Antigens, CD7 ; metabolism ; Burkitt Lymphoma ; immunology ; pathology ; CD3 Complex ; metabolism ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; immunology ; pathology ; Sarcoma, Myeloid ; immunology ; pathology

Burkitt Lymphoma ; pathology ; virology ; Epstein-Barr Virus Infections ; pathology ; Hematologic Diseases ; pathology ; Histiocytic Necrotizing Lymphadenitis ; pathology ; Hodgkin Disease ; pathology ; Humans ; Lymphoma ; classification ; pathology

Carcinoma, Intraductal, Noninfiltrating ; therapy ; Humans ; Lymphoma ; therapy ; Periodicals as Topic ; standards ; Practice Guidelines as Topic ; standards ; Publishing ; standards

Objective To investigate the status of Epstein Barr virus (EBV) latent infection, the subtypes of EBV, and the expression of EBV genome in intestinal T cell lymphoma (ITCL). Methods In situ hybridization for EBER1/2 and polymerase chain reaction for EBV nuclear antigen gene (EBNA 3C) of two EBV subtypes were performed in forty two cases of ITCL. Some cases which were positive in both in situ hybridization and immunohistochemistry were detected by double staining. Amplified product of EBNA 3C gene was analyzed by DNA sequencing. For immunohistochemical staining, EBNA 2 and LMP 1 monoclonal were applied. Results EBV infection was detected in 41 of the 42 cases ( 97.6% ). Thirty eight cases ( 90.5% ) exhibited specific bands by polymerase chain reaction, in which 32 (84.2%) were EBV type A, 2 (5.3%) were type B and 4 ( 10.5% ) were mixtures of type A and B. There were seldom base insertion and base deletion in EBNA 3C gene. In 36 ( 85.7% ) cases, the tumor cells showed positive in EBER1/2 ISH, and they were demonstrated to express CD 45 RO, CD 4, CD 8, CD 56 , or TIA 1 by in situ hybridization immunohistochemistry double staining. The expression frequency of LMP 1 was 38.1% (16/42). None case presented EBNA 2 positive reaction. There were two patterns of EBV latent infection in ITCL, the more common one was type Ⅰ and the other was type Ⅱ. Conclusions A high level EBV latent infection is present in ITCL in China, and EBV type A frequently occurs. The patterns of EBV latent infection in ITCL are either type Ⅰ or type Ⅱ. ITCL and nasal NK/T cell lymphoma might belong to the same spectrum.

China ; Hematologic Diseases ; pathology ; Humans ; Lymphoid Tissue ; pathology

Objective To study the clinicopathologic features and immunophenotype of cutaneous NK/T cell lymphoma and the association with Esptein－ Barr virus (EBV) infection. Methods Five cases of cutaneous NK/T cell lymphoma were studied. Histologic sections of embedded tissues were immunohistochemically stained with CD45RO, CD3? , TIA－ 1, CD20, Ki－ B5, CD68 and LMP1 antibodies, and in situ hybridization for EBV－ encoded small nuclear RNAs－ EBER1/2 was also carried out. Results Cutaneous NK/T cell lymphoma accounted for 5.68％ in the cutaneous malignant lymphoma in the same period of observation. There were 4 male and 1 female patients, and the mean age was 34 years. The main clinical manifestations were asymptomatic nodules and masses, which were accompanied by ulcers in 2 cases. Histologically, the tumors were mainly located in the dermis and subcutaneous adipose tissue, the infiltrated lymphoid cells were pleomorphic, and angiocentricity and angiodestruction were found in almost all cases. Immunohistochemical stain showed that five cases were T cell phenotype and the expression rate of TIA－ 1 was 100％ (4/4). The EBV was present in three of four cases by in situ hybridization. Conclusions Cutaneous NK/T cell lymphoma presents with unique and diagnostic clinicopathologic features, and is strongly associated with EBV.

Objective To search for the distinctive diagnostic features of Crohn's disease and intestinal tuberculosis in clinical manifestations with methods widely used clinically.Methods A retrospective study enrolled 33 Crohn's disease and 34 intestinal tuberculosis inpatients in West China Hospital of Sichuan University from 1996 to 2007.The clinical characteristics and key points of differential diagnosis were analyzed.All the pathological sections were studied again.Results The total duration of symptoms in patients with a diagnosis of Crohn's disease was longer than that in patients with intestinal tuberculosis ( P < 0.05 ).The incidence of eolectomy is significantly higher in Crohn' s disease than in intestinal tuberculosis because of intestinal obstruction or undefined diagnosis ( P < 0.05 ).Hematochezia,extra-intestinal manifestation and ileus occurred significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Night sweating and hypoalbuminemia occurred significantly more in intestinal tuberculosis than in Crohn's disease( P <0.05 ).The positive rate of serum antibodies to mycobacterium and increased erythrocyte sedimentation rate is higher in intestinal tuberculosis than in Crohn's disease(P < 0.05).Cobblestone sign and fissure-shape ulcers were only found in Crohn's disease,while circular ulcer occurred significantly more in intestinal tuberculosis( P <0.05).The involvement of stomach,jejunum or ileum was significantly more in Crohn's disease than in intestinal tuberculosis( P < 0.05 ).Granulomas were more common in intestinal tuberculosis than in Crohn's disease( P < 0.05 ) and the site of granulomas was valuable for differential diagnosis.In all the Crohn's disease specimens,lymphoid aggregates in the lamina propria or submucosa were significantly more in surgically reseeted specimens than in endoscopic biopsies (P <0.05).Conclusions There are definitely some different features between the two diseases.It is essential to review the whole clinical data of the patient.The frequency of granulomas and the distribution of chronic inflammation are identified as histological parameters that can be used to differentiate tuberculosis and Crolm's disease.

