RESUMO
BACKGROUND: Brentuximab vedotin (BV) has been approved for CD30-expressing cutaneous T-cell lymphoma (CTCL) after at least one previous systemic treatment. However, real clinical practice is still limited. OBJECTIVES: To evaluate the response and tolerance of BV in a cohort of patients with CTCL. METHODS: We analysed CTCL patients treated with BV from the Spanish Primary Cutaneous Lymphoma Registry (RELCP). RESULTS: Sixty-seven patients were included. There were 26 females and the mean age at diagnosis was 59 years. Forty-eight were mycosis fungoides (MF), 7 Sézary syndrome (SS) and 12 CD30+ lymphoproliferative disorders (CD30 LPD). Mean follow-up was 18 months. Thirty patients (45%) showed at least 10% of CD30+ cells among the total lymphocytic infiltrate. The median number of BV infusions received was 7. The overall response rate (ORR) was 67% (63% in MF, 71% in SS and 84% in CD30 LPD). Ten of 14 patients with folliculotropic MF (FMF) achieved complete or partial response (ORR 71%). The median time to response was 2.8 months. During follow-up, 36 cases (54%) experienced cutaneous relapse or progression. The median progression free survival (PFS) was 10.3 months. The most frequent adverse event was peripheral neuropathy (PN) (57%), in most patients (85%), grades 1 or 2. CONCLUSIONS: These results confirm the efficacy and safety of BV in patients with advanced-stage MF, and CD30 LPD. In addition, patients with FMF and SS also showed a favourable response. Our data suggest that BV retreatment is effective in a proportion of cases.
Assuntos
Imunoconjugados , Linfoma Cutâneo de Células T , Transtornos Linfoproliferativos , Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Feminino , Humanos , Pessoa de Meia-Idade , Brentuximab Vedotin/uso terapêutico , Imunoconjugados/efeitos adversos , Neoplasias Cutâneas/patologia , Micose Fungoide/patologia , Síndrome de Sézary/patologia , Sistema de Registros , Antígeno Ki-1RESUMO
Pigmented epidermotropic breast cancer metastases are a rarity, often clinically misdiagnosed as melanocytic lesions. Histopathologically, they show a dermal proliferation of neoplastic metastatic cells that extend to the overlying epidermis in a pattern identical to that seen in primary Paget disease (PD). Differential diagnosis should be established with entities with a similar presentation, such as pigmented mammary PD and malignant melanoma. Immunohistochemistry may be useful for this purpose. We present a new case of pigmented epidermotropic breast cancer metastases with a particularly unusual feature: the absence of dermal infiltration by neoplastic cells, thus considered as pure epidermotropic metastatic involvement.
Assuntos
Neoplasias da Mama , Melanoma , Neoplasias Cutâneas , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/secundário , Diagnóstico Diferencial , Feminino , Humanos , Melanoma/diagnóstico , Melanoma/metabolismo , Melanoma/patologia , Metástase Neoplásica , Doença de Paget Mamária/diagnóstico , Doença de Paget Mamária/metabolismo , Doença de Paget Mamária/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologia , Melanoma Maligno CutâneoRESUMO
ABSTRACT: The presence of neoplastic melanocytes within the eccrine apparatus into the reticular dermis and/or subcutaneous tissue is extremely rare. The staging of syringotropic melanomas and their biological behavior are still controversial. We present 6 new cases of syringotropic melanoma and their main histopathologic features; review the previous literature; and discuss about the origin, staging, and prognosis of this rare variant of melanoma.
Assuntos
Melanócitos/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Glândulas Sudoríparas/patologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Masculino , Melanócitos/química , Melanoma/química , Melanoma/cirurgia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Neoplasias Cutâneas/química , Neoplasias Cutâneas/cirurgia , Glândulas Sudoríparas/química , Glândulas Sudoríparas/cirurgia , Resultado do TratamentoRESUMO
ABSTRACT: Microcystic adnexal carcinoma (MAC) is a low-grade malignant neoplasm of slow growth and low metastatic potential, but locally aggressive. Architecturally, MAC is usually a poorly circumscribed neoplasm that tends to extend deeply into the dermis and subcutaneous tissue. We present here a lesion in which the histopathologic study showed a well-demarcated nodular lesion involving the mid dermis and composed of small cystic keratinous structures, solid aggregates of pale squamous cells without cytologic atypia and ductal structures. Although these neoplastic components resembled those of MAC, the sharp delimitation of the lesion as well as the absence of deep extension and perineural involvement supported the benign nature of this lesion. We have named this neoplasm microcystic adnexal adenoma, as the benign counterpart of MAC.
Assuntos
Adenoma/patologia , Doenças do Pé/patologia , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Neoplasias Cutâneas/patologia , Adenoma/cirurgia , Derme/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Targeted anticancer therapy is being used with greater frequency and dermatologic toxicities are among the most frequent adverse events of these drugs. However, histopathological features of these adverse events are not yet well characterized. We present two cases of clinically different cutaneous toxicities on two patients with hematologic neoplasia. They were treated with different drugs and in both cases medications shared inhibition of PI3K as mechanism of action. The skin biopsy specimen showed endothelial cell atypia with large nuclei and mitotic figures. To the best of our knowledge, no other cases with these striking histopathologic findings have been reported with PI3K inhibitors or other anticancer targeted therapy.
Assuntos
Toxidermias/patologia , Exantema/induzido quimicamente , Neoplasias Hematológicas/tratamento farmacológico , Terapia de Alvo Molecular/efeitos adversos , Inibidores de Fosfoinositídeo-3 Quinase/efeitos adversos , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Idoso , Antineoplásicos/toxicidade , Benzotiazóis/efeitos adversos , Benzotiazóis/uso terapêutico , Biópsia , Toxidermias/tratamento farmacológico , Inibidores Enzimáticos/administração & dosagem , Inibidores Enzimáticos/uso terapêutico , Feminino , Neoplasias Hematológicas/complicações , Humanos , Hidroxicloroquina/administração & dosagem , Hidroxicloroquina/uso terapêutico , Pessoa de Meia-Idade , Compostos de Fenilureia/efeitos adversos , Compostos de Fenilureia/uso terapêutico , Inibidores de Fosfoinositídeo-3 Quinase/uso terapêutico , Pirazóis/efeitos adversos , Pirazóis/uso terapêutico , Pirimidinas/efeitos adversos , Pirimidinas/uso terapêutico , Pirrolidinas/efeitos adversos , Pirrolidinas/uso terapêutico , Pele/patologia , Resultado do TratamentoRESUMO
Toker cells (TCs) are sometimes present in the nipple epidermis as oval cells with pale cytoplasm and roundish nuclei. In most cases, TCs may be easily distinguished from cancerous cells of Paget disease of the nipple (PCs). Especially in TC hyperplasia, in which mild-to-moderate atypia may be present, it may be challenging to distinguish between TCs and PCs. The combination of chronic inflammatory changes in the nipple, in the context of Zuska disease, and TC hyperplasia, may easily lead to an erroneous diagnosis of mammary Paget disease.
Assuntos
Abscesso/diagnóstico , Abscesso/patologia , Doenças Mamárias/diagnóstico , Doenças Mamárias/patologia , Fístula/diagnóstico , Fístula/patologia , Mamilos/patologia , Adulto , Neoplasias da Mama/patologia , Diagnóstico Diferencial , Feminino , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patologia , Doença de Paget Mamária/patologia , Fumar/efeitos adversosRESUMO
Microcystic adnexal carcinoma (MAC) is a low-grade adnexal carcinoma with controversial lines of differentiation. We present here an example of MAC showing histopathologic findings of germinative follicular differentiation in the form of solid aggregates of trichoblastoma intermingled with neoplastic aggregates of MAC. Immunohistochemical findings, showing positivity for PHLDA1 and negativity for BerEp4 in neoplastic aggregates of trichoblastoma, also supported a germinative follicular differentiation. Follicular differentiation in MAC supports an apocrine line of differentiation for this neoplasm.
Assuntos
Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Neoplasias Cutâneas/patologia , Idoso , Diferenciação Celular , Humanos , Masculino , Nariz/patologiaAssuntos
Púrpura , Dermatopatias Vasculares , Meios de Cultura , Humanos , Púrpura/induzido quimicamenteAssuntos
Eosinofilia/diagnóstico , Exantema/diagnóstico , Leucemia Mieloide Aguda/complicações , Síndromes Paraneoplásicas/diagnóstico , Prurido/diagnóstico , Administração Cutânea , Administração Oral , Biópsia , Eosinofilia/tratamento farmacológico , Eosinofilia/imunologia , Eosinofilia/patologia , Exantema/tratamento farmacológico , Exantema/imunologia , Exantema/patologia , Feminino , Glucocorticoides/administração & dosagem , Humanos , Leucemia Mieloide Aguda/imunologia , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/tratamento farmacológico , Síndromes Paraneoplásicas/imunologia , Síndromes Paraneoplásicas/patologia , Prurido/tratamento farmacológico , Prurido/imunologia , Prurido/patologia , Pele/imunologia , Pele/patologia , Resultado do TratamentoRESUMO
BACKGROUND: Non-neural granular cell tumor (NNGCT) is an uncommon neoplasm of controversial histogenesis and its histopathologic differential diagnosis includes, in addition to conventional GCT, other dermal tumors that may exhibit granular cell change. METHODS: Three patients with a diagnosis of NNGCT were identified in the authors' files. Hematoxylin and eosin-stained sections and immunohistochemical studies were performed. RESULTS: Histopathological study of the three lesions showed dermal proliferation of granular cells arranged in thick fascicles between collagen bundles. The lesions showed positivity for Factor XIIIa, CD163, CD68, NKIC3, vimentin, ALK, fascin, and cyclin D1. CONCLUSION: To our knowledge, positivity for cyclin D1 has not been reported to date in NNGCT. In borderline cases, where the diagnosis is unclear despite histopathologic and immunohistochemical findings, positivity for cyclin D1 may favor the diagnosis of NNGCT. Further investigations to assess the differentiation of this rare neoplasm are needed.