Acta Dermato-Venereologica, issue 9 97-9CompleteContent | Page 25

1140 SHORT COMMUNICATION Abscopal Effect of Local Irradiation Treatment for Diffuse Large B-cell Lymphoma Yuri HIDAKA 1 , Takuya TAKEICHI 1 *, Yuichi ISHIKAWA 2 , Mariko KAWAMURA 3 and Masashi AKIYAMA 1 Departments of 1 Dermatology, 2 Hematology and Oncology, and 3 Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai- cho, Showa-ku, Nagoya 466-8550, Japan. *E-mail: [email protected] Accepted Jun 8, 2017; Epub ahead of print Jun 9, 2017 The term “abscopal” was defined by Mole in 1953 in the context of radiotherapy as relating to tumour events occurring “at a distance from the irradiated volume but within the same organism” (1). Although the exact mechanism by which the abscopal effect occurs is un­ known, several theories have been proposed regarding the abscopal anti-tumour effect (2). Clinical reports of the abscopal effect after radiotherapy are not numerous, although this phenomenon has been detected in several different tumours, including lymphomas, melanomas and various carcinomas (2). For example, there are several reports of the abscopal effect detected in patients with advanced melanoma who were receiving ipilimumab treatment and radiation (3, 4). In addition, Grimaldi et al. (5) reported that administering radiotherapy after melanoma has progressed under ipilimumab treatment may lead to abscopal effects in some patients, and that these responses appear to be associated with prolonged survival. Thus, the abscopal effects of radiotherapy are commonly reported in combination with immunothera- pies or chemotherapies. In this report, we describe the useful abscopal effect of topical irradiation, without any combination therapies, to treat lesions distant from the irradiated sites in a patient with diffuse large B-cell lymphoma (DLBCL). CASE REPORT An 88-year-old Japanese male was referred with multiple erythematous eruptions. Physical examination showed a large number of variously sized, circumscribed erythema and nodules on his chest, abdomen and extremities (Fig. 1a–c). He had moderate pain at the largest erythematous nodule (6 × 6 cm 2 ) on the left buttock (Fig. 1c). His history included chronic obstructive pulmonary disease that had been treated with continuous nasal oxygen therapy (O 2 , 2 l/min), pulmonary hypertension, chronic heart failure, colon polyps, cholelithiasis and hyperli- pidaemia. Laboratory tests revealed a white blood cell count of 4,400/mm 3 (normal range 3,800–8,500; 57.9% neutrophils, 2.5% eosinophils, 11.3% monocytes, 26.5% lymphocytes and 0% atypical lymphocytes), a haemo- Fig. 1. Cutaneous features of the patient before (a–c) and after (d–f) treatment with local irradiation. (a) An erythematous nodule on the right hypochondrium and multiple small erythemas on the chest. (b) Variously sized pinkish erythemas on the thighs. (c) An erythematous nodule on the left buttock. Arrowheads indicate non-irradiation eruptions. (d–f) After 32 Gy (4 Gy × 8 times) of irradiation to the left buttock and 24 Gy (4 Gy × 6 times) of irradiation to the left upper arm, no eruptions are seen on the non-irradiated (d) chest, (e) thighs and (f) left buttock. doi: 10.2340/00015555-2729 Acta Derm Venereol 2017; 97: 1140–1141 This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2017 Acta Dermato-Venereologica.