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1.
An. bras. dermatol ; 94(1): 47-51, Jan.-Feb. 2019. tab
Article in English | LILACS | ID: biblio-983750

ABSTRACT

Abstract: Background: Sentinel lymph node biopsy in thin invasive primary cutaneous melanoma (up to 1mm thick) is a controversial subject. The presence of tumor-infiltrating lymphocytes could be a factor to be considered in the decision to perform this procedure. Objective: To evaluate the association between the presence of tumor-infiltrating lymphocytes and lymph node metastases caused by thin primary cutaneous melanoma. Methods: Cross-sectional study with 137 records of thin invasive primary cutaneous melanoma submitted to sentinel lymph node biopsy from 2003 to 2015. The clinical variables considered were age, sex and topography of the lesion. The histopathological variables assessed were: tumor-infiltrating lymphocytes, melanoma subtype, Breslow thickness, Clark levels, number of mitoses per mm2, ulceration, regression and satellitosis. Univariate analyzes and logistic regression tests were performed as well the odds ratio and statistical relevance was considered when p <0.05. Results: Among the 137 cases of thin primary cutaneous melanoma submitted to sentinel lymph node biopsy, 10 (7.3%) had metastatic involvement. Ulceration on histopathology was positively associated with the presence of metastatic lymph node, with odds ratio =12.8 (2.77-59.4 95% CI, p=0.001). The presence of moderate/marked tumor-infiltrating lymphocytes was shown to be a protective factor for the presence of metastatic lymph node, with OR=0.20 (0.05-0.72 95% CI, p=0.014). The other variables - clinical and histopathological - were not associated with the outcome. Study limitations: The relatively small number of positive sentinel lymph node biopsy may explain such an expressive association of ulceration with metastatization. Conclusions: In patients with thin invasive primary cutaneous melanoma, few or absent tumor-infiltrating lymphocytes, as well as ulceration, represent independent risk factors for lymph node metastasis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Skin Neoplasms/pathology , Lymphocytes, Tumor-Infiltrating/pathology , Sentinel Lymph Node/pathology , Lymphatic Metastasis/pathology , Melanoma/pathology , Logistic Models , Cross-Sectional Studies , Multivariate Analysis , Risk Factors , ROC Curve , Sex Distribution , Statistics, Nonparametric , Risk Assessment , Sentinel Lymph Node Biopsy/methods
2.
Clinics ; 67(5): 483-488, 2012. ilus, graf, tab
Article in English | LILACS | ID: lil-626345

ABSTRACT

OBJECTIVES: Forkhead box P3 (FoxP3) expression has been observed in human cancer cells but has not yet been reported in thyroid cells. We investigated the prognostic significance of both FoxP3 expression and intratumoral FoxP3+ lymphocyte infiltration in differentiated thyroid carcinoma cells. METHODS: We constructed a tissue microarray with 385 thyroid tissues, including 266 malignant tissues (from 253 papillary thyroid carcinomas and 13 follicular carcinomas), 114 benign lesions, and 5 normal thyroid tissues. RESULTS: We determined the expression of FoxP3 in both tumor cells and tumor-infiltrating lymphocytes using immunohistochemical techniques. Cellular expression of FoxP3 was evident in 71% of benign and 91.9% of malignant tissues. The nuclear and cytoplasmic expression patterns were quantified separately. A multivariate logistic regression analysis indicated that cytoplasmic FoxP3 expression is an independent risk factor for thyroid malignancy. Cytoplasmic FoxP3 staining was inversely correlated with patient age. Nuclear FoxP3 staining was more intense in younger patients and in tumors presenting with metastasis at diagnosis. FoxP3+ lymphocytes were more frequent in tumors smaller than 2 cm, those without extrathyroidal invasion, and in patients with concurrent chronic lymphocytic thyroiditis. CONCLUSIONS: We demonstrated FoxP3 expression in differentiated thyroid carcinoma cells and found evidence that this expression may exert an important influence on several features of tumor aggressiveness.


