RESUMO
Plasmablastic lymphoma (PBL) is a rare, highly aggressive lymphoma typified by immunoblast-like cells with abundant basophilic cytoplasm and paranuclear hof. It shows absent expression of CD45 and CD20. In contrast, it displays a constant reaction with CD138 and VS38c. It may be easily misinterpreted as some other lymphoma. An exhaustive integration of clinical, morphologic, phenotypic, and molecular features is important to exclude misdiagnosis and inappropriate treatment. We report a case of HIV-negative PBL arising on the left areas of posterior teeth mucosa of a 58-year-old man. Immunohistochemically, the tumor cell was immunoreactive for CD138, VS38c, VEGF, and vimentin; Ki-67 showed a high proliferation rate. Epstein-Barr virus (in situ hybridization) was nonreactive, and IgH gene rearrangement was identified by polymerase chain reaction amplification products. A diagnosis of PBL was rendered.
Assuntos
Neoplasias Gengivais/diagnóstico , Linfoma Difuso de Grandes Células B/diagnóstico , Mucosa Bucal/patologia , Biomarcadores Tumorais/metabolismo , Neoplasias Gengivais/genética , Neoplasias Gengivais/metabolismo , Soronegatividade para HIV , Humanos , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/metabolismo , Masculino , Pessoa de Meia-IdadeRESUMO
Metaplastic breast carcinoma (MBC) encompasses a heterogeneous group of tumors. Based upon the microarray of MBCs, these tumors showed features of basal-like carcinoma and myoepithelial differentiation. However, MBCs entity still remained unclear. So we performed a systematic research to explicit metaplastic breast carcinomas further. A panel of ER, PR, HER-2, CK5/6, CK14, P63 and EGFR were prepared for detection of MBCs, and fluorescence in situ hybridization for HER-2 gene amplification and ultrastructure observation were also performed. Sensitiveness between CK5/6 and other antibodies in diagnosis was analysed, and survival analysis was also carried out. ER, PR and HER-2 were negative. CK5/6 (12/12), CK14 (9/12), EGFR (10/12) and P63 (8/12) were positive. FISH for HER-2 displayed no amplification (ratio values < 1.8). Ultrastructure showed tonofibrils, thin filament and dense body in the cytoplasm. Significant statistical differences were detected between groups (F = 8.080, P = 0.000) of score of CK5/6, CK14, P63 and EGFR. Significant statistical differences were also detected between age and lymph node involvement and survival (χ(2) = 10.835, P = 0.004). MBCs may be actually basal-like carcinomas. In the diagnosis of MBCs, CK5/6, CK14, P63 and EGFR may be effective and CK5/6 may be more sensitive than CK14 and P63. Survival of MBCs may be associated with age and lymph node involvement. However, given the limitations of our research accumulated cases, prospective clinicopathologic studies are needed to further elucidate MBCs.
Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Carcinoma Basocelular/mortalidade , Carcinoma de Células Escamosas/mortalidade , Metaplasia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/genética , Carcinoma Basocelular/genética , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Receptores ErbB/metabolismo , Feminino , Amplificação de Genes , Humanos , Técnicas Imunoenzimáticas , Hibridização in Situ Fluorescente , Metaplasia/genética , Metaplasia/patologia , Pessoa de Meia-Idade , Prognóstico , Receptor ErbB-2/genética , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Taxa de SobrevidaRESUMO
BACKGROUND AND OBJECTIVES: Plasmablastic lymphoma is a recently described B-cell derived lymphoma. The prognosis of plasmablastic lymphoma patients is usually poor. We performed a systematic review of the literature on the use of highly active anti-retroviral therapy (HAART) and the prognosis of plasmablastic lymphoma. METHODS: A comprehensive search of relevant databases, including Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Science Citation Index yielded ten randomized controlled trials. Trials were divided into two groups according to therapy. The rates of plasmablastic lymphoma were analyzed using a fixed-effects model. Sensitivity analyses (on publication type, statistical model) were performed to further detect and evaluate clinically significant heterogeneity. Tests of survival for plasmablastic lymphoma were also performed by using Kaplan-Meier method. RESULTS: Meta-analysis result showed that the prognosis of plasmablastic lymphoma patients was statistically different in the patients receiving HAART in addition to chemotherapy and/or radiotherapy than in the patients receiving the chemotherapy and/or radiotherapy alone (pooled relative risk=3.04; P=.03). Survival analyses also displayed a statistically significant difference (chi-square=6.22, P=.013). CONCLUSION: HAART in addition to chemotherapy and/or radiotherapy is effective in improving the prognosis of plasmablastic lymphoma. However, the small sample sizes increase the likelihood of bias in the studies in this meta-analysis, and therefore, the results should be taken cautiously.
