BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin ...BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin infiltration,reporting a wide range of clinical presentations that frequently include ulcers;plaques,nodules and papules have also been noticed.CASE SUMMARY We report the case of a 56-year-old man who presented fever,multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions.After an initial diagnostic workup for a suspected active infectious disease,a lymph node biopsy was performed,which showed a neoplastic invasion from a mixed cellularity classical HL.The same histological pattern was described in a cutaneous biopsy of the chest lesions.The other staging procedures performed revealed an advanced disease,with unfavourable clinical prognostic features.The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin,bleomycin,vinblastine,dacarbazine),a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.CONCLUSION Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.展开更多
Extranodal NK/T-cell lymphoma, nasal type (ENKL), is an uncommon subtype of EBV associated lymphoma usually characterized by aggressive clinical course. We report an atypical sinonasal ENKL case with long-lasting indo...Extranodal NK/T-cell lymphoma, nasal type (ENKL), is an uncommon subtype of EBV associated lymphoma usually characterized by aggressive clinical course. We report an atypical sinonasal ENKL case with long-lasting indolent behaviour, developed in the setting of a polymorphic EBV-associated lymphoproliferative disorder (LPD). A 52-year-old woman had suffered from chronic sinusitis and nasal obstruction since 2000, moderately worsened during the last years (marked enlargement of the sino-nasal mucosa at MRI in 2011) with elevated anti-VCA IgG and IgM titers. Three subsequent biopsies revealed slightly increasing morphophenotypic atypia, ranging from a polymorphic B- and T-cell EBV positive proliferation (diagnosed in 2011, but not fulfilling CAEBV diagnostic criteria) to an overt monomorphic mildly atypical T LPD without necrosis and angiocentricty diagnosed as ENKL in 2013 upon immunophenotype and TCR-γ gene clonal rearrangement. Clinically indolent ENKL with low-grade morphology is extremely rare and diagnostically challenging;while the few reports in the literature describe long-survival in ENKL treated patients comparing histologically neoplastic lesions at onset and recurrences, no reports are published on the slow progression from a polymorphic EBV-related T/NK proliferation to a histologically overt clinically indolent ENKL in an untreated patient who only received occasional steroid administration.展开更多
We really appreciated Lin et al.’s“The influence of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography on the N-and M-staging and subsequent clinical management of intrahepatic cholangiocarci...We really appreciated Lin et al.’s“The influence of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography on the N-and M-staging and subsequent clinical management of intrahepatic cholangiocarcinoma”in HepatoBiliary Surgery and Nutrition(1).A 291-patient population affected by intrahepatic cholangiocarcinoma(ICC)was retrospectively analyzed with the aim of assessing the accuracy of preoperative staging and treatment reallocation by ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)(1).展开更多
We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both pap...We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both papers have been recently published in HepatoBiliary Surgery and Nutrition, 2019 (1,2). Starting from an analysis of the recent paper by Horkoff et al. "Adverse outcomes after bile spillage in incidental gall bladder cancer " in Annals of Surgery April 2019, they introduced a comprehensive discussion about epidemiology, diagnosis, therapy, prognostic factors and outcomes of incidental gallbladder cancer (1-3). They analyzed the possible risks related to bile spillage after cholecystectomy, in particular (1,2).展开更多
We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature...We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature reviews on indications and patient selection, surgical instruments, techniques, and outcomes of laparoscopic liver resections (LLRs) (1,2). Papers mentioned final statements by 2008 Louisville Statement and 2014 Morioka Consensus Conference (1,2). They stressed LLR non-inferiority to open procedures, in both minor and major liver resections as far as oncological and intraoperative/perioperative outcomes are concerned: reduced blood loss, lower postoperative morbidity and shorter length of hospitalization (1,2). Such results were corroborated by recent meta-analyses (3,4). Furthermore, some previous limitations for LLR look like they have been recently overcome (1-5). For example, tumor size, patient's old age and high BMI are no longer limitations for LLR, as Southampton Consensus guidelines suggested (5). Likewise, cirrhosis has been suggested as a further indication of LLR in highly selected patients with hepatocellular carcinoma and where it was performed by experienced surgeons (1-5).展开更多
文摘BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin infiltration,reporting a wide range of clinical presentations that frequently include ulcers;plaques,nodules and papules have also been noticed.CASE SUMMARY We report the case of a 56-year-old man who presented fever,multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions.After an initial diagnostic workup for a suspected active infectious disease,a lymph node biopsy was performed,which showed a neoplastic invasion from a mixed cellularity classical HL.The same histological pattern was described in a cutaneous biopsy of the chest lesions.The other staging procedures performed revealed an advanced disease,with unfavourable clinical prognostic features.The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin,bleomycin,vinblastine,dacarbazine),a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.CONCLUSION Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.
