2.Diagnosis of hematolymphoid malignancy by using effusion fluid cytology specimens: a study of 33 cases.
Xue-ying SU ; Xia XU ; Yuan TANG ; Gan-di LI
Chinese Journal of Pathology 2009;38(8):542-546
<b>OBJECTIVEb>To study the diagnostic accuracy of hematolymphoid malignancy by using effusion fluid cytology specimens and to evaluate the values of immunocytochemistry for this assay.
<b>METHODSb>The cytospin preparations/smears and cell block sections of effusion cytology specimens from 33 cases of hematolymphoid malignancy were retrospectively reviewed. Immunocytochemical study was performed. In selected cases, in-situ hybridization for Epstein-Barr virus-encoded RNA and immunoglobulin and T-cell receptor gene rearrangement study were carried out as indicated.
<b>RESULTSb>There were 33 cases of hematolymphoid malignancy, including 12 cases of T-lymphoblastic leukemia/lymphoma, 16 cases of mature B cell neoplasm (including 9 cases of diffuse large B-cell lymphoma, 2 cases of Burkitt lymphoma, 2 cases of plasmacytoma/multiple myeloma, 2 cases of B-small lymphocytic leukemia/lymphoma and 1 case of mantle cell lymphoma), 3 cases of mature T or NK-cell neoplasm (including 1 case of extranodal nasal NK/T-cell lymphoma, 1 case of angioimmunoblastic T-cell lymphoma and 1 case of T-cell prolymphocytic leukemia), 1 case of myeloid sarcoma and 1 case of mast cell sarcoma. Amongst the 33 cases studied, 16 represented disease relapses, including 8 cases of diffuse large B-cell lymphoma, 2 cases of plasmacytoma/multiple myeloma, 2 cases of B-small lymphocytic leukemia/lymphoma, 1 case of T-lymphoblastic leukemia/lymphoma, 1 case of angioimmunoblastic T-cell lymphoma, 1 case of mantle cell lymphoma and 1 case of mast cell sarcoma. The remaining 17 cases showed serous effusion as the primary manifestation, with the diagnosis primarily made upon cytologic examination. The cytologic findings seen in all the 33 cases studied were in agreement with the corresponding histologic diagnosis.
<b>CONCLUSIONSb>Diagnosis of hematolymphoid malignancy by effusion fluid cytology specimens is possible, especially when coupled with the clinical history, immunophenotype, in-situ hybridization and gene rearrangement study findings. This is especially so for cases with disease relapses.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ascitic Fluid ; metabolism ; pathology ; Burkitt Lymphoma ; diagnosis ; metabolism ; pathology ; Child ; Cytodiagnosis ; methods ; Female ; Humans ; Immunohistochemistry ; Lymphoma, Extranodal NK-T-Cell ; diagnosis ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; metabolism ; pathology ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; metabolism ; pathology ; Plasmacytoma ; diagnosis ; metabolism ; pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; pathology ; Retrospective Studies ; Young Adult
3.Unclassified B-cell lymphomas with "grey zone" characteristics.
Chinese Journal of Pathology 2011;40(4):278-281
Diagnosis, Differential
;
Gene Rearrangement
;
Hodgkin Disease
;
genetics
;
metabolism
;
pathology
;
Humans
;
Lymphoma, B-Cell
;
genetics
;
metabolism
;
pathology
;
Lymphoma, Large B-Cell, Diffuse
;
genetics
;
metabolism
;
pathology
;
Mediastinal Neoplasms
;
genetics
;
metabolism
;
pathology
;
Proto-Oncogene Proteins c-bcl-2
;
genetics
;
metabolism
4.Facial skin nodules.
Jian-lan XIE ; Xiao-ge ZHOU ; Yan JIN ; Xiao-dan ZHENG ; Xue-jing WEI
Chinese Journal of Pathology 2010;39(6):410-411
Adult
;
Antigens, CD20
;
metabolism
;
CD3 Complex
;
metabolism
;
Diagnosis, Differential
;
Facial Dermatoses
;
metabolism
;
pathology
;
surgery
;
Follow-Up Studies
;
Humans
;
Lymphoma, B-Cell, Marginal Zone
;
metabolism
;
pathology
;
Lymphoma, Large-Cell, Anaplastic
;
metabolism
;
pathology
;
Male
;
Pseudolymphoma
;
metabolism
;
pathology
;
surgery
;
Skin Neoplasms
;
metabolism
;
pathology
5.Increasing recognition of T zone lymphoproliferative disorders.
