No abstract available.
Lymphoma, B-Cell, Marginal Zone*

To determine the prevalence of Epstein-Barr virus infection in lymphoid neoplasms of various histology and location, the paraffin tissues of 74 non-Hodgkin's lymphomas and 13 Hodgkin's diseases were studied by EBER and BHLF RNA in situ hybridization as well as immunostaining using LMP-1, EBNA-2, and ZEBRA. As a control, non-neoplastic lymphoid tissues from the nasal cavity(10), lymph node(38) and Waldeyer's ring(12) were investigated. In non-neoplastic control, EBV genome was detected in none of 10 nasal mucosa, 6 of 38 lymph node, and 1 of 12 Waldeyer's ring. EBV-positive non-neoplastic lymphocytes expressed CD45RO in 2 cases and CD20 in 4 cases. Non-Hodgkin's lymphoma was positive for EBV in 37.8% of the cases in which T-cell lymphoma showed higher rate(56%) than B-cell lymphoma(15%), especially in nasal lymphoma(80%) and angiocentric lymphoma(63.6%). Hodgkin's disease was EBV positive in 38.4% of the cases. EBV genome in tumor tissue existed in latent form as well as in lytic form. LMP-1 was positive in 80% of Hodgkin's disease and 39% of non-Hodgkin's lymphoma in which EBV genome was detected. EBNA-2 was expressed in 3 cases of non-Hodgkin's lymphoma. On the basis of protein expression, most lymphomas belonged to type II latency. These results support that EBV is associated with pathogenesis of malignant lymphoma although its mechanism still awaits to be clarified.

NK/T cell lymphoma is a distinct clinicopathologic entity which is more prevalent in Asia than in America and Europe and is highly associated with Epstein-Barr virus (EBV) infection. Although the clinicopathologic features of the tumor have been clearly defined, genetic changes and roles of virus associated with the development and progression of tumor have not been well studied. In this study, we carried out polymerase chain reaction (PCR) for EBNA-3B, EBNA-3C, and LMP-1 30 bp deletion to investigate EBV subtype and variants in tumor tissue and performed comparative genomic hybridization (CGH) to screen chromosomal imbalances using frozen tissues from 7 patients with nasal-type NK/T cell lymphoma and 1 patient with blastic NK cell lymphoma. Of 6 cases infected with EBV, there were EBV type 1 in six, LMP-1 30 bp deletion variant in four, and LMP-1 40 bp deletion variant in one. Frequent chromosomal imbalances included deletions at 1p31-pter (4), 12q23-q24 (3), and 17p (4), and gains at 2q (5), 10q (3), and 13q34-qter (4). Blastic NK cell lymphoma displayed deletions of 9q, 7q, and 6q, similar to that of nasal-type NK/T-cell lymphoma. With these results, we assumed that candidate genes in these imbalanced chromosomal loci would provide the clue for further molecular studies to identify putative tumor suppressor genes or proto-oncogenes associated with pathogenesis of this neoplasm.
Americas ; Asia ; Comparative Genomic Hybridization* ; Europe ; Genes, Tumor Suppressor ; Genotype* ; Herpesvirus 4, Human* ; Humans ; Killer Cells, Natural ; Lymphoma* ; Polymerase Chain Reaction ; Proto-Oncogenes

No abstract available.
DNA* ; Thyroid Gland*

The diagnosis of primary cutaneous lymphoma is based on a combination of clinical, histological, immunophenotypic and genetic criteria. Nineteen cases of primary cutaneous lymphomas were studied for clinicopathologic, immunophenotypic, and genetic features. Seventeen (89%) cases were T cell origin and two cases (11%) were B cell origin. CD30-positive cutaneous lymphoproliferative disorder was the most frequent subtype, occupying 42% (8 cases) of the cases. CD8 was positive in 5 cases consisting of 3 cutaneous T cell lymphomas and 2 anaplastic large cell lymphomas. CD4 was positive in 2 cases of mycosis fungoides and 3 cases of lymphomatoid papulosis. Six (67%) of 9 cases of cutaneous T cell lymphoma were positive for TIA-1. Ten (83%) out of 12 cases showed clonal rearrangements of TCR gamma genes, however, one T/NK cell lymphoma and one anaplastic large cell lymphoma did not. EBV association was detected only in T/NK cell lymphomas among 10 cases examined. In conclusion, our study showed higher proportion of CD30-positive lymphoproliferative disorders and less frequent mycosis fungoides in Korea compared to the incidences in Western countries. Our immunostaining results suggested that mycosis fungoides and lymphomatoid papulosis are CD4-positive T cell origin, however, the remaining primary cutaneous T cell lymphoma is predominantly CD8-positive cytotoxic T cell origin.
Diagnosis ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Incidence ; Korea ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Mycosis Fungoides

BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

Leydig cell tumor of the ovary is a very rare tumor which usually occurs in the postmenopausal age, and which is frequently associated with virilization. It has been classified as a lipid cell tumor due to the presence of intracytoplasmic lipids. However, since up to 25% of these tumors contain little or no lipid, the new term "steroid cell tumor" is proposed for this type of neoplasm. We report a case of Leydig cell tumor of the ovary in a 16 year old girl. The patient exhibited recently recognized hirsuitism and secondary amenorrhea. Physical examination revealed moderate obesity with moderate amounts of coarse hair over the whole body and a deepening of the voice. Testosterone and dehydroepiandrosterone sulfate levels were markedly elevated in the peripheral blood. Pelvic ultrasonography revealed a right ovarian tumor. The resected ovary showed a well demarcated, golden yellow to orange colored solid mass, measuring 7 cm on the cut surface. Microscopically, the tumor was composed of solid and diffuse sheets of tumor cells having abundant eosinophilic cytoplasm, and large round nuclei with frequent crystalloids of Reinke in the cytoplasm. To our knowledge this is the first case of Leydig cell tumor of the ovary in a young girl in the Korean literature.

To evaluate the frequency of EM A and Ki-I antigen expression in the large cell lymphoma and to define the histologic characteristics of Ki-1 positive anaplastic large cell lymphoma, 40 cases of malignant lymphoma, diffuse large cell type were immunostained by Ki-I and EMA monoclonal antibodies. Eight cases of large cell lymphomas expressed EMA, among which 4 cases were positive for Ki-I antibody as well. The positive rate for EMA was much higher in T cell lymphomas than in B cell lymphomas. Among 4 cases of Ki-I positive lymphomas, 2 cases showing membrane staining of Ki-1 with prototypic histologic feature of anaplastic large cell lymphoma were classified as Ki-1 positive anaplastic large cell lymphoma(ALCL). Ki-I positive ALCL were T-cell in one and non-T, non-B cell type in the other, respectively. The remaining 2 cases of Ki-1 positive lymphomas showing cytoplasmic staining were classified as both B-cell centroblastic/centrocytic lymphoma and T-cell pleomorphic large cell lymphoma.

Cytologic findings from five cases with variable types of Hodgkin' disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants. Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth contour. Acidophilic prominent nucleoli with perinucleolar halo were conspicuous. In comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.
Hodgkin Disease* ; Lymphocytes ; Reed-Sternberg Cells* ; Sclerosis

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants