Mycosis fungoides (MF) is a type of cutaneous T-cell lymphoma (CTCL) with slow progression, usually presenting with patches and plaques. The infiltration of histiocytes and eosinophils in skin cancers can mask the underlying condition, posing a diagnostic challenge. While cases of MF associated with tissue eosinophilia or histiocytosis infiltration resembling Langerhans cell histiocytosis (LCH) have been reported, the simultaneous occurrence of both conditions in a single MF patient has not been documented.
In this case report, we presented an elderly man with a known history of patch and plaque-stage MF who developed a large cutaneous tumor on his right mandibular margin. Multiple biopsies initially led to misdiagnoses, attributing the lesion to Well's syndrome and LCH due to the dense infiltration of eosinophils and histiocytes, respectively. However, the absence of a BRAF V600 mutation and lack of clinical correlation reduced the likelihood of these initial diagnoses. After repeated biopsies and a thorough evaluation by hematopathology and dermatopathology specialists, the findings were reassessed, leading to the consideration of tumoral MF with reactive eosinophil and histiocyte infiltrates. The patient was subsequently started on chemotherapy and phototherapy, which led to tumor regression after treatment initiation.
This case highlights the importance of considering MF in patients presenting with tissue eosinophilia or Langerhans cell infiltration, even when initial biopsies lack definitive features.
Hepatocellular carcinoma (HCC) is a common primary liver malignancy. Despite advancements in treatment, HCC often has a poor prognosis because of frequent recurrence and metastasis. Hematogenous metastasis to the gastrointestinal tract is uncommon, and metastasis to the small intestine is particularly rare.
We report a case of a 72-year-old man with a history of hepatitis C virus and alcohol-related HCC. In 2017, he was initially managed with atypical hepatectomy of segments 5 and 6. He later developed bone and lung metastases, controlled by sequential systemic therapies. In early 2024, after undergoing a craniotomy for hemorrhagic occipital brain metastasis, he presented with diffuse abdominal pain, fullness, and vomiting. Imaging revealed distal ileal intussusception. A segmental small bowel resection was performed, and a fungating ileal tumor was identified as the lead point. Histology confirmed metastatic HCC (i.e., Hepar-1 positive). The postoperative course was uneventful, but within 3 months, new metastatic lesions appeared in the stomach and left breast; the latter was treated with a partial mastectomy.
Small intestine metastasis from HCC, although rare, should be considered in patients with gastrointestinal symptoms or unexplained elevated tumor markers. Surgical resection is the most effective treatment approach, with minimally invasive and endoscopic techniques available for select cases.
Evidence indicates that beta-2 microglobulin (β2M) plays a prognostic role in patients with diffuse large B-cell lymphoma (DLBCL).
However, due to controversies among previous studies, this meta-analysis was conducted to evaluate the prognostic role of β2M in DLBCL patients.
Relevant studies were identified through a systematic search using specific keywords in PubMed/Medline, Scopus, and Web of Science databases. Studies that provided complete information on the hazard ratio with a 95% confidence interval for β2M with respect to overall survival (OS) and progression-free survival (PFS) in multivariate models were included in the meta-analysis. A total of 30 studies, encompassing 25 128 patients, were included in this meta-analysis. The pooled analysis demonstrated a significant association between elevated β2M levels and poor OS in DLBCL patients (HR Pooled: 1.65, 95% CI: 1.45–1.88, p-value < 0.01). Similarly, increased β2M levels were significantly associated with lower PFS in DLBCL patients (HR Pooled: 1.54, 95% CI: 1.39–1.70, p-value < 0.01).
The available evidence suggests that β2M serves as an independent prognostic marker with significant effects on OS and PFS in DLBCL patients. Elevated serum β2M levels are associated with poor prognosis and worse OS and PFS outcomes in DLBCL patients.
Daratumumab represents the first-in-class fully humanized monoclonal antibody that targets CD38 for the treatment of relapsed/refractory multiple myeloma (RRMM). Evidence from randomized controlled trials has shown daratumumab to be efficacious in the setting of second-line combinational therapy for pretreated multiple myeloma. However, real-world evidence that supports daratumumab use in daily clinical practice remains scarce.
The primary objective of this study was to describe the real-world clinical and adverse effects observed in RRMM patients receiving daratumumab as second-line therapy.
This was an observational case series with a retrospective chart review of pretreated multiple myeloma patients who received daratumumab-based combinational therapy at an academic medical center. The primary end point was progression-free survival. Additional end points included overall response rates, adverse effects of daratumumab therapy, and subsequent treatment options following daratumumab.
Seventeen patients were included. The overall response rate of daratumumab in our patients with RRMM was 13/17 (76.5%), and the median progression-free survival was 20 months when daratumumab was used in the second-line setting. Common adverse effects included neutropenia (52.9%), thrombocytopenia (64.7%), anemia (35.7%), and pneumonia (35.3%). On follow-up, 10 patients remained alive at the experimental cut-off date, with 2 patients kept on daratumumab-based combinational therapy; 5 patients were switched to carfilzomib-based therapy; and 3 received best supportive care.
In our single-center experience with Taiwanese RRMM patients, daratumumab in combinational therapy showed promising efficacy, and modest tolerance in the second-line setting.
