Brentuximab vedotin in ALK-negative anaplastic large cell lymphoma presenting with alar mass: A case report

@#Anaplastic large cell lymphoma (ALCL) is a rare subtype of T-cell non-Hodgkin lymphoma (NHL) primarily involving the lymph nodes; however, extra-nodal manifestations are also common. Diagnosis can be confirmed by a combination of histopathology and immunohistochemical staining. Complete workup and staging include imaging and bone marrow examination. This presents a case of a 55-year-old male with anaplastic lymphoma kinase (ALK) - negative ALCL presenting with an alar mass. ALCL patients often present with rapidly progressing lymphadenopathy. Extra-nodal manifestations commonly involve the skin, liver, lung, and gastrointestinal tract. Biopsy of the mass showed small to medium-sized anaplastic lymphoid cells that stained positive for CD30, LCA (CD45), CD99, and negative for CD20, ALK (CD246), neuron-specific enolase, CD34, CD5, PAX5, TdT, MPO, CD138, EMA, pancytokeratin, CD3 and synaptophysin. These findings were most compatible with an ALK-negative ALCL. The patient was started on a combination of brentuximab vedotin, cyclophosphamide, doxorubicin, and prednisone (BV + CHP) every 21 days for 6 cycles. There was a progressive decrease in the size of the mass, and a resolution was noted after the 5th cycle. FDG-PET/CT scan was done after the 6th cycle of chemotherapy and 6 months after completion of treatment. Both scans showed no evidence of metabolically active nodal or extra-nodal lymphomatous disease. This case showed a unique extra-nodal manifestation of an ALK-negative ALCL presenting as an alar mass with a good response to BV + CHP. However, more evidence is necessary to further establish the role of BV as the first-line treatment regimen for CD30-positive peripheral T-cell lymphoma (PTCL), including ALK-negative ALCL.

Study on the determination of total flavonoids in Oxytropis falcata Bunge / 药学实践杂志

Objective To establish an UV spectrophotometry method for the determination of total flavonoids in Oxytropis falcata Bunge. Methods Using rutin as comparison，three coloration methods were used to find the optimal assay method, optimize the color conditions and take a systematic methodological investigation. Results The best color development method is aluminum chloride-sodium acetate color method. Using the test product without adding color reagent as a reference, 0.3 mol/L aluminum chloride solution 3.0 ml, 1.0 mol/L sodium acetate 4.0 ml, placed for 16 min, the sample was detected at 277 nm wavelength by AlCl3-CH3COONa reaction by using rutin as reference. The rutin content had a good liner relationship in the range of 8.8 to 44 μg/ml (r=0.9996), and the average recovery rate was 100.91% with RSD of 2.426%. Conclusion This method is simple, rapid, accurate and sensitive and can be used as a method for the determination of total flavonoids from Oxytropis falcata Bunge.

Evaluation of Glucosamine Effect Against Heart and Brain Damage Induced by Y-radiation or Aluminium Chloride in Female Rats

Abstract Glucosamine is known as anti-inflammatory, antioxidant and as neuroprotective as well as using to treat many of diseases. This work aimed to investigate the remedial effect of glucosamine (20mg/kg b.wt) against the damage induced by a single dose of γ-radiation (8Gy) or aluminium chloride (AlCl3) (100mg/kg b.wt) in the heart and brain tissues of female rats. Serum aspartate aminotransferase (AST), cholesterol, triglycerides (TGs), LDH and creatine kinase (CPK) were measured. Moreover, gene expression of amyloid protein precursor (APP) and seladin-1 were estimated in the brain tissue. Also, acetylcholinesterase activity (AChE) and p-tau protein expression were estimated in brain homogenate. Metallothioneine (MT) was estimated in the heart and brain tissues. Heart and brain histopathological examination was performed. Irradiation significantly decreased serum AST, CPK and LDH, as well as MT levels in heart and brain tissues. Also, gene expression of seladin-1 decreased. On the other hand, irradiation significantly increased serum TGs level and brain AchE activity, tau protein, and β-amyloid percursor (APP). AlCl3 administration (21 days) induced disturbance in most of the estimated parameters, especially AST, TGs, and MT. Glucosamine treatment with irradiation or AlCl3 improved most of the measured parameters. In addition, histopathological examination confirmed the biochemical results. In conclusion: Glucosamine could be used to improve the heart and brain damages induced by γ-radiation exposure or AlCl3.

