Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
Am J Surg Pathol ; 41(5): 706-716, 2017 May.
Article in English | MEDLINE | ID: mdl-28248816

ABSTRACT

We encountered a patient with infantile nephrotic syndrome associated with a dense interstitial inflammatory infiltrate and prominent extramedullary hematopoiesis. Immunohistochemical analysis revealed numerous terminal deoxynucleotidyl transferase (TdT)-positive cells, which may raise concern for lymphoblastic lymphoma. Thus, we further characterized a group of pediatric kidneys with inflammation. TdT-positive nuclei were quantitated, and dual immunostains for TdT/CD79a, TdT/CD3, and TdT/CD43 were performed in a subset of cases; flow cytometry was performed in 1 case. TdT-positive nuclei were present in inflamed pediatric kidneys in 40 of 42 patients. TdT counts (average of 3 maximal high-power fields) ranged from 1 to >200, with a mean of 47. The presence and number of TdT-positive nuclei showed a strong association with younger patient age. Extramedullary hematopoiesis was identified in 11/42 patients, all under the age of 1. The presence of extramedullary hematopoiesis did not correlate with TdT count (P=0.158). Dual immunostaining and flow cytometric analysis in 1 case showed weak expression of B-cell markers and favored normal precursor B cells. Although TdT is a common marker of lymphoblastic lymphoma, we have demonstrated that TdT-positive cells may be part of the inflammatory milieu in infant kidneys. Together with cytologic, architectural, and clinical features, these data can help to avoid misinterpretation of involvement by lymphoblastic lymphoma/leukemia.


Subject(s)
DNA Nucleotidylexotransferase/analysis , Kidney/chemistry , Nephritis/metabolism , Nephrotic Syndrome/metabolism , Adolescent , Biomarkers/analysis , Biopsy , CD3 Complex/analysis , CD79 Antigens/analysis , Child , Child, Preschool , Diagnosis, Differential , Flow Cytometry , Hematopoiesis, Extramedullary , Humans , Immunohistochemistry , Infant , Infant, Newborn , Kidney/pathology , Kidney/surgery , Leukosialin/analysis , Male , Nephrectomy , Nephritis/diagnosis , Nephritis/surgery , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/surgery , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Predictive Value of Tests , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...