Lymphomatoid Granulomatosis Induced by Imatinib-Treatment

Yazdi, Amir S.

doi:10.1001/archderm.143.9.1222

Cited by 17 publications

(5 citation statements)

References 6 publications

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“…More uncommon clinical presentations include plaque-like and lichen sclerosus-like lesions (15% and 10% of cases, respectively) 85 . Some cases of LyG have been reported in association with azathioprine, imatinib and methotrexate (the latter could be included under the realm of MTX-LPD) 182–185 . The clinical course is variable, with some cases showing spontaneous self-resolution, while others progressing to DLBCL 186,187 .…”

Section: Lymphomatoid Granulomatosis (Lyg)mentioning

confidence: 99%

Cutaneous EBV-related lymphoproliferative disorders

Gru

Jaffe

2017

Seminars in Diagnostic Pathology

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This article will focus on the cutaneous lymphoproliferative disorders associated with EBV, with an emphasis on the upcoming changes in the revised 4th Edition of the WHO classification of tumors of the hematopoietic system, many of which deal with cutaneous disorders derived from NK-cells or T-cells. Extranodal NK/T-cell lymphoma usually presents in the upper aerodigestive tract, but can involve the skin secondarily. EBV-associated T- and NK-cell lymphoproliferative disorders (LPD) in the pediatric age group include the systemic diseases, chronic active EBV infection (CAEBV) and systemic EBV+ T-cell lymphoma of childhood. Hydroa vacciniforme (HV)-like LPD is a primarily cutaneous form of CAEBV and encompasses the lesions previously referred to as HV and HV-like lymphoma (HVLL). All the T/NK-cell-EBV-associated diseases occur with higher frequency in Asians, and indigenous populations from Central and South America and Mexico. Among the B-cell EBV-associated LPD two major changes have been introduced in the WHO. The previously designated EBV-positive diffuse large B-cell lymphoma (EBV-DLBCL) of the elderly, has been changed to EBV-DLBCL with 'not otherwise specified' as a modifier (NOS). A new addition to the WHO system is the more recently identified EBV+ mucocutaneous ulcer, which involves skin and mucosal-associated sites.

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Section: Lymphomatoid Granulomatosis (Lyg)mentioning

confidence: 99%

Cutaneous EBV-related lymphoproliferative disorders

Gru

Jaffe

2017

Seminars in Diagnostic Pathology

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“…We did not find any neutrophilic dermatosis, neither any severe drug eruption, and only one of our patients complained of skin fragility in the dorsum of the hands, but no blisters, milia or other signs suggesting porphyria tarda, an entity that has been previously described associated to imatinib, 27 were seen in this series of patients. Some benign and malignant neoplasms have been reported in association with imatinib therapy, 11,28,29 but we have found some nonpreviously described lesions, such as multiple eruptive dermatofibromas (MEDF) and spindle cell lipoma of the oral mucosa. On this regard, we have postulated that the onset of MEDF in these patients should raise the possibility of immunosuppression or treatment failure 20 and the development of a spindle cell lipoma on the oral mucosa supports the idea that this lipoma is not testosterone‐dependent.…”

Section: Discussionmentioning

confidence: 80%

Cutaneous side effects in a cohort of patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: General description and further characterization, correlation with photoexposition and study of hypopigmentation as treatment's prognostic factor

Llamas‐Velasco

Ovejero-Merino²,

García‐Diez

et al. 2020

Dermatologic Therapy

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Cutaneous adverse effects (AE) related to tyrosine-kinase inhibitor (TKI) drugs have been mainly described as case reports. We have characterized their appearance and correlation with patient's photoexposition habits and, further, with treatment response, in 61 patients with chronic myelogenous leukemia (CML) treated with TKI drugs. We have found hypopigmentation in 49.2% of the cases and a statistically significant association with interferon (IFN) intake. Eyelid edema's frequency was 45.4%. Mean photo-exposure was 1.95 h/day and only 8.3% of the patients used sunscreen daily. 44.3% of the patients reported a lighter skin color with the treatment and a statistically significant relationship with conjunctival hemorrhage was also found. Concordance between patients and dermatologist was moderate (kappa index 0.41). We found xerosis (21.3%), eczematous eruptions (21.3%), melasma (4.9%) and other isolated skin problems (ie, granulomatous panniculitis) in up to 16.4% of cases. Appearance of hypopigmented macules is associated to vascular conjunctival fragility and these patients need a slightly longer time to reach a complete molecular response, but without additional changes in survival or relapse frequency. We have stablished a specific dermatologic diagnosis in all the cases and we have not found the previously published as maculopapular rashes. Hypopigmentation, the more frequent AE, was not perceived as a relevant side effect. Photosensitivity, in our cases, was not reported, although imatinib-treated patients avoided sun-exposure. In addition, we identified some nonpreviously described dermatologic conditions in patients taking TKI drugs, like granulomatous panniculitis tufted folliculitis or oral spindle cell lipoma.

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“…Salmons et al (8). and Yazdi et al (9). have presented case reports describing LYG following imatinib administration.…”

Section: Discussionmentioning

confidence: 99%

Case report: Simultaneous occurrence of primary pulmonary lymphoma and opportunistic infections in a patient with chronic myeloid leukemia

Bi¹,

Feng²,

Shang³

et al. 2022

Front. Oncol.

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BackgroundThe occurrence of primary pulmonary lymphoma (PPL) as a secondary malignancy in patients diagnosed with chronic myeloid leukemia (CML) is extremely rare. As the clinical manifestations are atypical, most patients with PPL tend to be misdiagnosed with pneumonia. When the radiographic features of PPL and pulmonary infection overlap, clinicians can be confused about the diagnosis. Here, we report the first case of coexistence of PPL and opportunistic infections in a patient with CML in chronic phase (CML-CP).Case presentationA 55-year-old woman presented with three weeks of hemorrhage of the oral mucosa at the Department of Hematology. After undergoing various examinations, she was diagnosed with CML-CP and was started on imatinib (400 mg/daily). Due to sudden respiratory distress, the patient was admitted to the respiratory intensive care unit 11 months later. Chest computed tomography (CT) revealed ground-glass opacities, patchy shadows, and multiple nodules in both lungs and enlarged mediastinal lymph nodes. The combination of biapenem and voriconazole antibiotic treatments was effective. The patient’s respiratory distress was relieved, but there was intermittent coughing. In the following time, the patient developed a fever, and the imaging findings indicated progression of the disease in both lungs. Bronchoalveolar lavage (BAL) identified pathogens of multiple opportunistic infections. The coexistence of lymphomatoid granulomatosis (LYG) was not confirmed in this patient until a second CT-guided biopsy was performed. Ultimately, the patient underwent chemotherapy in time and is currently alive today.ConclusionsWhen the patient’s recurrent respiratory symptoms and imaging findings do not coincide, secondary tumors should be considered in addition to infection as a diagnosis. In these cases, multiple pathological tissue biopsies should be performed.

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Lymphomatoid Granulomatosis Induced by Imatinib-Treatment

Cited by 17 publications

References 6 publications

Cutaneous EBV-related lymphoproliferative disorders

Cutaneous EBV-related lymphoproliferative disorders

Cutaneous side effects in a cohort of patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors: General description and further characterization, correlation with photoexposition and study of hypopigmentation as treatment's prognostic factor

Case report: Simultaneous occurrence of primary pulmonary lymphoma and opportunistic infections in a patient with chronic myeloid leukemia

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