Primary cutaneous anaplastic large cell lymphoma in a 73-year-old Filipino male

Introduction@#Primary cutaneous anaplastic large cell lymphoma (PCALCL) is an uncommonly encountered subtype of cutaneous lymphoma under the classification of CD30-positive lymphoproliferative disorders which presents histologically as large atypical lymphocytes with pleomorphic and anaplastic cytology that localizes to the dermis. Although recurrent, PCALCL usually carries a good prognosis, with 5-year survival rates ranging from 85% to 95%.@*Case Summary@#We report a 73-year-old elderly male who consulted at our out-patient department with a 3-year and 6-month history of multifocal, gradually enlarging, erythematous nodules with dry, necrotic areas on the scalp, right auricular area, left axillary area, right forearm, and right thigh, accompanied by loss of appetite and nontender cervical, left axillary, and right inguinal lymphadenopathy. Previous skin punch biopsy and immunohistochemical stain done by the patient’s preceding dermatologist was signed out as “suggestive” of pseudolymphoma. However, management with intralesional corticosteroid injections provided no improvement. Skin punch biopsy done at our institution revealed ALK negative (-) anaplastic large cell lymphoma. Patient was then referred to an oncologist, however, the patient was lost to follow-up and succumbed to community acquired pneumonia.@*Conclusion@#This case highlights the importance of a thorough diagnostic assessment as recent studies indicate a poorer prognosis of ALK (-) cases, with overall 5-year survival rates consistently below 50%.

Anaplastic large cell lymphoma presenting as sternal swelling

Lymphomas involving the sternum are very rare. We report a case of lymphoma presenting as lytic sternal lesion. A 14-year-old girl presented with history of painless swelling of central chest (sternum) of 3 months duration. Fine needle aspiration cytology from the site revealed anaplastic large cell lymphoma. It was confirmed by histopathology and immunohistochemistry. She underwent treatment with chemotherapy but succumbed to her illness after six months of treatment.

Linfoma anaplásico de células grandes (lacg) asociado a implante mamario. Reporte de un caso y revisión de la literatura / Breast implant-associated anaplastic large cell lymphoma (bia-alcl). Description of one case diagnosed at the Buenos Aires British Hospital and literature review

Introducción El linfoma anaplásico de células grandes (lacg) asociado a implante mamario es una rara entidad descripta por primera vez en 1977. Hasta la actualidad, la Food and Drug Administration (fda) ha recibido 359 reportes de casos. Se manifiesta habitualmente como un seroma peri-protésico tardío o, menos frecuentemente, como una masa peri-capsular. En la mayoría de los casos, se asocia con implantes texturizados. Es fundamental el estudio citológico del seroma y la realización de cd30 en casos de sospecha diagnóstica. El tiempo medio desde la colocación del implante al desarrollo de la enfermedad es de 7 años a 10 años. Más del 80% de las pacientes se presentan en estadios tempranos, pudiendo ser tratadas solo con cirugía y sin requerir tratamientos adyuvantes. Objetivo El objetivo del presente trabajo es realizar el reporte de un caso de lacg diagnosticado y tratado en el Hospital Británico de Buenos Aires y realizar una revisión de la literatura

Introduction Breast implant-associated anaplastic large cell lymphoma (bia-alcl) is a rare T-cell lymphoma first described in 1977. As of February 1, 2017, the fda has received a total of 359 medical device reports. It typically occurrs in a delayed fluid collection around a textured implant. Specimens should be sent for cytology; essential to the diagnosis of bia-alcl is immunohistochemistry for cd30 cell surface protein. The median time from implant placement to diagnosis of alcl was 7 to 10 years. Disease localized to the capsule may be treated with surgery alone. Objective In this report we describe our experience with one case of bia-alcl diagnosed at the Buenos Aires British Hospital and we perform a review of the literature.