Subject(s)
Adult , Female , Humans , Middle Aged , Carcinoma/chemistry , Forkhead Transcription Factors/analysis , Lymphocytes, Tumor-Infiltrating/chemistry , Neoplasm Proteins/analysis , T-Lymphocytes, Regulatory/chemistry , Thyroid Neoplasms/chemistry , Adenocarcinoma, Follicular , Carcinoma, Papillary , Cell Differentiation , Carcinoma/pathology , Immunohistochemistry , Logistic Models , Lymphocytes, Tumor-Infiltrating/pathology , Thyroid Neoplasms/pathology , Tissue Array Analysis/methods
3.
Article in English | WPRIM | ID: wpr-207483

ABSTRACT

Indolent T-lymphoblastic proliferation has been rarely reported in the upper aerodigestive tract. The lymphoid cells associated with this condition have the morphological and phenotypical features of immature thymocytes. However, their pathogenesis and biology are unknown. We present an unusual type of tumor infiltrating lymphocytes in a case with hepatocellular carcinoma, presumed to be a T-lymphoblastic proliferation. A 58-yr-old female patient presented with indigestion and a palpable epigastric mass. The abdominal computed tomography revealed a mass in the S6 region of the liver. A hepatic segmentectomy was performed. Microscopic examination showed dense isolated nests of monomorphic lymphoid cells within the tumor. Immunohistochemically, the lymphoid cells were positive for CD3, terminal deoxymucleotide transferase (TdT) and CD1a. In addition, they showed dual expression of CD4 and CD8. The polymerase chain reaction used to examine the T-cell antigen receptor gamma gene rearrangement showed polyclonal T-cell proliferation. This is the second case of hepatocellular carcinoma combined with indolent T-lymphoblastic proliferation identified by an unusual tumor infiltrating lymphocytes.


Subject(s)
CD3 Complex/metabolism , CD4 Antigens/metabolism , CD8 Antigens/metabolism , Carcinoma, Hepatocellular/diagnosis , DNA Nucleotidylexotransferase/metabolism , Female , Humans , Liver Neoplasms/diagnosis , Lymphocytes, Tumor-Infiltrating/pathology , Mastectomy, Segmental , Middle Aged , Precursor Cells, T-Lymphoid/pathology , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/complications , Tomography, X-Ray Computed
4.
Article in Korean | WPRIM | ID: wpr-219562

ABSTRACT

We report two cases of hepatocellular carcinoma with prominent lymphocytic infiltration, which has been described as a subtype of hepatocellular carcinoma with good prognosis. One case showed lymphoid follicles and dense lymphocytic infiltrates within the tumor and its periphery, and the other case showed marked lymphocytic infiltration in the cancerous tissue. Piecemeal necrosis of cancer cells and atypical reactive changes were evident. The two cases were seronegative for hepatitis B surface antigen, antibody to hepatitis C virus, and Epstein-Barr virus DNA. One of the cases showed Clonorchis infestation. The prognostic significance of lymphocytic stroma in hepatocellular carcinoma requires further investigation.


Subject(s)
Animals , Carcinoma, Hepatocellular/diagnosis , Clonorchiasis/diagnosis , Clonorchis sinensis , Diagnosis, Differential , Female , Humans , Liver Neoplasms/diagnosis , Lymphocytes, Tumor-Infiltrating/pathology , Male , Middle Aged , Tomography, X-Ray Computed
5.
Article in Korean | WPRIM | ID: wpr-34943

ABSTRACT

Lymphoepithelioma-like carcinoma (LELC) is an undifferentiated carcinoma with predominant lymphocytic infiltration, which is associated with Epstein-Barr virus (EBV) in variable proportions. We report two cases of carcinoma with predominant lymphoid stroma in hepatobiliary system. The first case was a lymphoepithelioma-like undifferentiated carcinoma with focal differentiation of cholangiocarcinoma (cytokeratin 19+) and hepatocellular carcinoma in light microscopy. The infiltration of CD8+ T lymphocytes was observed in the tumor and the surrounding hepatic parenchyme. In this tumor, EBV was detected and LMP1 was positive immunohistochemically. The second case showed the mixed features of lymphoepithelioma-like carcinoma and cholangiocarcinoma with predominant lymphoid stroma. In this case, EBV was detected. LELC of hepatobiliary system is an entity distinguished from conventional carcinoma with lymphoid stroma, and its association with EBV warrants further research.


