ABSTRACT
Objective@#To investigate the clinicopathological features, diagnosis and differential diagnosis of pulmonary extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT).@*Methods@#Eleven cases of newly diagnosed (10 puncture biopsies and 1 transbronchial biopsy), previously untreated pulmonary ENKTL-NT were collected at the First Affiliated Hospital of Zhengzhou University, from August 2013 to November 2018. The clinicopathological features including histomorphology, immunohistochemistry and in situ hybridization were collected and analyzed.@*Results@#Among the 11 cases, 8 were males and 3 were females, with a male to female ratio of 8∶3.The age range was from 30 to 74 years, with an average of 48 years and a median of 43 years. Tumors involved bilateral lung lobes in 8 cases, the upper left lobe in 1 case, lower left lobe in 1 case, and upper right lobe in 1 case. Main clinical symptoms included fever, often accompanied by cough, and bloody sputum in most cases. All cases were stage Ⅳ E. Histological features included scattered or focal aggregates of marked pleomorphic tumor lymphocytes, accompanied by necrosis and heavy admixture of inflammatory cells. In a few cases, diffuse neoplastic lymphocytes or vascular central and destructive infiltrations were seen. Tumor cells in most cases expressed CD3ε, CD3, CD43, CD56, TIA-1, granzyme B, but did not express CD20, CD79a, and CD5. Ki-67 index ranged from 40%to 90%.All cases were positive for EBER by in situ hybridization. Four of five patients died during follow-up with a survival period of only 1 week to 13 months.@*Conclusions@#Pulmonary ENKTL-NT is rare, high grade malignancy with a poor prognosis. Misdiagnosis is common due to lesional necrosis and heterogeneous cell components. Immunohistochemistry and EBER in situ hybridization are essential for accurate diagnosis.
ABSTRACT
Objective: To explore the characteristics of clinical pathology, diagnosis, and prognosis of primary renal lymphoma (PRL).Methods: The clinical features, pathological features, immune phenotypes, treatment, and prognosis of 22 patients were retrospectively analyzed. Results: The PRL patients' ages ranged from 2 to 72 years (mean, 54.3 years), of which 13 patients were older than 50 years (59.1%). All of the 22 patients were diagnosed with non-Hodgkin's lymphoma (NHL), including 20 cases of B-cell lymphoma and 2 cases of T-cell lymphoma. Seven patients were still alive and survived for 6-50 months, but the other 15 were dead and survived for only 5-35 months. Conclusion: PRL is uncommon. Clinical manifestations and imaging performance specificity are not obvious. and easily misdiagnosed. Histopathology is still the golden standard for the final diagnosis of this entity. The kidney is most easily involved followed by the bladder. B-cell NHL is the common subtype, and the most common type is the diffuse large B-cell lymphoma. Up to now,no standard regime could be performed for PRL patients. At present, comprehensive therapy, including surgery and chemotherapy, is recommended. For patients with locally advanced or highly aggressive status, therapeutic effect with chemotherapy alone is usually satisfied.
ABSTRACT
<p><b>OBJECTIVE</b>To study the significance of B-cell clones in angioimmunoblastic T cell lymphoma (AITL) and the correlation with Epstein-Barr virus (EBV) and prognosis.</p><p><b>METHOD</b>The histopathologic features, T cell clonality and EBV positivity in 33 cases of AITL and 10 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) collected from May 2010 to February 2014 were analyzed by immunohistochemistry, PCR gene rearrangement and in situ hybridization. Follow-up data were also collected.</p><p><b>RESULTS</b>Of the 33 cases with AITL, seven cases (21.2%) exhibited clonal rearrangement of Ig genes; 21 cases (63.6%) were EBV positive. Seven cases had B-cell clones and all (7/7) were EBV positive; 14 of the 26 (53.8%) cases without B-cell clones were EBV positive. The difference between the two groups was statistically significant (P = 0.032). Four levels were made according to the number of EBV-labeled cells, Ig gene rearrangements, but there was no significant difference among levels 1, 2 and 3. There was no correlation between B-cell clones and prognosis (P = 0.263).</p><p><b>CONCLUSION</b>Clonal rearrangement of Ig genes is a common finding in AITL, and it is highly associated with EBV positivity, but not with the number of EBV-labeled cells. The clinical significance remains unclear; further study with more samples is warranted.</p>
Subject(s)
Female , Humans , Male , B-Lymphocytes , Pathology , Gene Rearrangement , Genes, Immunoglobulin , Herpesvirus 4, Human , Immunohistochemistry , In Situ Hybridization , Lymphoma, Large-Cell, Immunoblastic , Genetics , Pathology , Lymphoma, T-Cell, Peripheral , Genetics , Pathology , Polymerase Chain Reaction , Prognosis , T-LymphocytesABSTRACT
