OBJECTIVETo evaluate pathomorphologic and immunohistochemical characteristics of the bone marrow involvement of lymphoma and its significance in the diagnosis and subtype of lymphoma with bone marrow involvement.

METHODSOne hundred and eighty eight formalin fixed and paraffin embedded bone marrow biopsy specimens were studied. Immunohistochemical staining was performed.

RESULTS(1) Five patterns of bone marrow involvement of lymphoma were found, including diffuse (44.9%), focal (29.3%), interstitial (11.6%) and nodular (6.1%). (2) There were many subtypes of lymphoma in these cases, the most common type was lymphoplasmacytic lymphoma (21.7%). (3) The lymphomas in bone marrow biopsy had their own special characteristics of morphology and immunophenotype as did in extra-medullar lymphomas. (4) Fibrosis (75.8%) and hematopoietic tissue hypoplasia (71.1%) were found in most cases and necrosis in a few cases.

CONCLUSIONSMost cases of bone marrow involvement of lymphoma could be diagnosed and classified by combination of histopathological and immunohistochemical analysis. Diagnosis of some cases could be made only after the review of pathological changes of lymph node. A few cases were difficult to classify their subtypes of lymphoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Marrow ; pathology ; Child ; Female ; Humans ; Immunophenotyping ; Lymphoma ; diagnosis ; immunology ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness

OBJECTIVETo evaluate the status of cell differentiation in nasal NK/T cell lymphomas.

METHODSThe clinical data of 88 cases of NK/T cell lymphomas were collected. Antibodies to the following antigens were used in the immunohistochemical study: T cell differentiation antigens (CD3epsilon, CD5 and CD1a); NK cell associated antigens (CD56, CD57) and antibodies of CD34 and CD38.

RESULTS(1) Clinicopathology: clinically, frequently involved sites were the nasal cavity and the pharynx. Ulceration and erosion of the mucosa were common signs. Pathologically, diffuse infiltration of the tumor cells was observed in 68 of 88 (70.45%) cases of nasal NK/T cell lymphomas. In 71 (80.68%) cases infiltrated cells were predominantly medium to large sized; (2) Differentiation status of tumor cells: the tumor cells expressed CD3epsilon in 78/88 (88.64%); CD5 in 56/88 (63.63%), CD56 in 25/88 (28.41%) and no positivity for CD1a, CD57, CD34 and CD38.

CONCLUSIONStatus of tumor cell differentiation in nasal NK/T cell lymphoma may have passed the stage of progenitor cell differentiation but not yet to the stage of mature T or NK cells.

Adolescent ; Adult ; Aged ; Cell Differentiation ; Female ; Humans ; Immunophenotyping ; Killer Cells, Natural ; immunology ; pathology ; Lymphoma, T-Cell ; immunology ; pathology ; Male ; Middle Aged ; Nose Neoplasms ; immunology ; pathology

OBJECTIVETo explore the prognostic factors of primary nodal diffuse large B-cell lymphomas (N-DLBCL).

METHODSAccording to the 2001 WHO classification of tumors of hematopoietic and lymphoid tissue, 51 cases of primary N-DLBCL were collected for clinical data analysis and immunohistochemical assay. Antibodies used for study were anti-CD20, CD79alpha, CD45RO, CD3, Bcl-2, Ki-67, CD30, CD15, kappa, lambda, Cyclin D1, TdT, GFAP, CK, MPO. The survival data was analyzed.

RESULTSOf the 51 cases of N-DLBCLs, 40 were reclassified as centroblastic, 3 B-immunoblastic, 1 T-cell/histiocytes rich, 2 B-cell anaplastic large cell, 1 plasmablastic, and 4 unclassified. Expression of Bcl-2 oncoprotein was observed in 24 cases (47.1%). The median Ki-67 index was 50.0% and the index more than 40% was found in 35 cases (68.6%). Survival analysis of 35 cases had follow up data showed that the 2 year and 5-year overall survival (OS) rates were 48.54% and 35.30%, respectively. The 5-year OS rates patients with International Prognosis Index (IPI) >/= 3 was lower than that with IPI < 3 (P < 0.01). The 5-year OS rates for patients with B symptoms was lower than that without B symptoms (P < 0.05). The 5-year OS rates for patients with Ki-67 index more than 40% was lower than that with less than 40% (P < 0.05). The expression of Bcl-2 oncoprotein was uncorrelated to prognosis (P > 0.05).

