Primary Cutaneous CD4+ Small/Medium Pleomorphic T-Cell Lymphoproliferative Disorder: A Case Series

Background: Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (CD4+ PCSM-LPD) is defined by a predominance of small- to medium-sized CD4+ pleomorphic T cells and a favorable clinical course. Objective: We performed a retrospective analysis of 6 patients with CD4+ PCSM-LPD and reviewed the literature to address questions about its diagnosis, treatment, and prognosis. Methods: Patients were 3 men and 3 women with a median age of 50 years. All patients presented with a single erythematous nodule, localised on the head in 4 patients and the upper trunk in 2 cases. No patients showed extracutaneous disease at any evaluation. Histopathologic features were characterised by nodular, diffuse, or, in 1 case, a superficial dense infiltrate of small/medium-sized pleomorphic CD4+/PD1+ T lymphocytes. T-cell receptor clonality was demonstrated in 5 cases. Treatment was surgical excision in 5 cases and radiotherapy in 1 case. Results: All patients achieved complete resolution without relapses, during a median follow-up of 3 years. A review of the literature confirmed that CD4+ PCSM-LPD presents predominantly with a solitary nodular lesion on the face, neck, or upper trunk in adult patients. Surgical excision is the preferred treatment. Spontaneous resolution after biopsy may occur. Conclusions: CD4+ PCSM-LPD is a rare disorder with a favorable course.

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Primary cutaneous CD4+ small/medium T-cell lymphoma: a case report

Archives of Craniofacial Surgery ◽

10.7181/acfs.2021.00199 ◽

2021 ◽

Vol 22 (4) ◽

pp. 199-203

Author(s):

Jeenam Kim ◽

Minkyoung Jeong ◽

Dongkeun Jun ◽

Myungchul Lee ◽

Donghyeok Shin ◽

...

Keyword(s):

Case Report ◽

T Cell ◽

Lymphoproliferative Disorder ◽

Cell Lymphoma ◽

Surgical Excision ◽

Lymphoid Cells ◽

The Face ◽

Single Mass ◽

Histopathologic Findings

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.

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Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder: Case series at the Semmelweis University, Department of Dermatology, Venereology and Dermatooncology and review of the literature

Bőrgyógyászati és Venerológiai Szemle ◽

10.7188/bvsz.2020.96.5.6 ◽

2020 ◽

Vol 96 (5) ◽

pp. 247-256

Author(s):

Tünde Zsuzsanna Kerner ◽

◽

József Szakonyi ◽

Judit Csomor ◽

Ágota Szepesi ◽

...

Keyword(s):

T Cell ◽

Lymphoproliferative Disorder ◽

Gene Rearrangement ◽

Receptor Gene ◽

Case Series ◽

Cell Receptor ◽

Good Prognosis ◽

Solitary Lesion ◽

University Department ◽

T Cell Receptor Gene

In the updated 2018 WHO-EORTC classification, the name of the disease was changed to primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder instead of the former primary cutaneous CD4+ small/medium T-cell lymphoma, because of its indolent behaviour and uncertain malignant potential. The authors present five cases of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder, through which they show the various clinical appearances, and the histological features of the disease, and review the literature. The authors point out that the disease, except for a few cases, presented with a solitary lesion, has a particularly good prognosis, remains localized and shows a tendency to regress despite the monoclonal T-cell receptor gene rearrangement.

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Failed Latarjet procedure: a systematic review of surgery revision options

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00587-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Matteo Buda ◽

Riccardo D’Ambrosi ◽

Enrico Bellato ◽

Davide Blonna ◽

Alessandro Cappellari ◽

...

Keyword(s):

Systematic Review ◽

Case Series ◽

Review Of The Literature ◽

Inclusion Criteria ◽

Latarjet Procedure ◽

Shoulder Stabilization ◽

Recurrent Instability ◽

Level Of Evidence ◽

Radiographic Outcomes

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/

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Sinus Floor Augmentation—Associated Surgical Ciliated Cysts: Case Series and a Systematic Review of the Literature

Applied Sciences ◽

10.3390/app11041903 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1903

Author(s):

Adrian Kahn ◽

Shlomo Matalon ◽

Rahaf Bassam Salem ◽

Lazar Kats ◽

Liat Chaushu ◽

...

Keyword(s):

Systematic Review ◽

Microscopic Examination ◽

Literature Search ◽

Case Series ◽

Systematic Literature Search ◽

Review Of The Literature ◽

Inclusion Criteria ◽

Sinus Floor Augmentation ◽

Sinus Floor

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.