Chinese Journal of Pathology 2007;36(2):73-75
Antigens, CD20
;
metabolism
;
Diagnosis, Differential
;
Hodgkin Disease
;
metabolism
;
pathology
;
Humans
;
Ki-1 Antigen
;
metabolism
;
Lymphoma, Large B-Cell, Diffuse
;
metabolism
;
pathology
;
Lymphoma, Large-Cell, Anaplastic
;
metabolism
;
pathology
;
Lymphoproliferative Disorders
;
metabolism
;
pathology
;
T-Lymphocytes
;
metabolism
;
pathology
7.Clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma involving bone marrow.
Qi SUN ; Pei-hong ZHANG ; En-bin LIU ; Wei LIU ; Zhan-qi LI ; Qing-ying YANG ; Li-huan FANG ; Fu-jun SUN ; Hui-shu CHEN ; Lu-gui QIU
Chinese Journal of Pathology 2013;42(4):234-238
<b>OBJECTIVEb>To study the clinicopathologic features and differential diagnosis of splenic B-cell marginal zone lymphoma (SMZL) involving bone marrow.
<b>METHODSb>The clinical and pathologic features of 22 patients with SMZL were retrospectively studied. Immunophenotypic analysis was carried out by flow cytometry and immunohistochemistry. Immunoglobulin heavy chain rearrangement study was performed using polymerase chain reaction-based method.
<b>RESULTSb>Villous lymphocytes were found in peripheral blood smears of 11/18 of the patients. In bone marrow aspirates, lymphocytosis (> 20%) was demonstrated in 15 cases (15/18) and villous lymphocytes in 6 cases (6/18). Flow cytometry showed CD19(+) CD20(+) FMC7(+) CD22(+) CD10(-) CD2(-) CD3(-) CD7(-) in 18 cases. Bone marrow biopsies of all the 22 patients revealed various degrees and patterns of neoplastic infiltration, as follows: mild (4 cases, 18.2%), moderate (11 cases, 50.0%) or severe (7 cases, 31.8%); intrasinusoidal (16 cases, 72.7%), interstitial (14 cases, 63.6%), nodular (11 cases, 50.0%) or diffuse (1 case, 4.5%). Reactive germinal center formation (CD23(+) bcl-2(-)) was found in 2 cases (91.0%). Immunohistochemical study showed the following results: CD20(+) PAX5(+) CD3(-) CD5(-) CD10(-) cyclin D1(-) CD23(-) CD43(-) Annexin A1(-) CD11C(-) CD25(-) in all the 22 cases, CD38(+) in 2 cases (9.1%) and CD138(+) in 2 cases (9.1%).
<b>CONCLUSIONSb>Different and overlapping patterns of bone marrow involvement are observed in SMZL. As the histologic and immunophenotypic features are not specific to SMZL, distinction from other types of mature B-cell lymphomas is necessary.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Bone Marrow ; pathology ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphoma, B-Cell, Marginal Zone ; genetics ; metabolism ; pathology ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Retrospective Studies ; Splenic Neoplasms ; genetics ; metabolism ; pathology ; Waldenstrom Macroglobulinemia ; metabolism ; pathology
8.Left cervical mass.
Jian-lan XIE ; Xiao-ge ZHOU ; Yan JIN ; Xiao-dan ZHENG ; Xue-jing WEI
Chinese Journal of Pathology 2012;41(3):195-196
Adult
;
Diagnosis, Differential
;
Female
;
Granulomatous Disease, Chronic
;
metabolism
;
pathology
;
Hodgkin Disease
;
metabolism
;
pathology
;
Humans
;
Ki-1 Antigen
;
metabolism
;
Lewis X Antigen
;
metabolism
;
Lymphoma, Large B-Cell, Diffuse
;
metabolism
;
pathology
;
Lymphoma, Large-Cell, Anaplastic
;
metabolism
;
pathology
;
Young Adult
9.Immunohistochemical patterns of follicular dendritic cell meshwork and Ki-67 in small B-cell lymphomas.