CONCLUSIONIPI, B symptoms and Ki-67 index are the prognostic factors for patients with N-DLBCL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; analysis ; Child ; Child, Preschool ; Cyclin D1 ; analysis ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Ki-1 Antigen ; analysis ; Ki-67 Antigen ; analysis ; Leukocyte Common Antigens ; analysis ; Lewis X Antigen ; analysis ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Survival Analysis ; Young Adult

OBJECTIVETo investigate the expression of B cell-specific activator protein (BSAP)/Pax-5 in lymphomas.

METHODSOne hundred and two cases of diffuse large B-cell lymphoma (DLBCL), 3 cases of follicular lymphoma (FL), 3 cases of extranodal marginal zone B-cell lymphoma, 1 case of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), 10 cases of anaplastic large cell lymphoma (ALCL) and 10 cases of plasmacytoma were studied immunohistochemically for BSAP and CD20.

RESULTSThe tumor cells in the 102 cases of DLBCL all expressed CD20, amongst which 100 cases also expressed BSAP. Three cases of FL, 3 cases of extranodal marginal zone B-cell lymphoma and 1 case of NLPHL also expressed BSAP and CD20. All the ALCLs and plasmacytomas did not express BSAP and CD20. The expression rates of CD20 and BSAP were highly consistent. The intensity of staining showed no statistical significance.

CONCLUSIONSBSAP/Pax-5 is a novel B-cell marker expressed in tumor nuclei of B-cell lymphomas. Though less sensitive than CD20, anti-BSAP has diagnostic value in routine surgical pathology practice.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Biomarkers, Tumor ; Cell Nucleus ; metabolism ; Child ; Child, Preschool ; Female ; Humans ; Lymphoma, B-Cell ; metabolism ; Lymphoma, Follicular ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; Male ; Middle Aged ; PAX5 Transcription Factor ; metabolism ; Plasmacytoma ; metabolism

OBJECTIVETo study the roles of histologic examination and polymerase chain reaction in diagnosis of toxoplasmic lymphadenitis (TL).

METHODSForty-six archival cases of histologically diagnosed TL, encountered during the period from April, 1999 to September, 2009 and with the paraffin-embedded lymph node tissue blocks available, were enrolled into the study. The presence of genome fragments of Toxoplasma gondii (T. gondii) was analyzed using semi-nested polymerase chain reaction (PCR). Thirty cases of one or two histopathologic triad of TL as the controls.

RESULTSThe positive rate of PCR in TL group was 76.1% (35/46), as compared to 10.0% (3/30) in the control group. The difference was of statistical significance. The sensitivity and specificity of the histologic triad in diagnosing TL was 92.1% (35/38) and 71.1% (27/38), respectively. The predictive value of positive and negative PCR results was 76.1% (35/46) and 90.0% (27/30). respectively.

CONCLUSIONSThe high specificity but low sensitivity of applying the histologic triad in diagnosing TL cases may be due to the occurrence of atypical histologic pattern. The sensitivity is improved with the use of semi-nested PCR in detecting T. gondii DNA.

Adolescent ; Adult ; Aged ; Child ; DNA, Protozoan ; analysis ; Female ; Genome, Protozoan ; genetics ; Humans ; Lymph Nodes ; pathology ; Lymphadenitis ; diagnosis ; genetics ; parasitology ; pathology ; Male ; Middle Aged ; Paraffin Embedding ; Polymerase Chain Reaction ; methods ; Staining and Labeling ; Toxoplasma ; genetics ; isolation & purification ; Toxoplasmosis ; diagnosis ; genetics ; parasitology ; pathology ; Young Adult

Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Female ; Herpesvirus 4, Human ; isolation & purification ; Hodgkin Disease ; classification ; metabolism ; pathology ; virology ; Humans ; Lymphocytes ; pathology ; Male ; Middle Aged ; PAX5 Transcription Factor ; metabolism ; RNA, Viral ; metabolism ; Trans-Activators ; metabolism ; Young Adult

OBJECTIVETo investigate the clinicopathologic features of lymphoplasmacytic lymphoma (LPL) with Waldenström's macroglobulinemia (WM) and to evaluate the usefulness of immunophenotype analysis in diagnosis and differential diagnosis of the tumor.

