Summa Health, Akron, Ohio, USA.
Department of Surgical Oncology, The Ohio State University, Columbus, Ohio, USA.
J Cutan Pathol. 2021 Nov;48(11):1423-1426. doi: 10.1111/cup.14094. Epub 2021 Jul 8.
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. Histopathology demonstrated a nodular mononuclear infiltrate that stained strongly and diffusely with CD45 and CD20 with a surrounding rim of CD3-positive T-cells. Immunoglobulin gene rearrangement was negative for a clonal B-cell population. To our knowledge, this is the first report of a pseudolymphomatous reaction mimicking recurrent melanoma after TVEC therapy.
替莫唑胺（TMZ）是一种基因修饰的单纯疱疹病毒 1 型，被批准作为一种瘤内溶瘤免疫疗法，用于治疗晚期黑色素瘤。注射部位的皮肤反应可能类似于复发性或进行性黑色素瘤；组织病理学发现包括慢性肉芽肿性皮炎、中性粒细胞性皮炎、淋巴细胞性皮炎和色素失禁。我们报告了一名 39 岁男性，转移性 IIIc 期黑色素瘤患者接受 TMZ 治疗，黑色素瘤病变出现临床消退，随后先前注射部位出现粉红色结节。组织病理学显示结节状单核细胞浸润，CD45 和 CD20 染色强烈且弥漫，周围有 CD3 阳性 T 细胞环绕。免疫球蛋白基因重排未显示克隆性 B 细胞群。据我们所知，这是 TMZ 治疗后模仿复发性黑色素瘤的首例假性淋巴瘤反应报告。
