Erythema multiforme‐like cutaneous lesions in monomorphic epitheliotropic intestinal T‐cell lymphoma: a rare case report

Aiempanakit, Kumpol; Amatawet, Chitiarpa; Chiratikarnwong, Kanokphorn; Auepemkiate, Sauvarat; Kayasut, Kanita; Suwiwat, Supaporn; Apinantriyo, Benjawan

doi:10.1111/cup.12864

Cited by 12 publications

(11 citation statements)

References 23 publications

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“…Treatment regimens mainly consisted of various chemotherapy regimens with 33% of patients receiving stem cell transplants. Unfortunately, survival after diagnosis was poor and ranged from 5 d to 3 yr despite therapy (Table 1) [9][10][11][12][13][14] .…”

Section: Discussionmentioning

confidence: 99%

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Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

Fisher¹,

Yousif²,

Piper³

2019

WJGE

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BACKGROUND Enteropathy associated T-cell lymphoma (EATL) is a rare form of peripheral T-cell lymphoma and makes up less than 5% of gastrointestinal lymphomas. EATL can be divided into type 1 which is associated with celiac disease, and monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), formally type 2, which is not associated with celiac disease. CASE SUMMARY We present a 60-year-old African American female, without celiac disease, who presented with abdominal pain, diarrhea, and 30 lb. weight loss over a 3 month period. She was subsequently diagnosed with EATL throughout her entire gastrointestinal tract. She is currently undergoing chemotherapy with EOCH (Etoposide, Oncovin, Cyclophosphamide, and Hydroxydaunorubicin). EATL is most common in the Asian and Hispanic population yet the incidence in African Americans is uncertain and emphasizes the rarity of this case. A literature review was included to further emphasize similarities and differences between our case and previously reported cases of MEITL. CONCLUSION The patient was diagnosed with EATL, immunochemical testing was not conclusive for MEITL however was suggestive of the disease.

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Section: Discussionmentioning

confidence: 99%

“…Chen et al [9] 2016, Singapore Aiempanakit et al [11] 2017, Thialand 67 y/o, Male Chronic diarrhea and weight loss…”

Section: History Of Celiac Disease? Treatment Prognosis After Diagnosismentioning

confidence: 99%

Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

Fisher¹,

Yousif²,

Piper³

2019

WJGE

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“…For differential diagnosis, cutaneous lymphomas [ 14 ], atypical pityriasis rosea [ 15 ], bullous pemphigoid [ 16 ], and lupus erythematosus [ 17 ] must be considered. Histopathology and immune serology allow differentiation.…”

Section: Discussionmentioning

confidence: 99%

Segmental Erythema Multiforme-Like Drug Eruption by Aromatase Inhibitor Anastrozole – First Case Report and another Example of an Immunocompromised District

Wollina¹,

Schönlebe²,

Heinig³

et al. 2018

Open Access Maced J Med Sci

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Anastrozole is a non-selective aromatase inhibitor for adjuvant breast cancer therapy in postmenopausal women. Cutaneous adverse events have been reported. We observed a 64-year-old female patient with a medical history of locally advanced breast cancer of her right breast that was treated with radiotherapy and adjuvant drug therapy with anastrozole. She developed a segmental bullous eruption limited to the cancer-affected breast. Cessation of the aromatase inhibitor and systemic therapy with prednisolone cleared the lesions completely. This is the first report of a segmental erythema multiforme like drug eruption by anastrozole and another example of the concept of the immunocompromised district of skin.

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“…Although the immunophenotypic study of this case did not include any cytotoxic markers, it might well represent a further example of pCAECD8+ CTCL presenting with EM‐like lesions. Interestingly, a wider PubMed search also revealed that EM‐like cutaneous lesions may be a clinical presenting feature of other T‐cell malignancies, such as aggressive mature T‐cell and NK/T‐cell lymphoma, adult T‐cell lymphoma/leukemia, refractory celiac disease, extra‐nodal NK/T‐cell lymphoma and monomorphic epitheliotropic intestinal T‐cell lymphoma, reflecting the functional attributes of the neoplastic lymphocytes that can recapitulate, at least in part, the clinical aspects of some cytotoxic, CD8+ T‐cell mediated, reactive skin disorders …”

Section: Discussionmentioning

confidence: 99%

“…15,19 Our case had CD2−/CD7+ CD15+ and a partially double CD4/CD8 negative phenotype, reinforcing the previous observations. 24 reflecting the functional attributes of the neoplastic lymphocytes that can recapitulate, at least in part, the clinical aspects of some cytotoxic, CD8+ T-cell mediated, reactive skin disorders. [25][26][27] An accurate and timely diagnosis of pCAE-CD8+ CTCL is crucial, as aggressive treatment strategies, such as multiagent chemotherapy and allogeneic stem-cell transplantation in selected cases might be considered and discussed at an early stage of the disease.…”

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confidence: 99%

Erythema multiforme‐like lesions in primary cutaneous aggressive cytotoxic epidermotropic CD8+ T‐cell lymphoma: A diagnostic and therapeutic challenge

et al. 2017

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Primary cutaneous aggressive cytotoxic epidermotropic CD8+ T-cell lymphoma is an extremely rare, rapidly progressing, cutaneous lymphoma, with frequent systemic involvement and poor prognosis, that still represents a diagnostic and therapeutic challenge, especially in the early stage. Herein, we report a case of an elderly woman with a fulminant course, who at onset presented with clinical and pathological features mimicking erythema multiforme (EM) and treated with cyclosporine that led to rapid deterioration with fatal outcome 6 months after disease onset. Histopathology showed a lichenoid, epidermotropic and nodular, angiocentric, dermal and subcutaneous infiltrate of sF1, CD8+, CD45RA+ small to medium-sized atypical lymphoid cells, which strongly expressed cytotoxic markers. Monoclonal T-cell-γ receptor was clonally rearranged and array-CGH showed numerous chromosomal imbalances. This case evidences the clinical, pathological and therapeutic challenges involved in this tumor. The first biopsy showed an interface dermatitis-like pattern, revealing the deceptive features that early cutaneous infiltrates of this aggressive lymphoma may have. A high suspicion for aggressive CTCL and a low threshold for repeat biopsies should be maintained when faced with rapidly progressing and/or ulcerative EM-like lesions, especially if immunomodulatory therapy is being considered.

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Erythema multiforme‐like cutaneous lesions in monomorphic epitheliotropic intestinal T‐cell lymphoma: a rare case report

Cited by 12 publications

References 23 publications

Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

Truth lies below: A case report and literature review of typical appearing polyps yet with an atypical diagnosis

Segmental Erythema Multiforme-Like Drug Eruption by Aromatase Inhibitor Anastrozole – First Case Report and another Example of an Immunocompromised District

Erythema multiforme‐like lesions in primary cutaneous aggressive cytotoxic epidermotropic CD8+ T‐cell lymphoma: A diagnostic and therapeutic challenge

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