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Malignant thyroid teratoma: an integrated analysis of case series and case reports

Endocrine Related Cancer ◽

10.1530/erc-21-0142 ◽

2021 ◽

Author(s):

Huy Gia Vuong ◽

Truong P.x. Nguyen ◽

Hanh T.t. Ngo ◽

Lewis Hassell ◽

Kennichi Kakudo

Keyword(s):

Clinical Course ◽

Case Reports ◽

Case Series ◽

Seer Program ◽

Integrated Analysis ◽

Continuous Variables ◽

Chi Square ◽

Large Tumor ◽

Exact Test

Malignant thyroid teratoma (MTT) is a very rare thyroid malignancy. These neoplasms have been reported only in case reports and small-sized case series so far. In this study, we searched for MTTs in the Surveillance, Epidemiology, and End Result (SEER) program during 1975-2016. Subsequently, we incorporated the SEER data with published MTT cases in the literature to analyze the characteristics and prognostic factors of MTTs. Integrated data were analyzed using Chi-square or Fisher’s exact test for categorical covariates, and t-test or Mann-Whitney test for continuous variables. We included 28 studies with 36 MTT cases and found additional 8 cases from the SEER program for final analyses. Our results showed that MTT is typically seen in adult females. These neoplasms were associated with an aggressive clinical course with high rates of extrathyroidal extension (80%) and nodal involvement (62%). During follow-up, the development of recurrence and metastases were common (42% and 46%, respectively), and one-third of patients died at the last follow-up. Large tumor size (p = 0.022) and the presence of metastases during follow-up (p = 0.008) were associated with a higher mortality rate. In conclusion, our study demonstrated the characteristic features of MTT patients and outlined some parameters associated with a negative outcome which could help clinicians better predict the clinical course of these neoplasms.

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Orbital Hydatid Cyst: An Interventional Case Series

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i2.1147 ◽

2021 ◽

Vol 37 (2) ◽

Author(s):

Tajamul Khan ◽

Ibrar Hussain ◽

Zaman Shah

Keyword(s):

Visual Acuity ◽

Hydatid Cyst ◽

Teaching Hospital ◽

Case Series ◽

Surgical Excision ◽

P Value ◽

Presumptive Diagnosis ◽

Female Ratio ◽

Orbital Imaging

Purpose: To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design: Interventional case series. Place and Duration of Study: Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods: This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results: Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion: Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. Key Words: Orbital hydatid cyst, Proptosis, Orbitotomy.

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A Case of Xanthoma Disseminatum with Spontaneous Resolution over 10 Years: Review of the Literature on Long-Term Follow-Up

Dermatology ◽

10.1159/000328137 ◽

2011 ◽

Vol 222 (3) ◽

pp. 236-243 ◽

Cited By ~ 10

Author(s):

H.Y. Park ◽

D.H. Joe ◽

H.C. Kang ◽

S.J. Yun

Keyword(s):

Spontaneous Resolution ◽

Review Of The Literature ◽

Long Term Follow Up ◽

Xanthoma Disseminatum

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Deep learning identifies antigenic determinants of severe SARS-CoV-2 infection within T-cell repertoires

Scientific Reports ◽

10.1038/s41598-021-93608-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

John-William Sidhom ◽

Alexander S. Baras

Keyword(s):

Deep Learning ◽

T Cell ◽

Clinical Outcomes ◽

Clinical Course ◽

Severity Of Illness ◽

Severe Infection ◽

Cell Receptor ◽

Asymptomatic Infection ◽

Antigenic Determinants ◽

Repertoire Sequencing

AbstractSARS-CoV-2 infection is characterized by a highly variable clinical course with patients experiencing asymptomatic infection all the way to requiring critical care support. This variation in clinical course has led physicians and scientists to study factors that may predispose certain individuals to more severe clinical presentations in hopes of either identifying these individuals early in their illness or improving their medical management. We sought to understand immunogenomic differences that may result in varied clinical outcomes through analysis of T-cell receptor sequencing (TCR-Seq) data in the open access ImmuneCODE database. We identified two cohorts within the database that had clinical outcomes data reflecting severity of illness and utilized DeepTCR, a multiple-instance deep learning repertoire classifier, to predict patients with severe SARS-CoV-2 infection from their repertoire sequencing. We demonstrate that patients with severe infection have repertoires with higher T-cell responses associated with SARS-CoV-2 epitopes and identify the epitopes that result in these responses. Our results provide evidence that the highly variable clinical course seen in SARS-CoV-2 infection is associated to certain antigen-specific responses.

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