ABSTRACT
Currently, lymphoma diagnosis is based on a combination of morphology, immunophenotyping, and molecular testing. Using the example of an unusual case of malignant non-Hodgkin lymphoma, we show that improved visualization using digital pathology contributes to the convergence of these complementary diagnostic modalities. A 45-year-old woman presented with skin rash and cervical lymphadenopathy. Histological workup of an excised lymph node showed loss of normal architecture with diffuse infiltration and increased mitotic activity. Immunohistochemistry for CD3/CD5 showed atypical arrangement and infiltration of a T-cell population that dominated over regionally dense, MUM1-positive plasmacellular infiltrates. Expanded CD21/CD23-positive meshworks of follicular dendritic cells were present within and between regressed follicles and the T-cell infiltrate; staining for CD56 and cyclin-D1 was negative. Quantification of Ki-67 staining within the T-, B- and plasmacellular compartments was achieved by digital image conversion, overlay and subsequent quantification algorithms that revealed proliferation within more than 60% of T-cells, over 50% of plasma cells and only 20% of B-cells. Clonality analysis by PCR revealed monoclonal rearrangement for both T-cell receptor gamma chains and immunoglobulin heavy chains. Taken together, we present an unusual combination of an angioimmunoblastic T-cell lymphoma (AITL) and simultaneous plasmacellular lymphoma. This report demonstrates how application of modern tools of digital pathology can visually integrate unusual morphological and molecular findings.
Subject(s)
Image Enhancement , Immunoblastic Lymphadenopathy/pathology , Immunophenotyping , Lymph Nodes/pathology , Lymphoma, T-Cell, Cutaneous/pathology , Neoplasms, Multiple Primary/pathology , Plasmacytoma/pathology , B-Lymphocytes/pathology , Biomarkers, Tumor/analysis , Biomarkers, Tumor/genetics , Diagnosis, Differential , Female , Gene Rearrangement, T-Lymphocyte/genetics , Humans , Immunoblastic Lymphadenopathy/genetics , Immunoblastic Lymphadenopathy/immunology , Immunoglobulin Heavy Chains/genetics , Interferon Regulatory Factors/genetics , Ki-67 Antigen/genetics , Lymphoma, T-Cell, Cutaneous/genetics , Middle Aged , Neoplasms, Multiple Primary/genetics , Plasma Cells/pathology , Plasmacytoma/genetics , Polymerase Chain Reaction , Receptors, Antigen, T-Cell, gamma-delta/genetics , T-Lymphocytes/pathologyABSTRACT
The paper defines metasyndromes as syndrome combinations. Within the framework of Configural Frequency Analysis the authors propose using a single test for identifying patterns of syndromes rather than applying simultaneous tests for identifying singular syndromes. The authors describe and illustrate the method using the "classical data" that describe symptom patterns under LSD (Lienert, 1971). The rationale of the new procedure is to combine independent tests as was proposed by Wartmann and Wette (1952) as a means for meta analysis.
Subject(s)
Affect/drug effects , Consciousness/drug effects , Lysergic Acid Diethylamide/pharmacology , Models, Statistical , Thinking/drug effects , Humans , SyndromeABSTRACT
The paper entitled "Two-sample CFA: Solitary and complementary discriminant types of treatment- and control groups" suggests to modify 2-sample and c-sample CFA as follows: While singular patterns of attributes define solitary types, complementary pairs of patterns define complementary types which may be interpreted as poles of a type-defining factor in factor analysis. The new version of 2-sample CFA is illustrated in 2 examples from clinical psychology with patterns of scales and symptoms.
Subject(s)
Depressive Disorder/psychology , Personality Tests , Depressive Disorder/therapy , Follow-Up Studies , Humans , Psychometrics/methods , TemperamentABSTRACT
A new concept on configural frequency analysis (CFA) is presented under the title: CFA, Victor's singular types and syndromes. The new concept is suitable and highly effective if one and only one type, a singular type, is present within a population of subjects or patients. It is based on the nullhypothesis of quasi-independence which assumes that a type-population with coincident variables is superimposed to a residual population with independent variables. The singular type CFA is illustrated by a set of data where a subgroup of dyslexics is mixed up with a residual group of non-dyslexics who have been evaluated as to reading, vocabulary and spelling. The resulting type, not to be identified by classical CFA, was shown to be singular and clear-cut with weakness in all 3 verbal tests. The importance of singular types and syndromes for psychopathology is discussed clinically and theoretically.
Subject(s)
Bipolar Disorder/diagnosis , Dyslexia/diagnosis , Neuropsychological Tests/methods , Psychiatric Status Rating Scales/methods , Schizophrenia/diagnosis , Analysis of Variance , Child , Humans , Psychometrics/methods , SyndromeABSTRACT
The paper discusses configural cluster analysis (CCA) as an alternative to configural frequency analysis (CFA). CFA defines types as deviations from the assumption of no interactions among the variables. CCA defines clusters as deviations from the stronger assumption of a total lack of effects, in the contingency table. Variations of CCA as aggregating CCA, hierarchical CCA, m-sample CCA, and CCA of profile shifts are discussed. An example analyzes data from research on depression.
Subject(s)
Cluster Analysis , Depressive Disorder/diagnosis , Personality Tests/methods , Psychometrics/methods , Depressive Disorder/psychology , Humans , SyndromeABSTRACT
The concept of conventional interaction-structure-analysis (ISA) consists of comparing and analyzing two groups of variables. In the present paper this concept is thus generalized that more than two groups of variables can be analyzed. Data from depression research are analyzed by forming three groups of symptoms. The discussion expounds on strategies of data analysis with generalized ISA (GISA).
