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The occurrence or the worsening of cutaneous T-cell lymphoma (CTCL) during or after a treatment with dupilumab has recently been reported in a limited number of patients including a small series of 7 patients, of whom 4 had been previously diagnosed with atopic dermatitis (AD).1 We hereby describe a previously unreported observation of systemic CD30+ lymphoproliferation occurring during treatment with dupilumab, adding to the literature of new-onset cutaneous lymphomas associated with dupilumab therapy.

Breast implants are associated with well-known common complications that have been widely studied, such as rupture and capsular contraction. However, the increasingly growing number of patients with breast implants has led to the increased likelihood of coming across less common complications; these include seromas or late infection; adenopathies in the internal mammary chain; granulomas in the capsule of the implant, which in some cases can extend beyond the fibrous capsule; desmoid tumors associated with the implants; and breast implant-associated large cell anaplastic lymphoma. This article aims to review the main uncommon complications associated with breast implants and to describe and illustrate their findings in different imaging techniques. Proper management of these complications is important; this is especially true of late seroma and the diagnosis of breast implant-associated large cell anaplastic lymphoma for their repercussions.

RESUMO A mamoplastia com próteses é uma das cirurgias plásticas mais realizadas no mundo. O processo cicatricial ao redor do implante e a presença de um biofilme pode acarretar o desenvolvimento de patologias como contratura capsular e seroma. Essas patologias parecem estar relacionadas fisiopatologicamente com o desenvolvimento do linfoma associado aos implantes mamários (BIA-ALCL), sendo este também um diagnóstico diferencial. A proposta deste trabalho é relatar o caso de uma paciente com desconforto mamário, que após 2 cirurgias prévias para drenagem de seroma e troca de próteses, apresentava desconforto mamário e alteração em exames de imagens da mama esquerda. Sendo submetida a uma capsulectomia em bloco da mama esquerda e completa à direita, tendo suas próteses substituídas. Os exames para investigação de BIA-ALCL foram negativos e os achados patológicos foram sugestivos de contratura capsular à esquerda e formação de dupla cápsula à direita. O trabalho enfatiza a importância do diagnóstico diferencial em patologias mamárias, o acompanhamento a longo prazo e medidas de profilaxia na formação do biofilme. Abstract Mammoplasty with prostheses is one of the most performed plastic surgeries in the world. However, the healing process around the implant and the presence of a biofilm can lead to the development of pathologies such as capsular contracture and seroma. These pathologies seem to be physiologically related to the development of lymphoma associated with breast implants (BIA-ALCL), which is also a differential diagnosis. The purpose of this study is to report the case of a patient with breast discomfort who, after two previous surgeries for seroma drainage and prosthesis replacement, presented breast discomfort and alteration in imaging of the left breast. She was, submitted to a capsulectomy in a block of the left breast and complete on the right, having her prostheses replaced. Bia-ALCL investigation tests were negative and pathological findings were suggestive of left capsular contracture and double capsule formation on the right. The study emphasizes the importance of differential diagnosis in mammary pathologies, long-term follow-up, and prophylaxis measures in biofilm formation.

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is a CD30+ lymphoproliferative disorder that rarely occurs in children. Although there are currently no consensus guidelines for the treatment of cutaneous lymphoma in the pediatric population, the isolated form of PC-ALCL is typically managed by surgical excision or external beam radiation therapy. We report the case of a 6-year-old girl with primary cutaneous anaplastic large cell lymphoma that was treated with brachytherapy with no recurrence after 21 months of follow-up, suggesting that brachytherapy may be considered as a treatment for pediatric cutaneous large cell anaplastic lymphoma.

espanolLos hallazgos de hipercalcemia, lesiones liticas craneales, anemia de trastornos cronicos y lesion renal aguda, suelen ser caracteristicos del mieloma multiple. En el presente documento se describe un caso interesante de linfoma anaplasico de celulas grandes con caracteristicas que imitaban un mieloma multiple. EnglishThe findings of hypercalcemia, cranial lytic lesions, anemia of chronic disorders and acute renal injury are often characteristic of multiple myeloma. Here we describe an interesting case of large cell anaplastic lymphoma with features mimicking multiple myeloma.

The following specific or characteristic chromosomal abnormalities are known: t(11;18)(q21;q21) in a subset of marginal zone lymphoma, t(14;18)(q32.3;q21.3) in centroblastic-centrocytic lymphoma, t(11;14)(q13;q32) in mantle cell lymphoma, rearrangement 3q27 in centroblastic lymphoma, t(8;14)(q24;q32) in Burkitt's lymphoma, t(2;5)(p23;q35) in large cell anaplastic lymphoma of T-type and O-type, i(7)(q10) in hepatosplenic γδ T-cell lymphoma, and t(8;13)(p11;q11–12) in T-cell lymphoblastic lymphoma with eosinophilia and myeloid malignancy.