Scutellaria barbata flavonoids inhibits NFT aggregation and regulatory mechanism in rats induced by composited Aβ / 中国病理生理杂志

AIM: To investigate the effects of Scutellaria barbata flavonoids (SBF) on neurofibrillary tangle (NFT) aggregation, tau protein phosphorylation and the regulated mechanism of glycogen synthase kinase (GSK) 3βand protein phosphatase (PP) 2A in the rats induced by amyloid βprotein 25-35 (Aβ25-35) in combination with AlCl3 and re-combinant human transforming growth factor ( RHTGF)-β1( composited Aβ) .METHODS:The male SD rats were used to establish the simulated Alzheimer disease ( AD) model by intracerebroventricular injection of composited Aβ.The Morris water maze was applied for screening the successful model rats with learning and memory deficits .The successful model rats were daily and orally administrated with SBF at doses of 35, 70 and 140 mg/kg or positive control drug Ginkgo biloba leaves flavonoids ( GLF) at 140 mg/kg for 37 d.The silver nitrate staining was used to determine the cortical NFT .The protein levels of total tau, phosphorylated protein of tau at Ser199 and Ser214 sites, GSK3βand PP2A in hippocampus and cortex were determined by Western blot .The mRNA expression of GSK3βand PP2A in the hippocampus and cortex was detected by RT-PCR.RESULTS:Compared with sham group , the cell number of positive NFT with silver nitrate staining in model rat cerebral cortex was significantly increased .The protein levels of phosphorylated tau protein at Ser 199 and Ser214 sites, GSK3βin the hippocampus and cerebral cortex in the model rats dramatically elevated , and PP2A was marked decreased as compared with the sham group rats.Meanwhile, the mRNA expression of GSK-3βsignificantly increased but PP2A was de-creased.However, these above abnormalities were differently attenuated by treating with SBF at different doses or GLF at 140 mg/kg for 37 d.CONCLUSION: SBF suppresses the NFT aggregation by inhibition of the regulatory functions of GSK-3βand PP2A, thus reducing the phosphorylation of tau protein .

Effects of acteoside on expression of caspase-3 in cerebral cortex of mouse models of Alzheimer’s disease / 中国药理学通报

Aim To investigate the effect of acteoside (AS)on the expression of caspase-3 in cerebral cortex of mouse models of Alzheimer’s disease(AD).Meth-ods Kunming (KM)strain mice were assigned into control group,model group,positive control group (VitE)and acteoside group.Every group was induced by a combination of D-galactose(i.p.60mg·kg -1 · d -1 )and AlCl3 (i.g.5mg·kg -1 ·d -1 )for 60ds ex-cept for control group,then mice were treated by dif-ferent concentrations(30,60,1 20 mg·kg -1 ·d -1 )of acteoside for 30ds.During the time,mice were in-duced continuously by a combination of D-galactose and AlCl3 .The learning and memory of mice were de-tected by step-down test,the activity of AChE in serum and brain of mice was measured by chemical colorime-try,the structure changes in cerebral cortex were ob-served by HE staining,and the expression of caspase-3 in cerebral cortex was analyzed through the immunohis-tochemical staining.Results Compared with model group,acteoside could improve the learning and mem-ory abilities(P <0.05 or P <0.01 ),decrease the ac-tivity of AChE in serum and brain(P <0.05 or P <0.01 ),and improve the morphology and number of neuron in cerebral cortex(P <0.01 ).Moreover,acte-oside could significantly inhibit the expression of caspase-3 in cerebral cortex (P <0.05,P <0.01 ). Conclusion Acteoside has significantly protective effects on brain damage of mice induced by a combina-tion of D-galactose and AlCl3 , and it′s protective mechanism probably relate to inhibiting the expression of caspase-3 and maintainings the normal morphology and number of neuron in cerebral cortex.

A study of 14 primary cutaneous anaplastic large cell lymphoma cases into their pathology features and relevance with clinical manifestations / 白血病·淋巴瘤

Objective To summarize the morphological and immunohistological and clinical manifestatical features of primary cutaneous anaplastic large cell lymphoma (PC-ALCL). Methods We analyzed retrospectively the morphological and immunohistological and clinical data of 14 cases with PC-ALCL and summarized their features. Results Fourteen cases of PC-ALCL were studied. Thirteen cases were followedup in which all cases were alive. There were 11 cases in common type which showed medium to large-sized cells with predominant pleomorphism, 2 cases in immunoblastic type and 1 case in small cell type. Immunohistochemical staining showed that more than 75 % tumor cells expressed CD30 in every case.Conclusion PC-ALCL is an uncommon subtype of lymphoma with an good prognosis. It is characterized by cutaneous nodules, the inflitartion of medium to large-sized cells and the diffuse expression of CD30.

