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April 2015

Volume 2 Issue 1

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Case Report

Indolent CD8+ Primary Cutaneous T-Cell Lymphoma of the Ear: A Case Report and Review of the Literature

LT Matthew J. Lail M.D.*,LCDR Steven J. Gauerke M.D.,CDR Edward F. Miles M.D

Primary cutaneous peripheral T-cell lymphoma (PTL), unspecified, is a rare, heterogeneous group of lymphomas that do not conform to any of the more well defined subcategories of cutaneous T-cell lymphoma (CTCL) as defined by the 2005 World Health Organization (WHO)-European Organization for Research and Treatment of Cancer (EORTC) classification for cutaneous lymphomas. The prognosis for these neoplasms is generally poor, although one of three provisional subtypes is characterized by an indolent clinical nature (primary cutaneous CD4+ small/medium pleomorphic T-cell lymphoma [CSMPTCL]). There have been several case reports of what were suggested to be either a CD8+ variant of CSMPTCL or an entirely distinct subtype of CTCL, including cases with a curious predilection for the ears as well as the nose. We report a similar case of indolent CD8+ CTCL occurring on the left ear followed by a relapse on the right ear almost two years later.

                                                                                                                                                                                                                                                         Full textDownload PDF

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Commentary

Target Volumes, Image Fusion and Contouring in Modern Radiotherapy Treatment Planning

Rex Cheung*, MD, PhD

In modern radiotherapy using ultra-tight treatment margins to spare normal tissues, accurate target delineation is very important. Traditional 2-Dimensional (2D) simulators we used for decades are now replaced by computed tomography (CT) and magnetic resonance imaging (MRI). Modern radiotherapy relies on 3D imaging data  that require contouring of the gross target volume (GTV), clinical target volume (CTV) and planning target volume (PTV). GTV includes the tumor imaged and all other pertinent information, CTV includes clinical at risk area of microscopic spread and lymph nodes at risk, internal target volume (ITV) includes CTVs from different respirator phases, and PTV includes the set up errors.

                                                                                                                                                                                                                                                          Full textDownload PDF

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Commentary

Challenges in Radiotherapy Treatment Planning in the High-Precision Radiotherapy Era

Rex Cheung*, MD, PhD

In modern era of high-precision radiotherapy including stereotactic radiotherapy (SRT), intensity modulated radiotherapy (IMRT), and image guided radiotherapy (IGRT), 3-dimensional (3D) target delineation has become very important. For example, in Japan, there are now about 50% of centers equipped for high-precision radiotherapy. The precision of modern radiotherapy is very high, radiation dose are becoming very high and the safety margin needs to be very small to spare normal tissues.

                                                                                                                                                                                                                                                         Full textDownload PDF


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