Subject(s)
Dermatologic Agents/therapeutic use , Lymphoma, T-Cell, Cutaneous , PUVA Therapy/methods , Radiotherapy/methods , Skin Neoplasms , Skin/pathology , Aged , Antigens, Differentiation, T-Lymphocyte/analysis , Atrophy , Diagnosis, Differential , Disease Management , Humans , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/immunology , Lymphoma, T-Cell, Cutaneous/pathology , Lymphoma, T-Cell, Cutaneous/therapy , Male , Skin Neoplasms/diagnosis , Skin Neoplasms/immunology , Skin Neoplasms/pathology , Skin Neoplasms/therapyABSTRACT
Shiitake mushroom-induced toxicoderma, or shiitake dermatitis, is a widely recognized phenomenon in Japan, China, and Korea but only recently has been reported outside of Asia. Affected individuals develop a characteristic pattern of whiplike, linear, erythematous wheals within 1 to 2 days after consumption of raw or cooked shiitake mushrooms. Lentinan, a polysaccharide component of shiitake mushrooms with antitumor properties, is thought to instigate a toxic reaction, resulting in the appearance of a rash. Shiitake dermatitis is self-limited and typically resolves within days to weeks of its appearance.
Subject(s)
Dermatitis/etiology , Mushroom Poisoning/complications , Shiitake Mushrooms , Dermatitis/pathology , Female , Humans , Male , Middle Aged , Mushroom Poisoning/pathology , Remission, SpontaneousSubject(s)
Blister/diagnosis , Lichen Planus/diagnosis , Basement Membrane/pathology , Blister/drug therapy , Blister/pathology , Complement C3/metabolism , Dermatitis/diagnosis , Dermatitis/pathology , Dermatologic Agents/therapeutic use , Eosinophilia/diagnosis , Female , Humans , Immunoglobulin G/metabolism , Lichen Planus/drug therapy , Lichen Planus/pathology , Middle Aged , Pigmentation Disorders/diagnosis , Pigmentation Disorders/pathology , Pruritus/diagnosis , Pruritus/pathology , Skin/pathology , Treatment OutcomeABSTRACT
Cutaneous T-cell lymphomas most commonly have a CD4(+) memory T-cell phenotype with relatively indolent course, but may in rare cases present with a CD8(+) cytotoxic phenotype exhibiting strikingly more aggressive clinical behavior. We present two cases of the clinically aggressive subtype of primary cutaneous epidermotropic CD8(+) cutaneous T-cell lymphoma and review the current literature, clinical behavior, and recommendations for treatment distinct from that of more common CD4(+) variants of cutaneous T-cell lymphoma.
Subject(s)
CD8-Positive T-Lymphocytes/immunology , Lymphoma, T-Cell, Cutaneous/immunology , Skin Neoplasms/immunology , Aged , Aged, 80 and over , Bexarotene , Combined Modality Therapy , Humans , Lymphoma, T-Cell, Cutaneous/pathology , Lymphoma, T-Cell, Cutaneous/therapy , Male , Skin/immunology , Skin Neoplasms/pathology , Skin Neoplasms/therapy , Tetrahydronaphthalenes/therapeutic useSubject(s)
Dermis , Neurothekeoma/pathology , Skin Neoplasms/pathology , Adult , Humans , Leg , Male , Neurothekeoma/surgery , Skin Neoplasms/surgeryABSTRACT
BACKGROUND: Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) has proven to be an effective diagnostic modality for the detection and staging of pancreatic malignancies. In recent years EUS-FNA has also been used to diagnose lesions of non-pancreatic sites such as structures in close proximity to the gut wall within the mediastinum, abdomen, pelvis and retro-peritoneum. AIMS: To evaluate experience with EUS-FNA of non-pancreatic sites at a large university medical centre. METHODS: The study cohort included 234 patients who underwent EUS-FNA of 246 lesions in non-pancreatic sites (122 peri-pancreatic and coeliac lymph nodes; 9 peri-pancreatic masses; other sites: mediastinum 12, gastric 25, liver 27, oesophagus 17, duodenum/colon/rectum 15, retro-peritoneum 8, lung 7, miscellaneous 4). RESULTS: The cytology diagnoses were classified as non-neoplastic/reactive in 82 (33%), atypical/suspicious for malignancy in 25 (10%), malignant in 86 (35%) and non-diagnostic in 53 (22%) cases. Surgical pathology follow-up was available in 75 (31%) cases. Excluding the non-diagnostic cases there were 7 false negative and 3 false positive cases. The sensitivity, specificity and positive predictive value of EUS-FNA in the diagnosis of lesions of non-pancreatic sites was 92%, 98% and 97%, respectively. CONCLUSIONS: EUS-FNA can be effectively used as a diagnostic modality in the diagnosis of lesions from non-pancreatic sites.
