Clinicopathological analysis and literature review of Burkitt-like lymphoma with 11q aberration / 中国综合临床

Objective:To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of Burkitt-like lymphoma with 11q aberration (BLL-11q).Methods:The clinical manifestations,histological morphology,immunophenotype and molecular genetic changes of 2 cases of BLL-11q admitted to the department of pathology of The First People's Hospital of Lianyungang in 2020 and 2021 were analyzed retrospectively,and the relevant literatures were reviewed.Results:Patients were found with right neck masses inadvertently and grew rapidly. They presented with localized disease with Ann Arbor stages IA and IIA. Microscopically, the normal structure of the lymph node disappeared and was replaced by a diffuse proliferation of lymphocytes, with consistent morphology and medium size. And the presence of "star-sky" phenomenon was obvious, the morphological characteristics were similar to Burkitt lymphoma. Immunophenotypically, tumor cells were diffusely positive for CD20, CD79α, PAX5, CD10 and Bcl-6, partly moderately positive for C-MYC and MUM-1, however, CD3, Bcl-2, CD30 and TDT were negative,Ki-67 positive index was more than 95%, and EBER was negative. FISH detection showed that MYC, Bcl-2, and Bcl-6 were negative. Both cases had the 11q23.3 gain and 11q24.3 loss. Both patients were treated with chemotherapy and followed up for 10-22 months,and achieved complete remission and disease-free survival.Conclusion:BLL-11q is a rare germinal center B-cell lymphoma with abnormal long arm of chromosome 11 and lack of MYC gene rearrangement. It should be distinguished from Burkitt lymphoma, diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, large B-cell lymphoma with IRF4 rearrangement and high-grade B-cell lymphoma. On the basis of morphology and immunophenotype, the diagnosis depends on genetic detection. There may be a better prognosis.

Granular cell tumor of breast: clinicopathological and biological behavior / 中华内分泌外科杂志

Objective To investigate the clinicopathological and immunohistochemical features,diagnosis and prognosis of granular cell tumor of breast (GCT)and to improve the awareness of the disease.Methods Three cases of GCT were collected;Specimens were fully drawn,microscopic pathologic examinations and immunohistochemistry (SP method)were performed.Results Three cases were female patients aged from 39 to 56 years old (average 46 years).In clinical,a single indolent or indolent mass with a hard texture was located in the breast parenchyma.In pathological,the lump was mainly solid or hard tumor with clear boundary or infiltration,with a mean diameter of 2.1 (1.2-3.0)cm,and grey to yellow sections.Histologically,large cells were round or polygonal in shape.The cytoplasm was abundant and eosinophilic.The boundary of the tumor was clear in one case,and in the other two cases,the boundary was unclear.The nucleus was small and located in the center or ectopic.The cytoplasm was coarse-grained with s-100 staining positive microparticles and PAS reaction positive (anti-digestive enzymes).Immunohistochemistrically,the tumor cells were strongly positive for S-100,CD56,NSE and Vimentin,and negative for CK and SMA.None of the patients had present malignant transformation or metastasis.Conclusions GCT can occur in any part of the body,but is not common in breast.GCT is similar to breast cancer in clinical manifestations,imaging and macroscopic observation,etc.The correct diagnosis of this lesion depends on HE morphology,immunohistochemistry and special dyeing.The close postoperative follow-up should be performed.

Values of CD21 and CD43 expression in differential diagnosis of mucosa-associated marginal zone B-cell lymphoma from benign lymphadenosis / 白血病·淋巴瘤

Objective To investigate the values of CD21 and CD43 proteins in the differential diagnosis of mucosa-associated marginal zone B-cell lymphoma (MALToma) from benign lymphadenosis. Methods The expression of CD21 and CD43 proteins in the tissues of 25 MALToma (case group) and 25 benign lymphadenosis (control group) was detected by immunohistochemistry. Results Abnormal CD21+follicular dendritic cells (FDC) meshes were found in all patients of case group. Most of the FDC meshes were sparse and broken, and a few were enlarged or fused into pieces. Intact CD21+FDC meshes were all found, and abnormal FDC meshes were not found in control group. The positive rate of abnormal FDC meshes in case group was significantly increased compared with that in control group (χ2 = 46.080, P= 0.000). The expression rate of CD43+in CD20+cells was 24 % (6/25) in case group, but it was negative in control group (χ2=4.375, P=0.030). Conclusions Abnormal CD21+FDC meshes and CD43+expression in CD20+cells are useful in the differential diagnosis between MALToma and benign lymphadenosis. The abnormal FDC meshes of MALToma are enlarged or fused in the minority of cases.