Subject(s)
Bile Duct Neoplasms/diagnosis , Bile Ducts, Intrahepatic , CD8-Positive T-Lymphocytes/pathology , Carcinoma/diagnosis , Cholangiocarcinoma/diagnosis , Herpesvirus 4, Human/isolation & purification , Humans , Liver Neoplasms/diagnosis , Lymphocytes, Tumor-Infiltrating/pathology , Male , Middle Aged , Tomography, X-Ray Computed
6.
Clinics ; 61(3): 203-208, June 2006. tab
Article in English | LILACS | ID: lil-430905

ABSTRACT

INTRODUÇÃO: O papel do sistema imunológico na patogênese e progressão do câncer de mama ainda é controverso, e isto nos estimulou a verificar a associação do imunofenótipo dos linfócitos tumor infiltrantes do câncer de mama inicial com a disseminação de células tumorais para os linfonodos axilares. MÉTODOS: Amostras tumorais de 23 pacientes com câncer de mama inicial do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto (USP) foram obtidas no momento da biópsia e depois submetidas ao método de digestão enzimática para a extração dos linfócitos tumor infiltrantes. Os linfócitos extraídos foram analisados por citometria de fluxo com anticorpos monoclonais nas seguintes combinações: CD3 FITC/CD19 PE, CD3 FITC/CD4 PE, CD3 FITC/CD8 PE, e CD16/56 PerCP, específicos para imunofenotipagem de linfócitos T e B, linfócitos T helper, linfócitos citotóxicos, e células Natural Killer. Os valores médios destas subpopulações leucocitárias foram comparados entre grupos de pacientes com ou sem metástases linfonodais. RESULTADOS: O valor médio do infiltrado por linfócitos T foi 24,72±17,37%, para o infiltrado por linfócitos B foi 4,22±6,27%, e para o infiltrado por células Natural Killer foi 4,41±5,22%, e para o infiltrado por linfócitos T CD4+ e CD8+ foram, respectivamente, 12,43±10,12% e 11,30±15,09%. Os valores médios do infiltrado por células T e T CD4+ foram maiores no grupo de pacientes com metástase axilar, enquanto nas outras subpopulações nada foi encontrado.CONCLUSÃO: A associação dos linfócitos T CD4+ tumor infiltrantes com metástases linfonodais sugere um papel destas células na disseminação das células neoplásicas aos linfonodos dos pacientes com câncer de mama inicial.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Breast Neoplasms/immunology , /immunology , Lymph Nodes/pathology , Lymphocyte Subsets/immunology , Lymphocytes, Tumor-Infiltrating/immunology , Antibodies, Monoclonal , Axilla , Breast Neoplasms/pathology , /pathology , Flow Cytometry , Immunophenotyping , Lymphatic Metastasis/immunology , Lymphatic Metastasis/pathology , Lymphocyte Subsets/pathology , Lymphocytes, Tumor-Infiltrating/pathology , Neoplasm Invasiveness , Neoplasm Staging
7.
Yonsei Medical Journal ; : 887-891, 2006.
Article in English | WPRIM | ID: wpr-141729

ABSTRACT

Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.


Subject(s)
Biomarkers, Tumor/analysis , Testicular Neoplasms/pathology , Male , Lymphocytes, Tumor-Infiltrating/pathology , Humans , Granuloma/pathology , Chorionic Gonadotropin, beta Subunit, Human/metabolism , Choriocarcinoma/pathology , Adult
8.
Yonsei Medical Journal ; : 887-891, 2006.
Article in English | WPRIM | ID: wpr-141728

ABSTRACT

Pure choriocarcinoma is very rare in the testes, and host immune responses including tumor infiltrating lymphocytes are unusual in choriocarcinoma. This study reports a case of pure testicular choriocarcinoma with extensive lymphocytic infiltrate and granulomatous inflammation. Scrotal ultrasonography revealed a heterogeneous, hyperechoic intratesticular mass. -human chorionic gonadotropin levels were elevated in a radioimmunoassay. The hemorrhagic and necrotic solid mass was composed of two cell populations - mononuclear pleomorphic cells and intimately admixed multinucleated smudged cells. The tumor cells were positive for cytokeratin 7, epidermal growth factor receptors, human placental lactogen and p57. Many inflammatory cells were present within the tumor. The majority of infiltrating cells were CD8-positive cytotoxic cells, which also expressed granzyme-B and TIA-1. The tumor cells were positive for FasL, but negative for Fas. Therefore, this case seemed to escape the host defense response to the tumor due to the loss of Fas, although the cellular host immune response was still active.


