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http://dx.doi.org/10.1016/j.pathol.2023.03.013DOI Listing

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Article Synopsis
  • - COVID-19 infection and vaccination can lead to various skin and immune reactions, with some cases resembling lymphoma.
  • - Two patients with skin issues post-vaccination exhibited abnormal T-cell infiltration, with one improving and the other worsening after a subsequent COVID-19 infection.
  • - The findings suggest that the immune response from the vaccine or infection might trigger lymphoma in individuals predisposed to such disorders, highlighting the difficulty in distinguishing these cases from non-cancerous reactions.
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Cutaneous angiosarcomas (AS) are uncommon and morphologically heterogeneous. Recently, a distinctive lymphatic-type AS with prominent lymphocytic infiltrate has been observed. Although conventional AS typically bear poor prognosis, lymphatic-type AS with prominent lymphocytic infiltrate and pseudolymphomatous AS show prolonged survival with rare extracutaneous spread.

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Talimogene laherparepvec pseudolymphomatous reaction mimicking metastatic melanoma.

J Cutan Pathol

November 2021

Department of Medicine, Division of Dermatology, The Ohio State University, Columbus, Ohio, USA.

Talimogene laherparepvec (TVEC) is a genetically modified herpes simplex virus-1 approved as an intralesional oncolytic immunotherapy for the treatment of advanced melanoma. Cutaneous reactions at the site of injection may mimic recurrent or progressive melanoma; histopathological findings have included chronic granulomatous dermatitis, neutrophilic dermatitis, lymphocytic dermatitis, and pigment incontinence. We report a 39-year-old male with metastatic stage IIIc melanoma treated with TVEC with clinical regression of melanoma lesions that later developed pink nodules at sites of prior injection.

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Pseudolymphomatous cutaneous angiosarcoma represents a rare, relatively new variant of cutaneous angiosarcoma exhibiting a prominent inflammatory lymphoid infiltrate that can mask the underlying vascular malignant proliferation and mimic a lymphomatous or pseudolymphomatous process. We describe the clinicopathologic characteristics of two new cases of pseudolymphomatous cutaneous angiosarcoma whose originality lies in the unusual setting from which they have arisen. In fact, the first case was an exceedingly lymphocyte-rich recurrence of a typical epithelioid cutaneous angiosarcoma whose primary lesion that was almost devoid of inflammatory infiltrate underwent surgical excision and radiotherapy while the second one was an unexpected histopathological finding associated with a basal cell carcinoma.

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