文摘Extranodal NK/T-cell lymphoma, nasal type (ENKL), is an uncommon subtype of EBV associated lymphoma usually characterized by aggressive clinical course. We report an atypical sinonasal ENKL case with long-lasting indolent behaviour, developed in the setting of a polymorphic EBV-associated lymphoproliferative disorder (LPD). A 52-year-old woman had suffered from chronic sinusitis and nasal obstruction since 2000, moderately worsened during the last years (marked enlargement of the sino-nasal mucosa at MRI in 2011) with elevated anti-VCA IgG and IgM titers. Three subsequent biopsies revealed slightly increasing morphophenotypic atypia, ranging from a polymorphic B- and T-cell EBV positive proliferation (diagnosed in 2011, but not fulfilling CAEBV diagnostic criteria) to an overt monomorphic mildly atypical T LPD without necrosis and angiocentricty diagnosed as ENKL in 2013 upon immunophenotype and TCR-γ gene clonal rearrangement. Clinically indolent ENKL with low-grade morphology is extremely rare and diagnostically challenging;while the few reports in the literature describe long-survival in ENKL treated patients comparing histologically neoplastic lesions at onset and recurrences, no reports are published on the slow progression from a polymorphic EBV-related T/NK proliferation to a histologically overt clinically indolent ENKL in an untreated patient who only received occasional steroid administration.
基金supported by Italian Ministry of Health-Ricerca Corrente Annual Program 2023.
文摘We really appreciated Lin et al.’s“The influence of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography on the N-and M-staging and subsequent clinical management of intrahepatic cholangiocarcinoma”in HepatoBiliary Surgery and Nutrition(1).A 291-patient population affected by intrahepatic cholangiocarcinoma(ICC)was retrospectively analyzed with the aim of assessing the accuracy of preoperative staging and treatment reallocation by ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)(1).
文摘We really appreciated Geramizadeh, " Bile spillage and incidental gall bladder adenocarcinoma ", and Sandstrom et al. ,"Bile spillage should be avoided in elective cholecystectomy " (1,2). Both papers have been recently published in HepatoBiliary Surgery and Nutrition, 2019 (1,2). Starting from an analysis of the recent paper by Horkoff et al. "Adverse outcomes after bile spillage in incidental gall bladder cancer " in Annals of Surgery April 2019, they introduced a comprehensive discussion about epidemiology, diagnosis, therapy, prognostic factors and outcomes of incidental gallbladder cancer (1-3). They analyzed the possible risks related to bile spillage after cholecystectomy, in particular (1,2).
基金We thank Dr. Daniela Masi (AUSL-IRCCS di Reggio Emilia) for support in English editing.
文摘We read with pleasure papers by Cai et al. and Jia et al. published in HepatoBiliary Surgery and Nutrition, 2018, Volume 7, Issue 2 and 4, respectively (1,2). Both papers introduced comprehensive up-to-date literature reviews on indications and patient selection, surgical instruments, techniques, and outcomes of laparoscopic liver resections (LLRs) (1,2). Papers mentioned final statements by 2008 Louisville Statement and 2014 Morioka Consensus Conference (1,2). They stressed LLR non-inferiority to open procedures, in both minor and major liver resections as far as oncological and intraoperative/perioperative outcomes are concerned: reduced blood loss, lower postoperative morbidity and shorter length of hospitalization (1,2). Such results were corroborated by recent meta-analyses (3,4). Furthermore, some previous limitations for LLR look like they have been recently overcome (1-5). For example, tumor size, patient's old age and high BMI are no longer limitations for LLR, as Southampton Consensus guidelines suggested (5). Likewise, cirrhosis has been suggested as a further indication of LLR in highly selected patients with hepatocellular carcinoma and where it was performed by experienced surgeons (1-5).