Subject(s)
Depressive Disorder/psychology , Psychological Tests , Attitude to Death , Child , Depressive Disorder/diagnosis , Humans , Motor Activity , Psychometrics , Sleep Wake Disorders/psychology , Social Adjustment , Somatoform Disorders/psychology , ThinkingSubject(s)
Dose-Response Relationship, Drug , Mathematical Computing , Female , Humans , Male , Nicotine/pharmacology , Sex Factors , SmokingABSTRACT
To avoid anticonservative rejections of CFA null hypotheses when using Lehmacher's test Küchenhoff suggested to apply a continuity correction. This correction reduces the differences between observed and expected cell frequencies by a constant. The present paper discusses this variant of Lehmacher's test. Application of the correction for continuity in the search for types of sociogene neuropathology are presented. The discussion covers the effectivity of CFA tests in connection with Holm's method of alpha adjustment.
Subject(s)
Child Behavior Disorders/diagnosis , Psychological Tests , Social Behavior Disorders/diagnosis , Child , Child Behavior Disorders/psychology , Humans , Psychometrics , Social Behavior Disorders/psychologyABSTRACT
Configural Frequency analysis (CFA) is a method for the detection of significantly high or low frequencies in multivariate contingency tables. As a criterion for the comparisons. CFA uses expected frequencies from log-linear models which reflect assumptions on the association structure of the variables under study. The present paper extends models of CFA such that triplet associations or even higher order associations can be considered. Examples use empirical data from research on depression in children. Results show the existence of higher order types.
Subject(s)
Depressive Disorder/psychology , Neurotic Disorders/psychology , Psychological Tests , Child , Humans , Psychometrics , Psychophysiologic Disorders/psychologySubject(s)
Clinical Trials as Topic/methods , Disease , Remission, Spontaneous , Humans , Psychotherapy , Research Design , Statistics as TopicABSTRACT
The paper entitled "Configural frequency analysis XXII. Types of normatively patterned scales" starts from assuming that a battery of clinical test scales is measuring just one dimension of pathology (general factor). If a battery is really measuring more than one dimension (multiple group factors) of pathology, the sample of testees will produce types of binarily patterned scales. An individual profil is to be interpreted as a profil if it is representing a so called scale pattern type; otherwise it is to be interpreted by its level only. The scale pattern CFA is identified as a variety of second order CFA and is discussed as to its implications in clinical diagnosis.
Subject(s)
Mental Disorders/diagnosis , Psychological Tests , Humans , Mental Disorders/psychology , Psychometrics , Reference ValuesABSTRACT
The paper entitled "Configural Frequency Analysis, XXI b. Type analysis of bivariate response curves in hypertensive and normotensive subjects" is concerned with plasma levels of epinephrine and norepinephrine recorded in the course of a mental strain experiment. Plasma level response curves allow to identify univariate and bivariate types of response patterns. "Discriminant" and "association" types of hyper- and normotensives are demonstrated as two alternative ways of interpretation. The types are seen as psycho-endocrinological correlates of psychosomatic induced hypertension.
Subject(s)
Hypertension/psychology , Analysis of Variance , Arousal/physiology , Blood Pressure , Epinephrine/blood , Humans , Norepinephrine/blood , Stress, Psychological/complicationsABSTRACT
Longisectional interaction structure analysis (LISA) is a method for evaluating multivariate observations in a sample of individuals (patients) at two or more than two subsequent times (stages). It combines cross-sectional configural frequency analysis (CFA) for defining interactions between variables at a given stage with longitudinal interaction structure analysis (ISA) in relating variables observed at two subsequent stages, nonparametrically. The interactions are identified locally as types rather than globally as contingencies, where types are defined as (cross-sectional or longitudinal) patterns occurring in more individuals than expected under H0 of no (cross-sectional or longitudinal) interaction. LISA is applied to data sets from a clinical follow-up study and from a longitudinal study within developmental psychology. It is shown to be a useful technique for the interpretation of such data.
Subject(s)
Developmental Disabilities/diagnosis , Mental Disorders/drug therapy , Psychopathology/methods , Psychopharmacology/methods , Statistics as Topic/methods , Adolescent , Child , Drug Evaluation/methods , Haloperidol/therapeutic use , Humans , Longitudinal Studies , Schizophrenia/drug therapyABSTRACT
Two types of schizophrenic patients, 27 with a high and 21 with a low energetic level, were treated for 3 weeks under double blind conditions with 16 (24 patients) or 80 mg (24 patients) haloperidol orally per day. The patients were rated by the ward psychiatrist as markedly or not markedly improved. Evaluation made by odds ratio comparison showed that (1) patients with a high energetic level (plus-type patients) improved with low doses whereas (2) patients with a low energetic level (minus-type patients) improved with high doses of haloperidol.
Subject(s)
Haloperidol/therapeutic use , Schizophrenia/drug therapy , Humans , Schizophrenia, Paranoid/drug therapy , Schizophrenic PsychologyABSTRACT
48 acute paranoic schizophrenics were treated by high or low dosages of haloperidol and rated for improvement after 3 weeks of treatment. The treatment effect was a differential one in that so-called plus-type schizophrenics improved from low dosages of haloperidol while so-called minus-type schizophrenics improved from high dosages of haloperidol. Testing for differential effects was made by 3-way configural frequency analysis.
