RESUMEN
T-cell posttransplant lymphoproliferative disorders are rare, with peripheral T-cell lymphoma not otherwise specified being the most common type. Although cases of the signet ring cell variant of primary cutaneous CD30+ lymphoproliferative disorder have been reported, such cases have not been described in the posttransplant setting. We describe a case with emphasis on the special contextual differential diagnostic considerations.
Asunto(s)
Biomarcadores de Tumor/análisis , Trasplante de Corazón/efectos adversos , Antígeno Ki-1/análisis , Linfoma Cutáneo de Células T/patología , Trastornos Linfoproliferativos/patología , Neoplasias Cutáneas/patología , Biopsia , Humanos , Inmunohistoquímica , Inmunosupresores/efectos adversos , Linfoma Cutáneo de Células T/etiología , Linfoma Cutáneo de Células T/genética , Linfoma Cutáneo de Células T/inmunología , Trastornos Linfoproliferativos/etiología , Trastornos Linfoproliferativos/genética , Trastornos Linfoproliferativos/inmunología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Neoplasias Cutáneas/etiología , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/inmunologíaRESUMEN
The Nutritional Prevention of Cancer Trial was a double-blind, randomized, placebo-controlled clinical trial designed to test whether selenium as selenized yeast (200 microg daily) could prevent nonmelanoma skin cancer among 1312 patients from the Eastern United States who had previously had this disease. Results from September 15, 1983, through December 31, 1993, showed no association between treatment and the incidence of basal and squamous cell carcinomas of the skin. This report summarizes the entire blinded treatment period, which ended on January 31, 1996. The association between treatment and time to first nonmelanoma skin cancer diagnosis and between treatment and time to multiple skin tumors overall and within subgroups, defined by baseline characteristics, was evaluated. Although results through the entire blinded period continued to show that selenium supplementation was not statistically significantly associated with the risk of basal cell carcinoma (hazard ratio [HR] = 1.09, 95% confidence interval [CI] = 0.94 to 1.26), selenium supplementation was associated with statistically significantly elevated risk of squamous cell carcinoma (HR = 1.25, 95% CI = 1.03 to 1.51) and of total nonmelanoma skin cancer (HR = 1.17, 95% CI = 1.02 to 1.34). Results from the Nutritional Prevention of Cancer Trial conducted among individuals at high risk of nonmelanoma skin cancer continue to demonstrate that selenium supplementation is ineffective at preventing basal cell carcinoma and that it increases the risk of squamous cell carcinoma and total nonmelanoma skin cancer.