Objective To detect chromosome translocation t (11;18)(q21;q21) and expression of BCL10 protein in gastric mucosa associated lymphoid tissue (MALT) lymphoma. Methods We, combining clinical and pathological data, detected API2 MLT fusion by reverse transcriptase polymerase chain reaction (RT PCR)as well as the expressions of BCL10 protein and Ki 67 by immunohistochemistry in cases of gastric MALT lymphoma and follicular gastritis (FG) and analyzed the relationships among them. Results API2 MLT fusion was detected in three cases (2 low grade and 1 low to high grade) out of 14 cases of gastric MALT lymphoma, and no in 8 cases of FG. BCL10 protein was weakly expressed in cytoplasm of B cells of germinal center in lymph follicles of FG; but abundantly in cytoplasm of tumor cells in gastric MALT lymphoma; 42.5% of the latter showed weak expression in nucleus. The expression of Ki 67 was significantly higher in low to high and diffuse large B cell lymphoma cases than in low grade cases( P 0.05), the frequency of nuclear expression of BCL10 increased with the increased expression of Ki 67. Conclusions Both API2 MLT fusion and BCL10 nuclear expression are associated with transformation of gastric MALT lymphoma from LG to HG. RT PCR technique used to detect API2 MLT fusion may be an important tool in identification of t(11;18)(q21;q21).

OBJECTIVETo investigate the clinicopathologic features of mantle cell lymphoma (MCL) and the significance of immunostaining for cyclin D1 in diagnosis.

METHODSClinicopathologic observation and immunohistochemical staining for CD20, CD45RO, cyclin D1, bcl-2, Ki-67, CD5 for 8 cases of mantle cell lymphoma were performed.

RESULTSThe 8 cases of mantle cell lymphoma consisted of 6 males and 2 females, aged from 43 to 78 years (mean 57 years). Histopathologically, MCL demonstrated architectural destruction by a vaguely nodular monomorphic lymphoid proliferation with vaguely nodular, diffuse or mantle zone growth patterns. Analogous to centrocytes, the lymphoma cells with slightly to markedly irregular nuclear contours showed moderately dispersed chromatin and a low mitotic figure. Three cases were transformed into highly aggressive blastoid variants. The tumor cells were positive for CD20, CD5, bcl-2 and cyclinD1 in all 8 cases and negative for CD45RO.

CONCLUSIONSThe clinicopathological features and special immunophenotypes were present in mantle cell lymphoma. This tumor can be differentiated from other small B-cell lymphomas on the basis of histopathologic features and positive cyclin D1 immunophenotype. The blastoid variant should also be differentiated from other variants.

Adult ; Aged ; Cyclin D1 ; analysis ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; analysis ; Lymphoma, Mantle-Cell ; diagnosis ; pathology ; Male ; Middle Aged ; Prognosis

Objective To investigate the expressions of survivin and Ki67 in cutaneous extranodal NK/T-cell lymphoma,nasal type and their significance.Methods Clinical data and laboratory test results were collected from 15 cases of cutaneous extranodal NK/T-cell lymphoma,nasal type with skin lesions as the initial manifestation.Immunohistochemical SP method was used to measure the expression of survivin and Ki67 in tissue sections from the lesions of these patients.To determine the percentage of survivin-or Ki67-positive cells,200 tumor cells were counted in a high power field (HPF) and 5 HPFs were observed in 1 section.Results There were 10 males and 5 females among the 15 patients,with the median age at diagnosis being 28.7 (range:9-62) years.Immunohistochemical study showed that the lesional tissue was positive for CD56 in 9 cases,CD3ε in 13 cases,T cell intracellular antigen (TIA)-1 in 15 cases,granzyme B in 10 cases,CD3 in 2 cases,βF1 in 1 case,but negative for CD4,CD5,CD8,CD20,and CD79α.All the 15 cases were positive for 1 or 2 T-cell associated antigens (CD2,CD7 or CD45RO).CD30 was observed in large tumor cells in 3 of the 15 cases.Monoclonal TCR-γ gene rearrangement was found in 3 of 14 cases.In situ hybridization for EBER1/2 was positive in all of the 15 cases.Survivin and Ki67 were expressed in 73.3％ (11/15) and 100％ (14/14,note:a tissue section was unavailable because of the detachment of tissue from the slide) of the specimens respectively,with the average percentage of positive cells being 23.97％ ± 18.35％ and 41.20％ ± 19.52％ for survivin and Ki67,respectively.Statistical differences were observed in the percentage of Ki67-expressing cells between the specimens with 0-2 mitotic figures per high power field from 9 cases and those with more than 2 mitotic figures from 6 cases (25.27％ ± 12.96％ vs.58.23％ ± 16.02％,F =19.14,P =0.001).No correlation was found between the expression of survivin and Ki67 in cutaneous extranodal NK/T-cell lymphoma,nasal type.Conclusion The high expressions of survivin and Ki67 may play a role in the occurrence and development of cutaneous extranodal NK/T-cell lymphoma,nasal type.