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Open Access Publications from the University of California

Scholarly Works (124 results)

  • Article
  • Peer Reviewed
Dermatology Online Journal, Volume 25, Issue 11 (2019)
CD30+ T cell pseudolymphomas (CD30+ PSL) are a group of benign inflammatory cutaneous disorders that can develop in settings of viral infections or drug reactions. Owing to their histological similarities to malignant lymphomas, these benign infiltrates are occasionally misdiagnosed as malignant, causing significant concerns for patients and physicians. Herein, we report a patient with CD30+ PSL associated with molluscum contagiosum whose initial biopsy revealed atypical large CD30-expressing cells, leading to a misdiagnosis of primary cutaneous anaplastic large cell lymphoma and referral to our cutaneous lymphoma clinic. We report this case to demonstrate that reactive CD30+ infiltrate associated with molluscum contagiosum can be mistaken for T-cell lymphomas and patients should be reassured in these cases.
    Cover page: Molluscum contagiosum infection with features of primary cutaneous anaplastic large cell lymphomaCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
    • Peer Reviewed
    Dermatology Online Journal, Volume 20, Issue 7 (2014)
    CD30 expression is the hallmark of the cutaneous CD30+ lymphoproliferative disorders, lymphomatoid papulosis and anaplastic large cell lymphoma. We report CD30 expression in cutaneous follicle center cell lymphoma and in cutaneous post-transplant peripheral T-cell lymphoma. Histopathologists should be aware of CD30 expression in cutaneous lymphomas outside the realm of so-called CD30+ lymphoproliferative disorders to avoid diagnostic errors and improper medical treatment.
      Cover page: CD30 expression in cutaneous B-cell and post-transplant peripheral T-cell lymphoma: report of 2 casesCreative Commons 'BY-NC-ND' version 4.0 license
      • Article
      • Peer Reviewed
      Dermatology Online Journal, Volume 22, Issue 10 (2016)

      Background

      CD30+ lymphoproliferative disorders are rare and may feature a wide variety of presentations that mimic other conditions.

      Purpose

      A man with metastatic papillary thyroid carcinoma to skin who subsequently developed cutaneous anaplastic large cell lymphoma is described.

      Methods

      The PubMed medical database was used to search the following terms separately and in combination: ALCL, anaplastic large cell lymphoma ALCL, cutaneous anaplastic large cell lymphoma CALCL, cutaneous t-cell lymphoma CTCL, large t-cell lymphoma LTCL, lymphoproliferative, lymphomatoid papulosis LyP, mimic, papillary, thyroid cancer.

      Results

      CD30+ cutaneous anaplastic large cell lymphoma was diagnosed in a man with metastatic papillary thyroid carcinoma based on the temporal, histologic, and immunochemical features of an enlarging lesion. To the best of our knowledge, this is the initial description of a CD30+ lymphoproliferative disorder occurring in a patient with primary carcinoma of the thyroid.

      Conclusion

      Cutaneous lesions may present with various morphologies. Our patient had a previous history of metastatic papillary thyroid carcinoma to skin. His new chest lesion was originally suspected to be either an infection or a cutaneous metastasis. Multiple biopsies, not only for microscopic evaluation but also cultures for infectious organisms, were performed. Unexpectedly, a CD30+ lymphoproliferative disorder was diagnosed; subsequently the tumor spontaneously resolved. Therefore, when skin lesions appear that have more than one clinical presentation, it may be prudent for the clinician to collect representative samples of each distinct morphology to assure that an accurate diagnosis is established.