METHODSA total of 40 cases of LPL with WM diagnosed according to the 2008 World Health Organization classification of tumors of hematopoietic and lymphoid tissues were analyzed using immunophenotype and follow-up information.

RESULTSThe mostly common initial clinical presentations were non-specific symptoms, such as fatigue, anemia and hemorrhage. Lymphadenopathy, splenomegaly and hepatomegaly were found in 42.5%, 20.0% and 12.5% of the patients respectively. The pattern of bone marrow involvement included mixed type (47.2%), diffuse type (41.7%) and interstitial type (11.1%). The nodal architecture was completely destroyed in one case and partially effaced with residual germinal centers and dilated sinuses in 8 cases. All of the neoplastic cells expressed CD20 and CD79a. Neoplastic plasma cells were positive for CD138 and CD79a. No cases expressed CD5. Four cases weakly expressed CD23. No significant prognosis related factors were identified in the survival analysis.

CONCLUSIONSLPL with WM is a rare indolent small B-cell lymphoma, which is commonly seen, in older male patients. The tumor frequently involves bone marrow and shows various clinical manifestations. Combination analyses of the bone marrow biopsy histology, immunophenotypic study and clinical data, especially the serum examination are important for the diagnosis of LPL with WM.

Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Bone Marrow ; metabolism ; pathology ; CD79 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin M ; blood ; Immunophenotyping ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphatic Metastasis ; Lymphoma, B-Cell, Marginal Zone ; metabolism ; pathology ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; metabolism ; pathology ; Male ; Middle Aged ; Multiple Myeloma ; metabolism ; pathology ; Neoplasm Invasiveness ; Survival Rate ; Syndecan-1 ; metabolism ; Waldenstrom Macroglobulinemia ; immunology ; metabolism ; pathology

OBJECTIVETo investigate the clinicopathologic features, immunophenotype and prognosis of lymphomatoid papulosis (LyP).

METHODSClinicopathologic analysis, immunohistochemical staining (LSAB and EliVision method) and in situ hybridization for EBER were undertaken in this study.

RESULTSThirteen cases of LyP were studied, derived from six male and seven female patients with a median age of 26.4 years. The most common presentation was multiple symptomless papules or nodules, involving predominately the extremities and trunks. Histologically, the tumor primarily involved the dermis and subcutaneous layer. Six tumors were type A, one was type B and six were type C. The main infiltration patterns were wedge-shaped, band-like, sheet-like or nodular. There was epidermotropism in eight cases. Immunohistochemical staining showed that the large tumor cells in all 12 types A and C cases expressed CD30. All 13 cases expressed two to three T-cell associated antigens (CD3, CD5 or CD45RO) and one to three cytotoxic granule associated antigens (TIA-1, GrB or Perforin). All cases expressed CD4, four expressed CD8, and one expressed CD15. Only one case expressed CD20; and all cases were negative for ALK-1. The tumor cells showing epidermotropism had CD3(+), CD4(+) and CD8(-) phenotype in most cases. Only one case was EBER1/2 positive. Follow up information was available in 12 patients; all were alive at the end of the follow up period.

CONCLUSIONSLyP has distinctive clinicopathologic features and immunophenotype with favorable prognosis. In types A and C, the atypical cells showing epidermotropism were similar to those in MF, these cells possess cerebriform and hyperchromatic nuclei. The epidermotropic tumor cells and the CD30(+) large cells may be derived from different clones. EB virus may not be correlated with LyP.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD3 Complex ; metabolism ; Child ; Child, Preschool ; Cyclophosphamide ; therapeutic use ; Epidermis ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunophenotyping ; Ki-1 Antigen ; metabolism ; Leukocyte Common Antigens ; metabolism ; Lymphomatoid Papulosis ; classification ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Skin Neoplasms ; classification ; drug therapy ; metabolism ; pathology ; Survival Rate ; Vincristine ; therapeutic use ; Young Adult

OBJECTIVETo study the expression of anaplastic lymphoma kinase (ALK) and the phosphorylation status of AKT, mammalian target of rapamycin (mTOR), 4E-binding protein 1 (4E-BP1) and ribosomal protein S6 kinase (p70S6K) and their interrelationships and clinical pathological significance in anaplastic large cell lymphoma (ALCL) patients.

METHODSImmunohistochemical and EnVision methods were used to detect the expression of ALK, p-AKT, p-mTOR, p-4E-BP1 and p-p70S6K.

