title: [Clinical and capillaroscopic regression of CD30 anaplastic lymphoma associated with limited cutaneous systemic sclerosis following autologous bone marrow transplantation].
abstract: BACKGROUND
  In rare cases, tumors are associated with secondary Raynaud's phenomenon in systemic sclerosis (SSc). We report the case of a patient presenting cutaneous limited SSc associated with CD30 anaplastic lymphoma with cutaneous and lymph node involvement in whom the capillaroscopic scleroderma pattern regressed completely after autologous bone marrow transplantation, with complete remission of the lymphoma.
  
  
  METHODS
  A 37-year-old man presented bilateral Raynaud's phenomenon associated with digital ulcers contracted one year earlier but subsequently neglected. Right axillary lymph nodes and regional cutaneous tumors were present, leading to the diagnosis of CD30+ anaplastic lymphoma with cutaneous and lymph node involvement. Chemotherapy containing cyclophosphamide achieved only partial remission of the lymphoma. Clinical examination showed bilateral Raynaud's phenomenon, sclerodactyly, a right axillary subcutaneous nodule and a pathological Allen's test for the right hand. Antinuclear antibodies were positive without any other immunological abnormalities, and capillaroscopy showed an SSc pattern with numerous megacapillaries. Digital blood pressure was reduced in the right index and the left middle fingers, in which ulcers of the pulp were observed. Bone marrow transplantation was performed, resulting in complete remission of the lymphoma and disappearance of the sclerodactyly, with no recurrence of the pulp ulcers and complete normalization of capillaroscopic appearance and digital pressure.
  
  
  CONCLUSIONS
  This case raises the question of authentic SSc and neoplasia and highlights the importance of capillaroscopy in the follow-up of SSc. The complete regression of SSc and of capillaroscopic abnormalities could be explained by the paraneoplastic nature of SSc or by the direct action of the chemotherapy and bone marrow transplantation.
authors.affiliation: Service de dermatologie-allergologie, UF de dermatologie vasculaire, hôpital Tenon, 4, rue de la Chine, 75970 Paris cedex 20, France. Electronic address: bellis.reza@neuf.fr.
authors.forename: R
authors.initials: R
authors.lastname: Bellis
authors.affiliation: Service de dermatologie-allergologie, UF de dermatologie vasculaire, hôpital Tenon, 4, rue de la Chine, 75970 Paris cedex 20, France; Université Paris VI, hôpital Tenon, 4, rue de la Chine, 75970 Paris cedex 20, France.
authors.forename: C
authors.initials: C
authors.lastname: Francès
authors.affiliation: Service de dermatologie-allergologie, UF de dermatologie vasculaire, hôpital Tenon, 4, rue de la Chine, 75970 Paris cedex 20, France.
authors.forename: S
authors.initials: S
authors.lastname: Barète
authors.affiliation: Service de dermatologie-allergologie, UF de dermatologie vasculaire, hôpital Tenon, 4, rue de la Chine, 75970 Paris cedex 20, France.
authors.forename: P
authors.initials: P
authors.lastname: Senet
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005385:Fingers / Q000098:blood supply; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000150:complications* / Q000628:therapy; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D020678:Microscopic Angioscopy; D010257:Paraneoplastic Syndromes / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D011241:Prednisone / Q000008:administration & dosage; D011928:Raynaud Disease / Q000209:etiology*; D012074:Remission Induction; D045745:Scleroderma, Limited / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D012883:Skin Ulcer / Q000209:etiology; D014182:Transplantation, Autologous; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D000974:Antibodies, Antinuclear; D001761:Bleomycin; D004317:Doxorubicin; D003520:Cyclophosphamide; D014751:Vindesine; D011241:Prednisone; D008727:Methotrexate
keywords: Capillaroscopie; Capillaroscopy; Lymphome non hodgkinien; Non-Hodgkin's lymphoma; Phénomène de Raynaud; Raynaud's phenomenon; Sclérodermie systémique; Systemic sclerosis