Objective To investigate the dynamic changes of claudin-5 expression around hematoma of intracerebral hemorrhage (ICH) in experimental rats and its correlation with cerebral edema.Methods 108 adult male SD rats were randomly divided into 6 groups:sham operation,6 h,12 h,24 h,3 d,7 d after operation groups respectively.The experimental ICH model was established by injecting autologous arterial blood into the caudate nucleus.Immunohistochemistry straining was used to detect the changes of expression of claudin-5 around hematoma at different time point after ICH.The permeability of blood-brain barrier (BBB) was tested by Evans blue method.The changes of brain water content were measured by the wet and dry weight method.Alexis method was used to examine the changes in neurological deficit scores.Results The expression of claudin-5 around hematoma was decreased gradually from 6 h after ICH,and it declined quickly at 12 h to 3 d after ICH.The expression of claudin 5 around hematoma was slightly lower at 7 d after ICH than in sham operation group.Permeability of the BBB was higher at 12 h to 3 d after ICH than any other groups,and reduced at 7 d after ICH.Brain water content was increased from 6h,the severest water content was at 12 h to 3 d after ICH,and it decreased gradually at 7 d after ICH.The neurologic impairment appeared from 6 h after ICH,the time point of severest neurologic impairment was at 12 h to 3 d after ICH,and it reduced from 7 d after ICH.The expression of claudin-5 around hematoma after ICH was negatively correlated with the permeability of BBB,brain water content and neurological deficit scores (r=-0.63,-0.71,0.59,all P＜0.05).Conclusions Claudin-5 expression plays an important role in the course of hemorrhagic cerebral edema and injury.It probably would he an effective way to alleviate the degree of hemorrhagic cerebral edema and injury after ICH by actively increasing the expression of claudin-5 at the early period of ICH.
ABSTRACT
Objective To study the usefulness of combined flow cytometry (FCM) and polymerasechain reaction examination for clonal TCR gene rearrangements in the diagnosis of T-cell lymphoma (T-NHL). Methods Histopathologic features, immunohistochemistry, flow cytometric immunophenotyping, cytomorphologic evaluation and TCR gene rearrangements of 32 T-NHL were reviewed retrospectively. The control cases were 18 reactive lesions and 1 histiocytic necrotizing lymphaderitis. Results Out of 32 T-NHL,23 were diagnosed as T-NHL by FCM / TCR gene rearrangements. Of 19 control group, 17 were diagnosed as reactive lesions by FCM / TCR gene rearrangements. The sensitivity, specificity and accuracy were 71.9%, 89.5% and 78.4%, respectively. Conclusions FCM / TCR gene rearrangement is a very important technique in diagnosing T-NHL. Thus, patients with fine needle aspiration cytology can be saved from having an invasive surgery.
ABSTRACT
Objective To investigate the efficacy and safety of preoperative systemic chemotherapy combined with regional intraarterial chemoembolization in the treatment of locally advanced gastric cancer.Methods Clinical data of 158 patients of locally advanced gastric receiving neoadjuvant chemotherapy cancer from January 2008 to July 2012 were retrospectively analyzed.Patients were divided into two groups:those who received preoperative systemic chemotherapy plus regional intraarterial chemoembolization (group A,n =78) and those who received preoperative systemic chemotherapy (group B,n =80).Radical resection was perfomed after 3 to 4 weeks.Results The overall satisfactory rate was significantly higher (60％) in group A compared with 42％ in group B (x2 =6.136,P ＜0.05).The incidence rate of toxicity reaction (except nausea) and postoperative conplications such as anastomotic leakage,intestinal obstruction,poor wound healing,abdominal infection and pulmonary infection were all lower in group A than in group B (all P ＜ 0.05),while the incidence rate of nausea was higher in group A than in Group B (x2 =16.458,P ＜ 0.01).There was no perioperative mortality related to neoadjuvant therapy in two groups.Conclusions Preoperative systemic chemotherapy combined with regional intraarterial chemoembolization was associated with better efficacy,and fewer toxicity reactions and postoperative complications in the treatment of locally advanced gastric cancer.
ABSTRACT
Objective To evaluate the diagnosis and application values of endoscopic ultrasonography (EUS) with micro-probe in duodenal lesions.Methods Clinical data of 37 patients with duodenal lesions and underwent EUS with micro-probe were analyzed retrospectively.All lesions were treated with endoscopic mucosal resection or surgical resection to get the pathological diagnosis.The diagnostic accuracy of EUS with microprobe and endoscopic biopsy was analyzed respectively.Results The overall diagnosis accuracy of EUS with micro-probe on duodenal lesions was 78.38％ (29/37),with a higher diagnostic rate in duodenal lipoma 4/4and duodenal adenomas 10/12 than in early duodenal cancer 2/4 or inflammatory hyperplasia 3/8.The overall diagnostic accuracy of biopsy on duodenal lesions was 40.54％ (15/37),with a higher diagnosis rate on duodenal carcinoid 1/1 and adenoma 7/12 than on duodenal stromal tumor 1/10 and lipoma 1/4.Conclusion Pathological evaluation of endoscopic biopsy sample is not a golden standard for the diagnosis of duodenal lesions,while EUS with micro-probe has better diagnostic and application value.