Clinicopathologic study of 105 lymphoblastic lymphoma cases / 白血病·淋巴瘤

Objective To study the clinicopathologic features and prognosis factor of Chinese lymphoblastic lymphoma.Methods 105 LBL cases were collected.Routine HE staining,immunostaining were used to investigate the clinicopathologic features,immunotype.Results The ratio of male to female was 1.76:1 (67:38),the medial age was 13 years old (0-73 years old).53 cases (53/105,50.48 ％) primarily showed lymph node involvement,including 34 cases (34/53,64.15 ％) showed jugular node involvement;mediastinum (12/52,23.08 ％) was the most frequent extranodal involvement site.69 cases (69/105,65.71％)showed bone marrow involvement with 15 cases as the primary involvement.The expression of TdT,CD99,CD3(E),CD20,CD79a,PAX5,MPO,CD34 and CD117 was 84.76 ％ (89/105),85.00 ％ (68/80),54.37 ％ (56/103),16.67 ％ (16/96),40.00 ％ (8/20),46.67 ％ (28/60),14.29 ％ (8/56),25.00 ％ (4/16) and 0.All cases were divided in to two groups,62 cases as T-LBL (59.05 ％,62/105) and 33 cases as B-LBL (31.43 ％,33/105),with 9 cases (8.57 ％,9/105) without the expression of T or B cell marker and 1 cases with the expression of both T and B cell marker.61 cases were detected the expression of myeloid markers and 8 cases were positive.All cases were followed up.The medial survival was 36 months.The survival at 1 year,2 year and 3 year was 66.67 ％ (70/105),48.81％ (41/84) and 20.69 ％ (12/58) respectively.Age was the prognosis associated factor.The children had better progonosis than adults.Immunotype,bone marrow involovement and transplantation didn' t show prognosis indicator (P ＞ 0.05).Conclusion Most of Chinese LBL occurs in child and younger male,multi-lymphadehypertrophy and bone marrow involvement are common.LBL is an aggressive tumor.Age is the prognosis associated factor.Children have a better prognosis than the adult.

Clinical and pathological features of the sporadic Burkitt's lymphoma / 白血病·淋巴瘤

Objective To investigate the clinical and pathological features of the sporadic Burkitt's lymphoma(BL),as well as its immunohistochemical and molecular characteristics.Methods 20 cases of sporadic BL were retrospectively studied by analyzing their light microscopy features,immunohistochemical expression,EBV infection detected by in stiu hybridization,chromosomal breakage of c-myc and/or lgH genes by interphase fluorescence in stiu hybridization (FISH),and their clinical manifestation.Results All the 20 cases of sporadic BL occurred in children(3-14 y)including 16 males and 4 females.Microscopically,the medium-sized tumor cells were monomorphic and proliferated in a diffuse pattern showingstarry-skywith numerous karyorrhectic debris.Mitotic figures were frequently seen.Immunohistochemically,the tumor cells were positive for CD20 and CD10,over 95%positive for Ki-67 and negative for TdT,CD99,MPO. No EBV infection wag found by in situ hybridization in 18 cases.Interphase FISH analysis detected c-myc gene breakage or amplification and/or IgH/c-myc gene breakage in all detected 15 cases.Conclusion Sporadic BL is a high-grade malignant B cell lymphoma.The tumor cell proliferation index is very high.Molecular and immunohistochemical analysis could reduce the incidence of misdiagnosis and thus phys a vital role on its correct diagnosis and appropriate therapy.

Expression of ALK-1, TIA-1 and granzyma B in primary systematic anaplastic large cell lymphoma and their significances on clinical outcome / 白血病·淋巴瘤

Objective To study the expressions of anaplastic lymphoma kinase (ALK-1) and cytotoxic proteins in primary systemic anaplastic large cell lymphoma (S-ALCL) and their relationship with clinical outcome. Methods 51 S-ALCL cases were collected from Lymphoma Lab of Peking University Health Science Centre & Peking Children's Hospital. The morphologic characteristics were studied under routine microscope, and essential immunohistochemical stainings were performed and reviewed to confirm the diagnosis of S-ALCL. Immunohistochemical stainings for ALK-1 and cytotoxic proteins (TIA-1 & granzyme B) were performed using standard SP method. Patients related clinical data including follow-up materials were collected. Results Survival time of 44 cases with completely clinical follow up materials ranged from 0.5～66months. 36 out of 51 cases(37 %) was positive for ALK-1 protein. While 20 cases out of 47 S-ALCL cases ( 42.55 % ) positive for granzyme B and 22 out of 28 cases (81.48 %) were positive for TIA-1. The prognosis of patients with ALK-1 protein positive and granzyme B negative expression was better, but TIA-1 expression might have nothing to do with clinical outcome (P＞0.05). In addition, multivariate analysis confirmed that ALK-1 protein expression, granzyme B protein expression and Ann-Arbor stage system were possible for prognosis(P＜0.05), Conclusion Expression of ALK-1 and granzyme B protein expression may serve as two independent prognostic predictors in S-ALCL patients.

Pathological characteristics mixed epithelial and stromal tumor of kidney / 北京大学学报(医学版)

Objective:To study the clinicopathological features of mixed epithelial and stromal tumor of the kidney(MESTK). Methods:Clinical and pathological characteristics of one case of MESTK was stu-died. Results:A case of MESTK which uncommonly occurred in a 16-year old adolescent male presented with dysuria and a large mass in the right renal region without a history of estrogen/progestogen treatment and/or obesity or urogenital surgery. Radiology revealed a large cystic/solid mass within the right kidney. Grossly, it was well demarcated and had a solid and cystic appearance on sectioning. Microscopically, the tumor was composed of a mixture of stromal and epithelial components. The epithelial component was composed of flat to columnar cells forming glands or tubules. The stromal components essentially consisted of bland, loosely packed spindle cells in an edematous and myxoid background. In some areas, there were smooth muscle cells forming bands and fascicles but no ovarian-type stroma was present. Immunohistochemical staining revealed that the epithelial components were positive for AE1/AE3 and focally positive for estrogen receptor(ER),progesterone receptor(PR), CD10 and Vimentin, whereas the stromal components were positive for ER, PR, Desmin and smooth muscle actin(SMA). Both epithelial and stromal components were negative for HMB-45, S-100,?-inhibin and WT-T. Five months after resection, the patient was well without evidence of recurrence. Conclusion:MESTK occurred in a pubertal male, as in the current case, supports the hypothesis that proliferation of remnants of the primitive mesenchyme in the kidney in situation of sex-steroid abnormity may play an important role in the pathogenesis of male MESTK.