Unusual presentation of paediatric anaplastic large cell lymphoma.

Anaplastic large cell lymphoma (ALCL) is a rare disease. Among childhood non-Hodgkin lymphoma, it constitutes less than 20% of the incidence of all cases. The clinical presentation though is known to be much diversified, most of the patients will present with an enlarged palpable cervical lymphadenopaty. Other reported features include fever of unknown origin, nonspecific pain, cough, shortness of breath, fatigue and malaise. We report a case of ALK-positive ALCL in a patient who presented with submandibular abscess. After defaulted treatment, the mass became fungating externally with everted edge that mimic squamous cell carcinoma.

A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma Mimmicking Keratoacanthoma / 대한피부과학회지

Pseudoepitheliomatous hyperplasia with a massive neutrophil infiltrate associated with primary cutaneous anaplastic large cell lymphoma has been rarely reported. Herein we report on a 33-year-old man who presented with multiple asymptomatic erythematous walnut-sized rapidly growing tumors on the axilla, trunk and left inguinal area for 1 month. The histopathologic features showed a keratoacanthoma-like epithelial hyperplasia in the epidermis and several large atypical lymphoid cells with nuclear plemorphism and abundant cytoplasm in the dermis. The atypical cells were obscured by a rich infiltrate of neutrophils and some eosionophils. Immunohistochemical studies confirmed the majority of the large anaplastic cells in the dermis were CD30+ cells. In addition, the expressions of anaplastic lymphoma kinase (ALK) and epithelial membrane antigen (EMA) were negative. There was no evidence of extracutaneous involvement. The patient was diagnosed with primary cutaneous anaplastic large cell lymphoma (ALCL) and he was treated with low dose methotrexate (15 mg/week). We think that this case was challenging both clinically and histologically.

A Case of Primary Cutaneous Anaplastic Large Cell Lymphoma with Extensive Inflammatory Cell Infiltration / 대한피부과학회지

Primary cutaneous anaplastic large cell lymphoma (ALCL) is composed of large cells with anaplastic, pleomorphic cytomorphology and the expression of the CD30 antigen by the majority (more than 75%) of tumor cells. Recently some variants of ALCL with extensive inflammatory cell infiltration have been reported. A 34-year-old male presented with multiple tumors over the arm, groin, and legs. The tumors of the right groin showed ulceration and purulent discharge. The biopsy specimens revealed extensive infiltrate of large atypical lymphoid cells with mixed inflammatory cells consisting of numerous eosinophils and neutrophils. Immunohistochemical staining was positive for CD3, CD4, and CD30. TCR-gamma gene rearrangement was detected. There was no evidence of extracutaneous involvement. We report a case of primary cutaneous ALCL, associated with marked inflammatory cell infiltration. Diagnosis in such cases is challenging because the large atypical lymphoid cells may be easily obscured by the massive infiltrate of eosinophils and neutrophils.

A Case of CD30 (+)/ALK (-) Primary Systemic AnaplasticLarge Cell Lymphoma with Atypical Clinical Features / 대한피부과학회지

Anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's lymphoma, and this tumor is predominantly composed of large lymphoid cells that have a strong expression of CD30. Two major groups of ALCL have been described. The first is a spectrum of CD30+ lymphoproliferative disorders, including primary cutaneous ALCL and lymphomatoid papulosis. The second is systemic nodal ALCL, which can be subdivided into two groups: anaplastic lymphoma kinase (ALK)-positive and ALK-negative. The relative frequency of ALCL in Korea is about 19% of all cutaneous lymphomas. Solitary or multiple large nodular tumoral lesions confined to one body compartment are the most common presentation. We report here on a case of CD30 (+)/ALK (-) primary systemic ALCL in a 77 year-old-male, and the skin lesion manifested as multiple papules, plaques and tumors on the trunk, buttocks and upper and lower extremities.