Subject(s)
Biomarkers, Tumor/analysis , Testicular Neoplasms/pathology , Male , Lymphocytes, Tumor-Infiltrating/pathology , Humans , Granuloma/pathology , Chorionic Gonadotropin, beta Subunit, Human/metabolism , Choriocarcinoma/pathology , Adult
9.
Rev. méd. Chile ; 132(11): 1403-1406, nov. 2004. ilus
Article in Spanish | LILACS | ID: lil-391846

ABSTRACT

We report a 78 year old male with prostatism, that was subjected to a prostate biopsy. The pathological study showed a microvascular lymphocytic infiltration. Four months later, the patients presentd with reduced alertness, cough, dyspnea, fever and elevation of lactic dehydrogenase and erythrocyte sedimentation rate. Chest and abdominal CAT scans, bone marrow aspirate, protein electrophoresis and prostate specific antigen were normal. A re-evaluation of prostate biopsy showed an intravascular lymphoid infiltration, positive for CD45 and CD20, compatible with the diagnosis of intravascular lymphoma. Chemotherapy was started, but it was not tolerated by the patient and the response was partial. Therefore, treatment with monoclonal antibodies anti CD20 (Rituximab) was started. The tumor had a complete and prolonged (24 months) remission after the treatment.


Subject(s)
Humans , Male , Aged , Antibodies, Monoclonal/therapeutic use , /therapeutic use , Antineoplastic Agents/therapeutic use , Lymphoma, Non-Hodgkin/pathology , Vascular Neoplasms/pathology , Biopsy , Endoscopy, Gastrointestinal , Hospitalization , Lymphocytes, Tumor-Infiltrating/pathology , Lymphoma, B-Cell/drug therapy , Lymphoma, B-Cell/pathology , Lymphoma, Non-Hodgkin/drug therapy , Vascular Neoplasms/drug therapy
10.
Rev. méd. Chile ; 132(11): 1407-1411, nov. 2004. ilus
Article in Spanish | LILACS | ID: lil-391847

ABSTRACT

Bacterial meningitis of otological origin is caused by the pass of bacteria from a suppurated otitis to the central nervous system. Patients subjected to otological surgery have a higher risk of contracting it. We report a 30 years old female with a history of non progressive long lasting hear loss in the left ear, that suffered two episodes of bacterial meningitis after being subjected to a stapedotomy. Temporal CAT scan revealed a malformation of the inner ear. An exploratory tympanostomy showed a perilymphatic fistula that was repaired.


Subject(s)
Humans , Male , Aged , Diagnostic Techniques, Otological , Meningitis, Bacterial/microbiology , Meningoencephalitis/surgery , Neisseria meningitidis/isolation & purification , Recurrence , Suppuration/complications , Tomography, X-Ray Computed , Biopsy , Endoscopy, Gastrointestinal , Hospitalization , Lymphocytes, Tumor-Infiltrating/pathology , Lymphoma, B-Cell/drug therapy , Lymphoma, B-Cell/pathology , Lymphoma, Non-Hodgkin/drug therapy , Vascular Neoplasms/drug therapy
11.
Rev. invest. clín ; 45(1): 71-5, ene.-feb. 1993. ilus
Article in English | LILACS | ID: lil-121175

ABSTRACT

Se describe el caso de un hombre de 80 años de edad que desarrolló un linfoma de linfocitos pequelos con diferenciación plasmocitoide que afectó al tubo digestivo en toda su extensión. El linfoma estuvo asociado a depósito de amiloide, presumiblemente producido por los linfocitos neoplásicos. Los síntomas sobresalientes fueron astenia, fiebre, acentuada pérdida de peso, diarrea y melena. En el estudio posmórtem se encontró, además, infiltración linfomatosa en la vesícula biliar, en ganglios linfáticos mesentéricos y en testículos. El presente caso es excepcional, en vista de la infiltración difusa y generalizada por el linfoma en el tubo digestivo y su asociación con amiloidosis masiva, que no han sido previamente documentados en la literatura disponible.


Subject(s)
Humans , Male , Aged , Amyloidosis/pathology , Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology , Lymphocytes, Tumor-Infiltrating/cytology , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Lymphocytes, Tumor-Infiltrating/pathology
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