        Cover page: CD30+ lymphoproliferative disorder in a patient with metastatic papillary thyroid carcinomaCreative Commons 'BY-NC-ND' version 4.0 license
        • Article
        • Peer Reviewed
        Dermatology Online Journal, Volume 24, Issue 1 (2018)
        Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma that can involve the skin primarily or secondarily. Our case describes an unusual presentation of eruptive tumors localized to the leftbreast region several years following breast cancer surgery and radiation for carcinoma of the breast. This report highlights the challenges in reachingthe diagnosis of an aggressive systemic lymphoma presenting on the skin.
          Cover page: Anaplastic large cell lymphoma localized to the left breast years after radiotherapy for breast cancerCreative Commons 'BY-NC-ND' version 4.0 license
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2001)
          Systemic anaplastic large-cell lymphoma is an uncommon type of non-Hodgkin lymphoma characterized by strong expression of the Ki-1 (CD30) antigen. Gastrointestinal involvement typically is less common than in other types of non-Hodgkin's lymphoma. We report a case of CD30-positive anaplastic large-cell lymphoma occurring at the site of colonic anastomosis in an elderly patient who had been treated for colonic adenocarcinoma by right hemicolectomy 10 years previously. The lymphoma was a 2-cm mass composed of large, atypical cells infiltrating the mucosa, submucosa, and muscularis propria. Immunoperoxidase stain was strongly positive for Ki-1, and negative for LeuM1, L26, UCHL1, EMA, and cytokeratin. There have been numerous reports of unusual extranodal presentations of systemic anaplastic large-cell lymphoma; the only previously reported case involving the colon, however, occurred in the context of ulcerative colitis. Anastomotic recurrence is a relatively common complication of surgical therapy for adenocarcinoma, but the recurrent tumors are invariably adenocarcinomas. We are aware of no cases of lymphoma of any type occurring at the site of anastomosis after resection for adenocarcinoma.
            Cover page: Ki-1 anaplastic large-cell lymphoma occurring at the site of ileocolonic anastomosis in a patient treated surgically for colonic adenocarcinoma: Case report and review of the literature
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2022)
            Anaplastic large cell lymphomas (ALCL) are mature T-cell neoplasms, approximately half of which harbor rearrangements of the ALK gene that confer a good prognosis. Recent studies have demonstrated that a significant proportion of ALK-negative ALCLs demonstrate rearrangements of the IRF4/DUSP22 locus that also are typically associated with a favorable prognosis. ALCL with primary involvement of the central nervous system (CNS) is extremely rare. We report what may be the first case of ALK-negative ALCL with IRF4/DUSP22 rearrangement involving the brain in a 55-year-old man. Magnetic resonance imaging demonstrated signal abnormalities in the periventricular region, corpus callosum and cingulate gyrus. Biopsy revealed a diffuse parenchymal and angiocentric infiltrate of CD30-positive cells that showed IRF4/DUSP22 rearrangement by fluorescence in situ hybridization. We also review the clinical and pathologic features of primary CNS ALK-negative ALCLs in the literature and highlight the need for awareness of this entity to optimize appropriate management.
              Cover page: Central nervous system ALK-negative anaplastic large cell lymphoma with IRF4/DUSP22 rearrangement.
              • Article
              • Peer Reviewed
              Dermatology Online Journal, Volume 22, Issue 12 (2016)
              Anaplastic large-cell lymphomas (ALCLs) are agroup of CD30-positive non-Hodgkin lymphomasthat are linked by common morphologic andimmunophenotypic features but have varyingclinical and genetic characteristics. The World HealthOrganization classification currently recognizes threesubtypes of ALCL: systemic anaplastic lymphomakinase-positive ALCL, systemic anaplastic lymphomakinase-negative (ALK-) ALCL, and primary cutaneousALCL. Here we present a 42-year-old man with ahistory of systemic ALK- ALCL, who was in remissionfor six months before relapsing with skin-limitedanaplastic large-cell lymphoma.
                Cover page: Skin-limited relapse of systemic anaplastic large-cell lymphomaCreative Commons 'BY-NC-ND' version 4.0 license
                • Article
                • Peer Reviewed
                UCLA Radiological Sciences Proceedings, Volume 3, Issue 4 (2023)

                We report a case of primary pulmonary anaplastic lymphoma kinase-positive anaplastic large cell lymphoma in a 38-year-old woman with a smoking and vaping history. The patient presented with hypoxemia and a history of shortness of breath, cough, and intermittent fevers. Initial imaging and pleural fluid studies suggested possible empyema. Despite being given antibiotics, her respiratory status continued to deteriorate and she was put on extracorporeal membrane oxygenation. Repeat imaging showed increased size of intrathoracic lymph nodes and perilymphatic pulmonary nodules. IV steroids were initiated after bronchoalveolar lavage revealed lipophages suggestive of e-cigarette, or vaping, product use-associated lung injury. A laboratory workup revealed no signs of rheumatologic disease, and negative cultures ruled out a bacterial or fungal cause of the disease. Because of these laboratory results and because the patient did not show clinical signs of improvement, a biopsy of the left lower lobe lymph node was performed. The patient was diagnosed with anaplastic lymphoma kinase-positive anaplastic large cell lymphoma based on the results of the biopsy. This case highlights the importance of suspecting pulmonary lymphoma in patients with a history of B-symptoms and compatible imaging findings, despite its rarity.

