Primary cutaneous follicular lymphoma: an assessment of clinical, histopathologic, immunophenotypic, and molecular features.

PURPOSE: Unlike nodal follicular lymphoma (NFL), Primary cutaneous follicular lymphomas (PCFLs) rarely express Bcl-2 protein or t(14;18)(q32;q21) (Bcl-2/IgH). The aim of this study was to further characterize PCFL in a large series from North America. PATIENTS AND METHODS: Clinical data and archival formalin-fixed, paraffin-embedded tissue were obtained from 32 patients. PCFL was defined as follicular lymphoma limited to the skin at the time of diagnosis and within the first 6 months after diagnosis. Specimens were analyzed for the expression of CD3, CD10, CD20, Bcl-2, and Bcl-6 proteins by immunohistochemistry as well as for the presence of t(14;18)(q32;q21) by polymerase chain reaction. RESULTS: The male-to-female ratio was 1.5:1, with a median age of 60 years. Twenty-four patients had lesions on the head and neck, five had lesions on the trunk, and three had lesions on both head and trunk. Follow-up data were available in all cases, with a mean length of 35.8 months. The majority of the patients were treated with radiation therapy. All patients were alive at last follow-up except one. Recurrence was noted in seven patients (22%), after a mean disease-free survival time of 17.7 months. CD10 and Bcl-6 expression were seen in 29 (91%) of 32 and 31 (97%) of 32 cases, respectively. Bcl-2 expression was noted in 13 (41%) of 32 cases. PCR results for t(14;18)(q32;q21) were positive in 11 (34%) of 32 patients and showed correlation with Bcl-2 protein expression. The sequencing of the t(14;18)(q32;q21) amplicons confirmed unique breakpoints in each of the seven tested cases. Comparison between the Bcl-2 and/or t(14;18)(q32;q21)-positive and t(14;18)(q32;q21)-negative cases revealed no significant difference in age, site, clinical course, or outcome. CONCLUSION: We demonstrated Bcl-2 protein expression and t(14;18)(q32;q21) in a significant minority of cases, suggesting a relationship with NFL. It remains to be seen whether, on longer follow-up, there is any clinical difference in cases with and without t(14;18)(q32;q21).

Granular cell tumor of the thyroid.

A case of granular cell tumor of the thyroid gland occurring in a 23-year-old woman is reported. The patient presented with a painless mass in the neck, but was otherwise in good health and had no associated disorders. Fine-needle aspiration biopsy was performed prior to surgery and yielded thyroid epithelial cells with possible oncocytic-type change. To our knowledge, the English language literature contains only one other report of a granular cell tumor of the thyroid. Our case supports the recent suggestion of a neural crest origin for some types of thyroid neoplasia.

Effect of intracerebroventricular injection of neokyotorphin on the thermoregulatory responses in rats.

Intracerebroventricular injection of neokyotorphin (NKT) (0.5-2.0 micrograms) caused a dose-related increase in body temperature (Tb) of rats maintained at 28 degrees C. The change in Tb of the rat induced by the optimal dose of NKT (1 microgram) was attenuated when the rat was exposed to 18 degrees C. At both ambient temperatures, heat production was not affected but heat loss was significantly reduced at 28 degrees C in rats receiving 1 microgram NKT. Pretreatment with naloxone (5 mg/kg, IP) significantly reduced the hyperthermic effect induced by NKT (1 microgram). These results suggest that NKT can affect the prevailing thermoregulatory heat loss activities and this effect may be mediated through stimulated release of endogenous opioids.