Chinese Journal of Pathology 2013;42(4):222-226
<b>OBJECTIVEb>To identify the immunohistochemical patterns of follicular dendritic cell (FDC) meshwork and Ki-67 labeling index in small B-cell lymphomas (SBLs) and their significance in differential diagnosis.
<b>METHODSb>Sixty-eight cases of SBLs were included collected from November 2008 to June 2012. The patterns of FDCs and Ki-67 expression were studied on paraffin sections by CD21, CD23 and Ki-67 immunohistochemistry. The characteristic staining patterns of FDCs and Ki-67 expression among different SBLs were analyzed statistically.
<b>RESULTSb>The age of SBL patients ranged from 28 to 85 years with a mean of 55.2 years. The male to female ratio was 1.2:1. Fifty-five cases involved only lymph nodes (80.9%), and the remaining cases involved multiple extra-nodal sites. Histological classification of the cases was made according to the 2008 WHO lymphoma classification criteria: 22 were low-grade follicular lymphomas (FLs, including grade 1 and grade 2), 19 marginal zone lymphomas (MZLs), 17 mantle cell lymphomas (MCLs), and 10 chronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLLs). FDC meshwork limited to the central part of neoplastic follicles was characteristic for FL (90.9%, 20/22). The germinal center FDC meshwork was destroyed primarily at periphery in MZL (14/19). The absence or scattered FDC clusters were typical of SLL/ CLL. Irregular FDC was seen in 7/17 of MCL, while 7/17 MCL displayed FDC pattern similar to that of CLL/SLLs. The pattern of FDCs was a significantly diagnostic feature in distinguishing the four types of SBLs (P < 0.01). Ki-67 was also a statistically significant parameter (P < 0.05) with decreasing labeling index as the following: MCL, FL, SLL and MZL. Ki-67 showed scattered pattern in germinal centers with loss of polarity in FLs. MZL presented uniformly scattered positive pattern in interfollicullar areas. Ki-67 staining was uniform in MCL, but its labeling index varied from 5% to 90%. The Ki-67 index was higher in the morphological "proliferation centers" of all CLL/SLLs.
<b>CONCLUSIONb>Immunohistochemical staining patterns of FDC meshworks and Ki-67 labeling index offer a significant discriminatory power in the differential diagnoses among SBLs.
Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Dendritic Cells, Follicular ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphoma, B-Cell ; classification ; metabolism ; pathology ; Lymphoma, B-Cell, Marginal Zone ; metabolism ; pathology ; Lymphoma, Follicular ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; metabolism ; pathology ; Lymphoma, Non-Hodgkin ; metabolism ; pathology ; Male ; Middle Aged ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Retrospective Studies
10.Role of CyclinD1/IgH Detection by FISH in Differential Diagnostic Significance between Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia.
Guo-Ping LI ; Wan-Zi CHEN ; Hui-Fang HUANG ; Jia-Di CHEN ; Xiao-Lan LIN ; Qiang FU
Journal of Experimental Hematology 2015;23(5):1314-1317
<b>OBJECTIVEb>To investigate the feasibility of CyclinD1/IgH detection by FISH in diferential diagnosis between mantle cell lymphoma (MCL) and chronic lymphocytic leukeamia (CLL).
<b>METHODSb>The FISH detection was performed for CyclinD1/IgH fusion gene. A comprehensive analysis was carried out for clinical features, such as age, sex , WBC count and lymphocyte count, the bone marrow morphology and immunohistochemical staining were carried for CyclinD1/IgH.
<b>RESULTSb>It is often difficult to distinguish MCL from CLL by bone marrow morphology, when the cell morphology was not typical; there was no difference in age, sex, WBC count and lymphocyte count between MCL and CLL groups; 9 out of 52 patients were diagnosed as MCL, and the direction of CyclinD1/IgH by FISH was positive in 7 of 9 MCL, while 3 of the 7 patients were negative by immunohistochemical staining for CyclinD1.
<b>CONCLUSIONb>Detection of CyclinD1/IgH by FISH can be used as a specific and feasible method for differential diagnosis of mantle cell lymphoma from chronic lymphocytic leukeamia.
Bone Marrow ; pathology ; Diagnosis, Differential ; Humans ; Immunophenotyping ; Leukemia, Lymphocytic, Chronic, B-Cell ; diagnosis ; metabolism ; Lymphoma, Mantle-Cell ; diagnosis ; metabolism ; Oncogene Proteins, Fusion ; metabolism