The "large cell anaplastic lymphoma, Ki-1 positive" is a recently described lymphoma subtype (about 1-8% of all NHL). Distinction from Hodgkin's disease and true histiocytic lymphoma/malignant histiocytosis is not always possible, even by experienced pathologists. It was recently incorporated in the updated Kiel Classification of lymphomas. Classical histologic appearance is a sinusoidal growth pattern in lymph nodes and presence of large bizarre anaplastic cells. Use of cell markers LCA, EMA and Ki-1 or Ber-H2 is essential for diagnosis. The mean age of patients is 50 years. Approximately 50% of patients have an advanced stage (III-IV). Prognosis depends on age and tumor localisations. Cutaneous involvement only is usually associated with a good prognosis. Median survival for patients with extra-cutaneous disease is 13 months. Treatment with intensive chemotherapy is usually needed. Long term remissions are more frequently seen in children and adolescents.

The authors describe a case of a 73-year-old man who had been treated with corticosteroids and azathioprine for 3 years for the Lambert–Eaton (myasthenic myopathic) syndrome, who had a primary esophageal Ki-1–positive large cell anaplastic lymphoma.

Large cell anaplastic lymphoma (ALCL) is characterized mainly by the presence of large, atypical lymphoid cells with anaplastic nuclear morphology and positivity to Ki-1 antigen. We describe, to our knowledge, the fourth reported case of primary ALCL of the spleen. The patient, a 62 year old woman, presented symptoms resembling a splenic abscess.

The clinical characteristics of 31 patients (pts.) (17 boys, 14 girls, median age 12 11/12 years) with large cell anaplastic lymphoma (LCAL) have been evaluated. 17 of these pts. had originally been diagnosed as suffering from "malignant histiocytosis" ("MH") and were therefore included in the DAL-Histiocytosis X 83 study. Another 14 pts. with Ki-1 lymphomas were enrolled in the BFM-NHL therapy studies. According to Murphyclassification 24 pts. (77%) had stage III or IV disease and in general presented in a severe condition. The lymphatic system was involved in 28 pts., 8 pts. (26%) had skin infiltration. With regard to lymphoma involvement of lung, bones and bone-marrow were unexpectedly frequent. CNS involvement was seen in just one pt. Despite rather heterogeneous therapy approaches (ALL-schedules, DAL-HX 83 protocol for treatment of "MH", combination of B-NHL-BFM and AML-BFM schedules, CHOP, BFM protocols for B-NHL) 30 out of 31 pts. achieved clinical remission (CR). The only nonresponder died during bone marrow transplantation of septicemia. 4 pts. relapsed during therapy. 3 of them died, 1 during a BMT. 1 pt. achieved 2nd CR with a BFM-B-NHL protocol. 3 pts. experienced a late relapse, 1 died, 1 2nd CR was achieved, the third pt. is still alive after 2 further relapses disease-free for 3 years. 23 pts. (74%, 13 out of 14 of BFM-NHL therapy study, 10 out of 17 of DAL-HX 83 study, 1 pt. after BMT) are in 1st CR with a median observation time of 2 9/12 years (range 5/12 to 17 9/12 years).(ABSTRACT TRUNCATED AT 250 WORDS)

We describe an adult case of anaplastic large cell lymphoma who presented with nonepidermotropic skin lesions histologically simulating malignant histiocytosis. The patient later developed systemic symptoms and peripheral lymphadenopathy. B- and T-cell markers and the Leu-M1 antigen were absent from immunohistochemically investigated skin lesions and lymph nodes. The expression of Ki-1 antigen by most tumor cells was the distinctive immunologic character of this disorder which helped to clarify the pathological diagnosis. The unusual clinical, pathologic, and immunologic features of this patient represent the adult counterpart of a clinicopathologic syndrome, so far described in children and adolescents, of Ki-1 lymphoma presenting with skin lesions and peripheral lymphadenopathy. Prompt recognition of this disorder and early delivery of chemotherapy seem important to improve prognosis.

Large cell anaplastic lymphoma (LCAL) is a recently described entity recognized by its constant expression of the CD30 antigen and by its morphology. LCAL is classified as high grade malignant lymphoma. We report 10 patients with LCAL of the skin, three with primary LCAL and others in which it developed with cutaneous T-cell lymphoma, mainly mycosis fungoides. The immunophenotype in all but one of these cases, was that of activated T cells.

Pleomorphic T-cell lymphoma and large-cell anaplastic lymphoma are recently defined lymphoma types that both occur in the skin. This report outlines the characteristics of these lymphomas and describes the clinical, histological, immunological, and ultrastructural features as seen in two typical case histories. Cutaneous T-cell lymphomas other than mycosis fungoides and Sezary syndrome are heterogeneous; they deserve further scientific attention to obtain data about their natural history and their response to therapy.