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Inmunosupresores/efectos adversos , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/diagnóstico , Pitiriasis Rubra Pilaris/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , UstekinumabAsunto(s)
Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Inmunoglobulina G/uso terapéutico , Linfoma Anaplásico de Células Grandes/diagnóstico , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Antirreumáticos/efectos adversos , Antirreumáticos/uso terapéutico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/patología , Cartílago Articular/efectos de los fármacos , Cartílago Articular/patología , Diagnóstico Diferencial , Etanercept , Humanos , Inmunoglobulina G/efectos adversos , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , Linfoma Anaplásico de Células Grandes/inducido químicamente , Masculino , Persona de Mediana Edad , RecurrenciaRESUMEN
There is a new concern about a possible association between anaplastic large cell lymphoma (ALCL) and breast implants. The purpose of this review was to identify and analyze all reported cases of ALCL occurring in patients with breast implants. Therefore, we reviewed all articles published concerning this subject between 1991 and 2011. We found 41 cases of ALCL. The mean age of the patients was 51 years old with an average of 108 months between the implantation and the diagnosis. Over 60 % of the reported cases were aesthetic augmentations. However, none of the published study managed to highlight a correlation between the prosthesis and this lymphoma. Therefore, we believe that for the moment, we can reassure our patients, but we must be aware of this association if a late seroma or a tumefaction occur on prosthesis. The surgical management seems to be essential for the diagnosis and the treatment, especially by the negative ALK and CD 30 expression of this lymphoma.
Asunto(s)
Implantes de Mama/efectos adversos , Neoplasias de la Mama/etiología , Neoplasias de la Mama/cirugía , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/cirugía , Neoplasias de la Mama/inducido químicamente , Neoplasias de la Mama/patología , Femenino , Humanos , Linfoma Anaplásico de Células Grandes/patología , Persona de Mediana Edad , Factores de Riesgo , Siliconas , Cloruro de Sodio , Factores de Tiempo , Resultado del TratamientoRESUMEN
Concerns have been raised recently regarding the increasing number of reports of non-Hodgkin lymphoma (NHL) that developed in close proximity to silicone or saline breast implants. In particular, an increased risk of anaplastic large cell lymphoma (ALCL) in patients with breast prostheses has been proposed. We reviewed clinical and pathologic findings in 40 women who received a diagnosis of breast NHL arising in association with breast implants and of 27 patients who had a diagnosis of ALCL with breast involvement reported in the published literature. Among the 40 reported cases of prosthesis-associated breast lymphomas, 28 were anaplastic lymphoma kinase-1-negative (ALK-1(-)) ALCLs, whereas of 27 ALCLs in patients without implants found in the literature, only 10 were ALK-1(-). The finding of 28 cases of breast ALK-1(-) ALCL occurring in patients with implants compared with 10 cases in women without implants is in favor of an association between silicone breast prostheses and ALK-1(-) ALCL. Although the incidence of this type of lymphoma remains remarkably low given that breast prostheses have been widely used for decades, clinical and pathologic evidence for a causative role is becoming dramatically strong. The histologic, phenomenologic, and clinical similarities of the majority of implant-related ALK-1(-) ALCLs suggest a common mechanism, especially when compared with the counterpart of patients without implants in which very few and highly dishomogeneous cases of the same malignancy were detected. There is convincing evidence that primary implant-related ALK-1(-) ALCL represents a distinct clinicopathologic entity that has been inappropriately fitted into the category of systemic ALK-1(-) ALCL. Thus it should be recognized as a separate category and classified on its own.
Asunto(s)
Implantes de Mama/efectos adversos , Neoplasias de la Mama/inducido químicamente , Linfoma Anaplásico de Células Grandes/inducido químicamente , Proteínas Tirosina Quinasas Receptoras , Adulto , Anciano , Anciano de 80 o más Años , Quinasa de Linfoma Anaplásico , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Linfoma Anaplásico de Células Grandes/metabolismo , Persona de Mediana Edad , Estudios Retrospectivos , Siliconas , Cloruro de SodioRESUMEN
Bortezomib, a reversible proteasome inhibitor, is used for the treatment of hematologic malignancies. Common adverse events with bortezomib include gastrointestinal symptoms, thrombocytopenia, and neuropathy, whereas severe pulmonary complications have been rarely described. Herein, we present a case of rapid fatal pulmonary complications in a patient with ALK-negative anaplastic large-cell lymphoma after receiving a treatment with bortezomib.
Asunto(s)
Ácidos Borónicos , Pirazinas , Anciano , Pueblo Asiatico , Ácidos Borónicos/efectos adversos , Ácidos Borónicos/farmacología , Ácidos Borónicos/uso terapéutico , Bortezomib , Inhibidores Enzimáticos/uso terapéutico , Resultado Fatal , Neoplasias Hematológicas/inducido químicamente , Neoplasias Hematológicas/enzimología , Humanos , Pulmón/enzimología , Pulmón/metabolismo , Linfoma de Células B Grandes Difuso/inducido químicamente , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/enzimología , Linfoma Anaplásico de Células Grandes/inducido químicamente , Linfoma Anaplásico de Células Grandes/enzimología , Masculino , Pirazinas/efectos adversos , Pirazinas/farmacología , Pirazinas/uso terapéuticoRESUMEN
OBJECTIVE: To report the association of the development of a primary, cutaneous, anaplastic large-cell lymphoma after initiation of glatiramer acetate treatment of a patient with relapsing-remitting multiple sclerosis. DESIGN: Case report. SETTING: Dermatology outpatient clinic. Patient A 33-year-old white woman developed an erythematous nodule on her leg 4 months after starting treatment with glatiramer acetate. Biopsy showed primary, cutaneous, anaplastic large-cell lymphoma. Further evaluation showed no systemic involvement. Intervention Radiation therapy induced a complete remission. CONCLUSIONS: Several T-cell-mediated skin conditions have been associated with the use of glatiramer acetate, such as pseudolymphoma, drug eruptions, and erythema nodosum. We report the association of a T-cell malignancy with the use of glatiramer acetate.