                  Cover page: Primary Pulmonary Anaplastic Large Cell Lymphoma Presenting as Progressive Respiratory Failure in a 38-Year-Old Woman: A Case Report of a Rare EntityCreative Commons 'BY' version 4.0 license
                  • Article
                  • Peer Reviewed
                  Dermatology Online Journal, Volume 27, Issue 12 (2021)
                  Extranodal NK/T-cell lymphoma (NKTCL) is a rarely occurring non-Hodgkin lymphoma with predilection for the nasal cavity. Cutaneous involvement, rarely occurring and often aggressive in behavior, may present as nodular mass-forming lesions with or without ulceration. Histologically, lesions are characterized by an atypical dermal lymphoid infiltrate with angioinvasion and associated necrosis. Fortuitously, Epstein-Barr virus (EBV) infection, implicated in the pathogenesis of this entity, serves as a useful diagnostic marker (i.e. EBER in situ hybridization). We present a 54-year-old-man who initially presented with two ulcerations on the right lower leg which progressed despite antibiotic therapy. Histologic examination demonstrated dense lymphoid infiltrates exhibiting epidermotropism, angiocentricity and angioinvasion extending into the deep dermis. Immunohistochemical staining demonstrated expression of CD2, CD3, CD8, TIA-1, perforin, and granzyme-B, consistent with a cytotoxic T-cell phenotype. Additionally, CD56 was positive, confirming the presence of a coexistent NK cell phenotype. Testing also demonstrated significant CD30 expression, and molecular analysis was positive for TCR gene rearrangement. These findings, in conjunction with EBER in situ hybridization positivity, confirmed a diagnosis of extranodal NKTCL. We aim to increase awareness of this rarely occurring lymphoma with cutaneous involvement. CD30 expression in NKTCL raises the possibility of targeted treatment with brentuximab.
                    Cover page: Extranodal NK/T-cell lymphoma primarily presenting as two adjacent slowly growing skin nodules with prominent epidermotropism and CD30 expression, a case report and review of literatureCreative Commons 'BY-NC-ND' version 4.0 license
                    • Article
                    • Peer Reviewed
                    UCLA Previously Published Works (2016)
                    Systemic anaplastic large cell lymphomas (ALCLs) are classified into ALK-positive and ALK-negative types. We recently reported that ALK-negative ALCLs are genetically heterogenous. The largest subset, representing 30% of cases, had rearrangements of the DUSP22 locus. These cases had favorable outcomes similar to ALK-positive ALCL, and superior to other ALK-negative ALCLs. Here, we examined the morphologic features of these cases in more detail. First, we conducted blinded review of hematoxylin and eosin slides of 108 ALCLs from our previous study, scoring cases for the presence of 3 histologic patterns and 5 cell types. Cases then were unblinded and re-reviewed to understand these features further. DUSP22-rearranged ALCLs were more likely than other ALK-negative ALCLs to have so-called doughnut cells (23% vs. 5%; P=0.039), less likely to have pleomorphic cells (23% vs. 49%; P=0.042), and nearly always (95%) had areas with sheet-like growth (common pattern). To examine the reproducibility of these findings, we conducted blinded review of hematoxylin and eosin slides of 46 additional ALK-negative ALCLs using a 0 to 3 scoring system to predict likelihood of DUSP22 rearrangement, the results of which correlated strongly with subsequent findings by fluorescence in situ hybridization (P<0.0001). Although all ALCLs share certain morphologic features, ALCLs with DUSP22 rearrangements show significant differences from other ALK-negative ALCLs, typically showing sheets of hallmark cells with doughnut cells and few large pleomorphic cells. These morphologic findings and our previous outcome data suggest that ALK-positive ALCLs and DUSP22-rearranged ALCLs represent prototypical ALCLs, whereas ALCLs lacking rearrangements of both DUSP22 and ALK require further study.
                      Cover page: Morphologic Features of ALK-negative Anaplastic Large Cell Lymphomas With DUSP22 Rearrangements
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