RESUMO
Primary skin large B-cell lymphosarcomas (PLBCL) present with skin lesions, other organs and systems are not involved. As CHOP courses are not high effective in PLBCL, we were the first to treat a patient with modified block therapy NHL BFM-90. A complete remission was achieved after the first course of polychemotherapy and was consolidated by two courses of treatment. Further follow-up is needed.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Intervalo Livre de Doença , Relação Dose-Resposta a Droga , Humanos , L-Lactato Desidrogenase/sangue , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Indução de Remissão , Neoplasias Cutâneas/patologiaRESUMO
AIM: To analyse immunophenotype of diffuse large B-cell lymphoma (DLBCL) with flow cytometry. MATERIAL AND METHODS: Combinations of antibodies against the following antigens were used: CD3/ CD19/CD45, CD5/CD19/CD38, CD19/CD10/CD23, CD4/CD8/CD3, kappa/lambda/CD19, CD25/CD20/FMC7; CD43/CD22/CD20; CD79a/Ki-67/CD3; cytoplasmic kappa/lambda. The analysis was made on flow fluorimeter FacsCalibur using computer program CellQuest (Beckton Dickenson, USA). RESULTS: Specific coexpression of markers is not detectable in DLBCL, in the greatest degree the phenotype corresponds to lymphoma from the cells of the marginal zone. The study of cells with maximal direct light diffusion provides more precise assessment of clonality and proliferative potential of tumor cells than the analysis of the whole lymphocytic polygon. The proliferative index in 33 cases of DLBCL varied in the range 10-60%. CONCLUSION: Flow cytometry in most DLBCL cases allows identification of B-cell clonality, more precise assessment of a proliferative potential of the tumor.
Assuntos
Antígenos de Neoplasias/análise , Citometria de Fluxo , Linfoma de Células B/patologia , Linfoma Difuso de Grandes Células B/patologia , Diagnóstico Diferencial , Humanos , ImunofenotipagemRESUMO
Uncontrolled proliferation is one of the main features of tumor cells, and therefore proliferative indices provide prognostic information, which might be valuable for treatment selection. However, in aggressive human lymphoid tumors, an admixture of normal (reactive) cells may be available in all organs infiltrated by neoplastic cells. We have presented data on determining proliferative activity using Ki-67 immunostaining, and demonstrated that an admixture of reactive cells could exert significant influence on the assessments of proliferative indices. We developed an experimental approach, which makes it possible to select neoplastic cells from the overall lymphoid population and to assess their proliferative activity - tumor cell proliferative indices. Tumor cell proferative indices determined in large cell lymphomas might be significantly higher than proliferative indices of overall populations, and the use of tumor cell proliferative indices will result in a more accurate assessment of disease prognosis.
Assuntos
Linfoma de Burkitt/patologia , Leucemia Linfocítica Crônica de Células B/patologia , Linfócitos/patologia , Linfoma de Burkitt/diagnóstico , Núcleo Celular/patologia , Proliferação de Células , Progressão da Doença , Humanos , Citometria por Imagem , Imunofenotipagem , Antígeno Ki-67/análise , Leucemia Linfocítica Crônica de Células B/diagnóstico , Linfonodos/patologia , Linfócitos/imunologiaRESUMO
We describe three lymphoid tumors with the same immunophenotype characteristic for chronic lymphoid leukemia (CD19+/CD5+, clonality of the light immunoglobulin chains, CD23+ and CD10-). However, clinical picture and morphology of neoplastic cells dictate different clinical forms of these cases: chronic lymphoid leukemia, large cell transformation of chronic lymphoid leukemia and diffuse large B-cell lymphoma. Taking into account that immunophenotype reflects the origin of tumor, while clinical outcome and morphological features of cells reflect the stage of tumor progression and/or pathway of tumor formation, we discuss the approach to natural classification of lymphoid tumors based on the process of their evolution.