A Case of Primary Cutaneous CD30+/ALK- Anaplastic Large Cell Lymphoma Presenting with Nodules and Numerous Eruptive Papules / 대한피부과학회지

Primary cutaneous CD30-positive, anaplastic large cell lymphoma (ALCL) is a rare cutaneous peripheral T cell lymphoma with a favorable prognosis. ALCL is characterized by a solitary or localized skin tumor composed of sheets of atypical lymphoid cells with pleomorphic or anaplastic nuclei. Herein we report a 67-year-old woman presented with tender nodules and severely pruritic numerous eruptive papules. Histopathologic examination revealed dense non-epidermotrophic infiltrates of atypical large cells with round, oval or irregularly shaped nuclei and abundant cytoplasm. Immunohistochemical studies demonstrated that most lymphoid cells in the dermis and subcutis were positive for CD30 and CD45RO, and negative for CD20 and CD56.

A Case of ALK-Negative Systemic Anaplastic Large Cell Lymphoma

No abstract available.

Effects of chrysophanol on memory impairment mice and its mechan ism analysis / 中国药理学通报

AIM To study the protective effects and mechanism of chrysophanol on learning and memory impairment of mice with acute senile model induced by AlCl 3. METHODS After sc of AlCl 3 60 mg?kg -1 for 7 d and ip chrysophanol 10,1,0 1 mg?kg -1 for 15 d, using step-through test and step-down test, the effect of chrysophanol on learning and memory was observed and the superoxide dismutase (SOD) activities in cerebrum and glutathione peroxidase (GSH-px)activities in plasma and cerebrum were measured. RESULTS Chrysophanol 10,1,0 1 mg?kg -1 significantly improved me mory impairment induced by AlCl 3 and enhanced the activities of GSH- px and SOD. CONCLUSION Chrysophanol showed protective effect on br ain memory impairment of mice in acute senile model induced by AlCl 3, perhaps the mechanism is involved in enhancing the activities of GSH-px and SOD, cleari ng away the oxygen radicals, protecting the brain neurons from the harm of lipop eroxide.

A Case of Primary Cutaneous CD30+/ALK- Anaplastic Large Cell Lymphoma / 대한피부과학회지

Primary cutaneous CD30(Ki-1) positive anaplastic large cell lymphoma(ALCL) is a rare subset of cutaneous lymphoma, with a much better prognosis. ALCL is a heterogeneous process that may have a T-cell, B-cell, or indeterminant(null) phenotype and which may or may not express the anaplastic lymphoma kinase(ALK) oncoprotein. We report a case of ALCL in a 72 year old man. About 4 months ago, multiple erythematous firm ulcerative mass and satellite nodules developed on the right lower leg. The skin lesions rapidly increased in number and size. Some lesions became painful and centrally ulcered. The histologic findings showed a diffuse infiltrate of large lymphocytes with large nuclei, prominent and multiple nucleoli, and ample cytoplasm. Immunohistochemical stainings for CD30, CD5 were positive but stainings for LCA, CD3, CD45RO, CD20, cytokeratin, EMA, and ALK were negative. Therefore, we diagnosed our case as CD 30+/ALK- ALCL.

Modulation of AlCl_3 on GABA-activated currents in isolated rat DRG neurons / 中国药理学通报

AIM To study the modulation of AlCl 3 on GABA activated currents in isolated rat dorsal root ganglion (DRG) neurons. METHODS Using whole cell patch clamp technique to investigate the effects of AlCl 3 on GABA activated currents in isolated rat DRG neurons. RESULTS The majority of the neurons examined(46/58) were sensitive to GABA in the concentration range from 1 to 1 000 ?mol?L -1 . In the 46 GABA sensitive cells, responses induced by AlCl 3 manifested three types: (1) outward current(3/46); (2) inward current(5/46) and (3) no detectable response(38/46). As compared with GABA activated current, the amplitude of AlCl 3 activated current was smaller. Preapplication with low concentrations of AlCl 3 (≤100 ?mol?L -1 ), the GABA activated current in majority of the cells(32/38) was potentiated, which was dose dependent, the current in a few cells(4/38) was inhibited, while the remaining two(2/38) showed no effect. At higher concentration( 1 000 ?mol?L -1 ), AlCl 3 inhibited the GABA activated current( n =8). It was found that AlCl 3 potentiated both the peak value of and the steady state value of GABA activated currents. CONCLUSION AlCl 3 can modulate the function of GABA A receptors.