RESUMO
A subset of variant histological patterns of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) has been associated with advanced disease stage and increased recurrence risk. Histopathology reports on core needle (CNB) and/or surgical excision biopsies (SEB) for 33 adult patients with NLPHL were examined for variant histology prevalence and association with disease stage and clinical outcome. Variant histological pattern was present in 13/33 patients (39%). Obtained tissue was inadequate for diagnosis in 1/23 (4.3%) cases of CNB. Variant histology was associated with stage IV disease at presentation (p<0.001). While SEB should be the procedure of choice in workup of patients for a diagnosis of NLPHL, CNB is an alternate option when SEB is contraindicated or difficult to undertake. Diagnostic reports should specifically note presence of variant histological patterns. Although late-stage disease was associated with progression or recurrence, overall prognosis is excellent for patients with NLPHL.
Assuntos
Doença de Hodgkin , Humanos , Adulto , Doença de Hodgkin/terapia , Doença de Hodgkin/patologia , Estudos Retrospectivos , Prognóstico , Biópsia , Linfócitos/patologiaAssuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Leucemia-Linfoma de Células T do Adulto/tratamento farmacológico , Adulto , Doença Crônica , Ensaios Clínicos como Assunto , Humanos , Leucemia-Linfoma de Células T do Adulto/patologia , Prognóstico , Indução de RemissãoAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Linfoma não Hodgkin/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Terapia de Salvação , Adulto , Idoso , Idoso de 80 Anos ou mais , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Feminino , Seguimentos , Humanos , Linfoma não Hodgkin/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Prognóstico , Taxa de Sobrevida , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina , Adulto Jovem , GencitabinaRESUMO
Primary lymphoma of bone is extremely rare. There are increasing reports of lymphoma arising in bone adjacent to metallic prostheses. Herein, we describe the case of a 76-year-old man who developed diffuse large B cell lymphoma in the tibia 3 years after total knee arthroplasty for osteoarthritis. A review of the literature has identified 11 other cases of lymphoma arising in the context of orthopaedic metallic implants. To our knowledge this is the first reported case of a primary lymphoma arising in bone adjacent to a knee prosthesis. Possible pathogenetic mechanisms may include chronic antigenic stimulation of lymphocytes, proliferation of EBV-infected B lymphocytes, and direct mutagenic effects of metallic ions. Further research is required to investigate this intriguing link between metallic orthopaedic prostheses and localized lymphoma.
Assuntos
Artroplastia do Joelho , Neoplasias Ósseas/cirurgia , Linfoma Difuso de Grandes Células B/cirurgia , Idoso , Humanos , Masculino , Tomografia por Emissão de PósitronsRESUMO
A bone marrow examination in a young woman with anemia and ß-thalassemia trait showed dyserythropoiesis in less than 10% of erythroblasts without other myelodysplastic changes, and cytogenetic analysis revealed trisomy of chromosome 8. Although she did not fulfill the current World Health Organization (WHO) criteria for diagnosis of a myelodysplastic syndrome, her acquired bone marrow disorder behaved as such, and she later developed acute myeloid leukemia.
Assuntos
Detecção Precoce de Câncer/métodos , Síndromes Mielodisplásicas/diagnóstico , Pancitopenia/diagnóstico , Análise Citogenética , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Síndromes Mielodisplásicas/complicações , Síndromes Mielodisplásicas/genética , Pancitopenia/complicações , Pancitopenia/genética , Adulto JovemRESUMO
AIMS: Asteroid B cells are a component of normal thymus. It is currently unclear whether these cells are identifiable in T cell lymphoblastic leukaemia/lymphoma (T-ALL/LBL) of the thymus. The aim of this study was to identify asteroid B cells both in thymic and extrathymic tissue involved by T-ALL/LBL. METHODS AND RESULTS: Thymic, lymph node (LN) and bone marrow trephine biopsy (BMTB) samples from eight patients with T-ALL/LBL were reviewed. All had been investigated by immunohistochemistry and one by fluorescent in situ hybridization (FISH). The BMTB samples of two of eight T-ALL/LBLs and LN sample in one of them showed the presence of asteroid-shaped B cells with dendritic cytoplasmic processes. These B cells also expressed CD23 and the features were akin to the unique thymic asteroid B cells. Both patients had aggressive/resistant disease. Cytogenetic analysis in one showed a complex translocation involving the T cell receptor beta (TCRB) gene at 7q35 and a distal region of 9q known to harbour the NOTCH1 gene. CONCLUSION: This is the first report of T-ALL/LBL documenting the presence of an asteroid B cell-rich microenvironment at bone marrow and LN sites. In this small subset, T-ALL/LBL cells are possibly dependent upon asteroid B cells, and whether targeting of asteroid B cells with anti-CD20 monoclonal antibody in such cases will result in clinical benefit remains to be determined.
Assuntos
Linfócitos B/patologia , Medula Óssea/patologia , Linfonodos/patologia , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia , Timo/patologia , Linfócitos B/imunologia , Medula Óssea/imunologia , Células da Medula Óssea/imunologia , Células da Medula Óssea/patologia , Humanos , Hibridização in Situ Fluorescente , Linfonodos/imunologia , Masculino , Pessoa de Meia-Idade , Leucemia-Linfoma Linfoblástico de Células T Precursoras/imunologia , Timo/imunologiaAssuntos
Leucemia-Linfoma de Células T do Adulto/patologia , Anemia/etiologia , Antígenos CD/análise , Células Sanguíneas/patologia , Células da Medula Óssea/patologia , Exame de Medula Óssea , Humanos , Hipercalcemia/etiologia , Leucemia-Linfoma de Células T do Adulto/sangue , Leucemia-Linfoma de Células T do Adulto/complicações , Linfócitos/ultraestruturaRESUMO
A young man presented with systemic symptoms and marked eosinophilia. Subsequently cyclical weight gain and edema contributed to a diagnosis.
Assuntos
Eosinofilia/diagnóstico , Adulto , Angioedema , Contagem de Células , Eosinófilos/patologia , Seguimentos , Humanos , Masculino , Aumento de PesoRESUMO
The alpha-helical amphipathic peptide D-(KLAKLAK)2 is toxic to eukaryotic cells if internalized by a suitable targeting mechanism. We have targeted this peptide to malignant hemopoietic cells via conjugation to monoclonal antibodies, which recognize lineage-specific cell surface molecules. An anti-CD19/peptide conjugate efficiently killed 3/3 B lymphoid lines. However, an anti-CD33/peptide conjugate was cytotoxic to only one of three CD33-positive myeloid leukemia lines. The IC50 towards susceptible lines were in the low nanomolar range. Conjugates were highly selective and did not kill cells that did not express the appropriate cell surface cognate of the antibody moiety. Anti-CD19/peptide conjugates efficiently killed cells from patients with chronic lymphocytic leukemia but anti-CD33/peptide reagents were less effective against fresh acute myeloid leukemia cells. We therefore suggest that amphipathic peptides may be of value as targeted therapeutic agents for the treatment of a subset of hematologic malignancies.