Diagnostic utility of immunohistochemical markers SALL4, D2-40 and Glypican-3 in primary testicular germ cell tumors / 临床与实验病理学杂志

Purpose To investigate the diagnostic utility of the immunohistochemical markers SALL4, D2-40 and Glypican-3 in prima-ry testicular germ cell tumors (TGCTs). Methods The expression of SALL4, D2-40 and Glypican-3 protein was detected by EnVi-sion immunohistochemical method in 56 cases of primary testicular germ cell tumors, including 5 intratubular germ cell neoplasms ( IT-GCNs) , 10 seminomas, 14 embryonal carcinomas ( ECs) , 14 yolk sac tumors ( YSTs) , 1 choriocarcinoma, 5 immature teratomas and 12 mature teratomas. 10 normal testicular tissues and 5 lymphomas were selected as control. Results All of ITGCNs, seminomas, YSTs and ECs were diffusely strongly positive for SALL4. Focal SALL4 staining was seen in choriocarcinoma, 3 of 5 immature terato-mas and 3 of 12 mature teratomas. All of ITGCNs, seminomas showed diffusely strong D2-40 staining. ECs (4/14) were focally posi-tive for D2-40, while choriocarcinoma, YSTs and teratomas were negative for D2-40. Glypican-3 was diffusely positive in YSTs (13/14), and focally weakly positive in ECs (2/14), respectively. ITGCNs, seminomas, choriocarcinoma and teratoma were negative for Glypican-3. In contrast, 10 normal testicular tissues and 5 lymphomas showed no SALL4, D2-40 and Glypican-3 staining. Conclu-sions SALL4 is a useful diagnostic marker with high sensitivity and specificity for TGCTs. Combination of SALL4, D2-40 and Glypi-can-3 is helpful to the diagnosis and differential diagnosis for TGCTs.

Clinicopathological features and prognostic factors of apocrine carcinoma of breast / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic features and prognostic factors of apocrine carcinoma ( AC) of breast. Meth-od Clinical data of 70 ACs and 283 invasive carcinomas, not otherwise specified were collected. Differences between the prognostic outcomes of the two groups were compared, and the relationship between clinicopathological characteristics and prognosis was also ana-lyzed. Results The mean age of the patients with AC (56. 17 ± 12. 41 years) was older than those with invasive carcinoma not other-wise specified (52. 77 ± 11. 07 years) (P=0. 039). The patients with AC had a lower frequency of axillary nodal metastasis, a lower frequency of ER and PR positivity comparing to invasive carcinoma not otherwise specified ( P<0. 05 ) . No significant differences in the overall survival (P=0. 221) and disease-free survival (P=0. 378) periods of the two groups were observed. Kaplan-Meier surviv-al analysis showed tumor size, lymph node metastasis, pathological stage, lymph node tissue infiltration were related with prognosis of patients with AC ( P<0. 05 ) . In multivariate analysis, lymph node metastasis was associated with a worse prognosis ( P<0. 05 ) . Conclusions Although AC and invasive carcinoma not otherwise specified have different clinicopathologic characteristics, the prog-noses of patients with these diseases are similar. Lymph node metastasis could be used as an independent factor for predicting the prog-nosis of patients with AC, early diagnosis and early treatment is the key to improve its prognosis.

Multiple primary carcinomas including esophageal basaloid squamous cell carcinoma and gastric adenocarcinoma / 中华消化外科杂志

Synchronous multiple primary carcinomas refers to 2 or more than 2 kinds of different primary malignant tumors develop synchronously or in 6 months.The incidence of synchronous multiple primary carcinoma is low.A patient with esophageal basaloid squamous cell carcinoma (BSCC) and gastric adenocarcinoma was admitted to the First People's Hospital of Lianyungang in October 2011.The main symptom of this patient was dysphagia,and multiple lesions were found in esophagus,cardia and stomach fundus by gastroscopy respectively.On computed tomography image,eminence lesion in esophageal midpiece and wall thickening from esophagus-cardia to stomach fundus were displayed and were both enhanced slightly by enhancement scanning.The esophageal and cardia tumors were resected via left thoracic approach,and postoperative pathological examination revealed esophageal BSCC and moderately differentiated adenocarcinoma of cardia respectively.Comedo necrosis and red basal membrane material were seen under light microscope.The expressions of cytokeratin 5/6 and P63 were positive,the expression of cytokeratin L was weak positive and the expressions of synaptophysin,chromogranin A and CD117 were negative.The patient suffered from pleural effusion and multiple liver metastases after 4 months follow-up and died of liver metastases in May 2012.Multiple primary carcinomas including esophageal BSCC and gastric adenocarcinoma are rarely seen in clinical practice.Their diagnosis and differential diagnosis mainly depend on histological morphology and immunohistochemical method.Surgical resection combined with postoperative radiotherapy and chemotherapy is selectable,but the prognosis is poor.