BACKGROUND Subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) is an uncommon type of skin lymphoma. The natural history, optimal treatment strategy, and prognostic factors associated with this malignancy are not well defined. METHODS The authors performed a systematic analysis of all patients with SPTCL reported on in the English‐language medical literature, with emphasis on specific clinical features, experiences involving the use of radiotherapy and systemic agents, and prognostic factors predictive of treatment response and clinical outcome. RESULTS One hundred fifty‐six patients with SPTCL were identified in the literature. Hemophagocytic syndrome (HPS) was a presenting feature in 37% of patients, and > 90% of patients required treatment at diagnosis. Prednisone was used frequently as initial therapy in patients who had less aggressive disease at presentation; however, durable complete remissions (CR) were infrequent. Anthracycline‐based chemotherapy regimens were the most commonly used and most effective systemic treatment options, producing long‐term CR in ∼30% of patients. Among patients who received high‐dose chemotherapy and stem cell transplantation (HDT‐SCT) for refractory or recurrent disease, 92% achieved CR, with a median response duration of ≥ 14 months. The presence of HPS at diagnosis and expression of the γ/δ T‐cell receptor (TCR) by tumor cells were associated with poor survival, whereas age was not. After a median follow‐up of 24 months, 48% of patients died of disease. The median survival duration was 27 months. CONCLUSIONS SPTCL has an aggressive natural history. Nonetheless, a subgroup of patients with SPTCL can have long‐term disease remission following anthracycline‐based initial therapy or subsequent HDT‐SCT. HPS and the TCR phenotype may be useful prognostic markers for patients with this malignancy. Cancer 2004. © 2004 American Cancer Society.

Tumoral pseudoangiomatous stromal hyperplasia (PASH) is a rare benign proliferative disease of the breast. The majority of the literature reports of PASH have not contained detailed descriptions of the imaging characteristics of PASH. A 10-year retrospective study of patients with tumoral PASH and a 20-year Ovid MEDLINE® search were performed to determine whether specific imaging and needle biopsy results could characterize PASH preoperatively. We identified 22 patients with tumoral PASH. Seventeen (77%) of 22 women had a palpable lump and 14 (72%) of 21 had a density on mammography. Ultrasound (US) findings included mixed or hypoechoic echogenicity in 83 per cent and ill-defined borders in 62 per cent. Eight (36%) patients had lesions with a Breast Imaging Reporting and Data System (BI-RADS®) classification of 4 or 5. The sensitivity of preoperative core needle biopsy (CNB) to identify PASH was 83 per cent. A review of the literature revealed that 90 per cent of patients with PASH had some malignant imaging characteristics and 95 per cent had a mass on mammography. The imaging characteristics of PASH exhibited marked variability. Excision of PASH after CNB may be considered for patients with symptoms, enlarging lesions, or lesions classified as BI-RADS® 4 or 5. PASH diagnosed by CNB allows selected patients to avoid excision.

Fine-needle aspiration biopsy is a safe and accurate method for diagnosing thyroid nodules. Personnel who have experience with the aspiration technique and with the cytologic classification of specimens are crucial to accurate results. One important advantage of using fine-needle biopsy to initially screen patients with nodules is that it can save substantially on healthcare resources.

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