RESULTSAmong the 81 ALCL patients, 51 (63.0%) expressed ALK, whereas the other 30 (37.0%) did not. Patients with ALK(+) ALCL had a better prognosis than those with ALK-ALCL (P < 0.05). Out of the 71 ALCL samples studied, p-AKT was detected in 54 (76.1%) samples and its phosphorylation was correlated with ALK expression (P < 0.05); p-mTOR was detected in 57 (80.3%) samples and its expression was correlated with both ALK and p-AKT (P < 0.05); p-4E-BP1 and p-p70S6K were detected in 64 (90.1%) and 66 (93.0%) samples respectively, and their expressions were related with p-mTOR (P < 0.05), but not with ALK or p-AKT (P > 0.05). COX Proportional Hazard Model analysis showed that both the expression of ALK and the B symptoms affected the prognosis (P < 0.05), moreover, the former had greater impact than the later.

CONCLUSIONExpressions of p-AKT, p-mTOR, p-4E-BP1 and p-p70S6K are detected in ALCL, while ALK(+) cases have higher incidence than those with ALK(-) cases. Phosphorylation of AKT and mTOR is correlated with ALK expression, suggesting that there is an activated pathway of AKT/mTOR in patients with ALK(+) ALCL, but the activation have no obvious prognostic significance.

Adaptor Proteins, Signal Transducing ; metabolism ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; metabolism ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; Male ; Middle Aged ; Phosphoproteins ; metabolism ; Phosphorylation ; Protein-Serine-Threonine Kinases ; metabolism ; Protein-Tyrosine Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Receptor Protein-Tyrosine Kinases ; Ribosomal Protein S6 Kinases, 70-kDa ; metabolism ; Signal Transduction ; TOR Serine-Threonine Kinases ; Young Adult

OBJECTIVETo study the clinicopathologic features of diffuse large B-cell lymphoma (DLBCL) with expression of anaplastic lymphoma kinase (ALK) protein.

METHODSNine hundred and forty-five (945) cases of DLBCL (including 177 consultation cases) diagnosed according to the 2001 World Health Organization classification of tumors of hematopoietic and lymphoid tissues were enrolled into the study. Immunohistochemical study for anti-ALK-11 was performed using LSAB technique. The ALK-positive cases were further confirmed by immunohistochemical study using EnVision technique. Only ALK-positive cases by EnVision technique were further analyzed by immunostaining for antigens including CD20, CD3, CD30, EMA, granzyme-B, TIA-1 and PC. Immunoglobulin heavy chain gene rearrangement study was also performed and follow-up data collected.

RESULTSThere were altogether 5 (4 males and 1 female) cases of DLBCL showing expression of ALK protein. The age of the patients ranged from 34 to 72 years. All were primary nodal DLBCL. One case belonged to clinical stage I, 2 in stage II and 2 in stage III. The duration of follow up ranged from 4 to 32 months. Three patients subsequently died and the longest survival was 32 months. Morphologic subtypes included centroblastic 2, anaplastic 1, immunoblastic with plasmacytoid differentiation 1 and plasmablastic 1. Immunohistochemically, 4 cases were CD20 positive (including 2 centroblastic, 1 anaplastic and 1 immunoblastic cases). The plasmablastic case expressed kappa light chain and was negative for CD20. Rearrangement of immunoglobulin heavy chain gene was demonstrated in all 5 cases studied. As for ALK protein staining, a mixed membranous and cytoplasmic (1 immunoblastic case), granular cytoplasmic (2 centroblastic and 1 anaplastic cases) and mixed nuclear and cytoplasmic (1 plasmablastic case) patterns were observed.

CONCLUSIONSExpression of ALK protein is a rare phenomenon in DLBCL and can be seen in centroblastic, anaplastic, immunoblastic and plasmablastic subtypes. It is often associated with aggressive clinical behavior and worse prognosis. A new pattern of ALK protein expression, mixed membranous and cytoplasmic, is reported.

Adult ; Aged ; Antigens, CD20 ; metabolism ; Female ; Follow-Up Studies ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; genetics ; Humans ; Immunoglobulin kappa-Chains ; metabolism ; Immunohistochemistry ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Polymerase Chain Reaction ; Prognosis ; Protein-Tyrosine Kinases ; metabolism ; Receptor Protein-Tyrosine Kinases