Symptomatic bone marrow metastasis in squamous cell lung cancer after achieving a complete response to immunochemotherapy has not been reported previously.
A 63-year-old Japanese man was referred to our hospital for further examination of an abnormal chest radiograph. Whole-body computed tomography revealed left hilar swelling and osteolytic lesions. Bronchoscopic examination led to a diagnosis of squamous cell lung carcinoma with multiple bone metastases. He was treated with carboplatin/Nab-paclitaxel and pembrolizumab, and achieved complete response as determined by positron emission tomography with fluorodeoxyglucose-computed tomography. Despite pembrolizumab maintenance therapy for 1 year, thrombocytopenia, anemia, and leukoerythroblastosis occurred. Bone marrow biopsy revealed squamous cell carcinoma cells within fibrotic tissue, confirming the diagnosis of symptomatic bone marrow metastases. The patient died 1 month after this diagnosis.
Recurrence presenting bone marrow metastasis should be considered in patients with squamous cell lung cancer, even achieving complete response to immunochemotherapy, particularly those with bone metastases.
Lisocabtagene maraleucel (liso-cel) is a CD19-directed chimeric antigen receptor T-cell therapy for patients with relapsed or refractory large B-cell lymphoma.
In this retrospective study involving 22 patients, we evaluated the association between peripheral blood CD4/CD8 ratios and the occurrence of out-of-specification (OOS) products during manufacturing. Expanded access protocols have permitted the infusion of OOS products, despite their failure to meet commercial release criteria, under close regulatory oversight.
Five patients who received OOS products had significantly lower CD4/CD8 ratios (median 0.22 vs. 0.46; p = 0.008).
Our findings suggest that a low CD4/CD8 ratio (below one-third) may be a predictive marker for OOS outcomes, potentially supporting patient selection and treatment planning. Therefore, prospective validation using a larger cohort is warranted.
Solid tumors are one of the leading causes of cancer-related deaths. Measurable combined inflammatory markers in the blood, which indicate the inflammatory response, play a crucial role in managing patients with malignancies. These markers have been validated as less invasive, practical, and cost-effective tools in the clinical decision-making process. The aim of this study is to evaluate the predictive value of inflammatory markers based on complete blood count (CBC), including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in major solid tumors, including breast, lung, colorectal, and prostate cancers, due to their high prevalence and strong evidence base.
In this study, studies from 2015 to June 2025 were searched in Google Scholar, PubMed, and Scopus using keywords such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, prognosis value, predictive value, diagnosis value, lung cancer, colon cancer, prostate cancer, and breast cancer. Findings indicate that elevated NLR and PLR, alongside reduced LMR, are commonly associated with advanced disease, poorer survival, and diminished response to treatment, though the strength of evidence varies by cancer type. Limitations across studies include retrospective design, inconsistent cut-off values, and confounding factors such as comorbidities and treatment regimens.
Current evidence suggests that NLR, PLR, and LMR have significant potential as accessible biomarkers for risk stratification and treatment monitoring in common solid tumors. However, lack of standardization in methodology and cut-off definitions limits their widespread clinical implementation. High-quality prospective studies are needed to establish unified thresholds and clarify their role alongside established biomarkers.
Retinoblastoma (RB) is a malignant eye tumor that predominantly affects children. Although survival rates have improved significantly due to advancements in treatment, subsequent malignant neoplasms (SMNs) continue to be major causes of death in both heritable and non-heritable RB cases. These SMNs are often associated with mutations in the RB1 gene, as well as the effects of radiotherapy or chemotherapy. There are no previous reports of a nonhereditary RB survivor developing three sequential hematologic malignancies (AML, lymphoma, and ALL) over 20 years. Most secondary primary cancers (SPCs) in RB survivors are solid tumors, such as osteosarcoma, soft tissue sarcoma, and melanoma, with hematologic malignancies being far less common, especially as third or subsequent primary tumors.
We report a case of a 21-year-old Iranian male who developed multiple distinct hematologic malignancies following retinoblastoma treatment. Using NGS, Sanger sequencing, and bioinformatic analysis, the possibility of germline mutations was surveyed.
Germline changes associated with malignancies were examined using next-generation sequencing (NGS). There were no germline alterations discovered, suggesting no predisposition to develop cancer. Three pathogenic/likely pathogenic heterozygous variants were found in the patient by carrier screening. Absence of germline RB1 mutations or other hereditary cancer syndromes implicates treatment-related factors (chemotherapy/radiotherapy) as the primary driver of sequential malignancies. Nonhereditary retinoblastoma (RB) survivors have a lower risk of secondary malignancies (SMNs) compared to their hereditary counterparts. Chemotherapy, especially alkylating agents, increases the risk of secondary acute myelogenous leukemia (AML) and other leukemias and lymphomas due to its mutagenic effects and genetic factors. Although RB survivors rarely develop secondary cancers, the limited patient numbers and short follow-up periods may influence SPC risk assessments. Continuous monitoring and personalized follow-up care are crucial for managing long-term risks in these survivors. This research emphasizes the essential importance of ongoing monitoring and follow-up for survivors of retinoblastoma (RB) to identify and address secondary malignancies (SMNs), improve the management of long-term complications, and enhance both life expectancy and quality of life.
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