There are some major changes win the revised 2016 WHO Classification of Lymphoid Neoplasms.Based on the clinicopathological changes and genetic/molecular findings in the past years,the new classification clarified the diagnosis and clinical management of some very early stages of lymphoproliferative disorders,refined the diagnostic criteria for some lymphoid neoplasms,and further emphasized the significance of genetic/molecular studies in the diagnosis and clinical treatment of lymphomas.A small number of new provisional entities were added to the 2016 edition.

Objective To investigate epigenetic silencing of the proapoptotic gene MAPK10 by methylation in B-cell lymphoma. Methods We examined MAPK10 expression and methylation in seven cell lines derived from B-cell lymphoma by semi-quantitative RT-PCR and methylation-specific PCR (MSP), respectively. Methylation status was further examined in 24 diffuse large B-cell lymphoma (DLBCL), 15 follicular lymphoma (FL) and 12 reactive hyperplasia lymph nodes (LRH) both by MSP and bisulfite genomic sequencing (BGS). Results MAPK10 is silenced or downregulated in all seven B-cell lymphoma cell lines mostly due to promoter methylation. MAPK10 methylation was frequently detected in DLBCL (17 of 24, 71%) and FL (15 of 15, 100 %), but not in 12 LRH tissues. Conclusion MAPK10 is frequently inactivated by tumor-specific methylation, and thus, is a potential biomarker.

Objective In Caucasian populations, the tumor cells of Epstein Barr virus (EBV)-positive classical Hodgkin lymphoma (cHL) patients more frequently express HLA class Ⅰ and HLA class Ⅱ molecules compared to EBV-negative cHL patients. HLA expression (in relation to EBV) in Asian cHL patients has not been previously investigated. Methods 145 cHL patients with formalin-fixed, paraffin embedded tissue blocks available from Beijing, China were randomly selected. Hematoxylin & Eosin-stained slides were used to reclassify the histological subtypes according to the WHO classification. EBV status was determined by visualization of EBER in tumor cells using in situ hybridization. Membranous expression of HLA molecules was detected by immunohistochemistry using antibodies HC-10 (class Ⅰ heavy chain) and antiβ2-microglobulin for HLA class Ⅰ, and CR3/43 for HLA class Ⅱ. Results EBV (+) tumor cells were observed in 40 % (58/145) of the cHL patients. As expected, the percentage of EBV(+) cases was much higher in the mixed cellularity subtype (71%) than that in the nodular sclerosis subtype (16 %) (P ＜0.001). The expression of HLA class Ⅰ was observed in 79 % of the EBV (+) cHL cases and in 30 % of the EBV (-) cases (P ＜0.001). For HLA class Ⅱ, 52 % of EBV(+) cHL cases were positive, compared to 43 % in EBV(-) cases (P =0.277). Conclusion The results in China population were similar to that in the Caucasian population for HLA class Ⅰ, but not for HLA class Ⅱ.

Objective:To investigate the clinicopathological and immunohistochemical characteristics of soft tissue mesenchymal chondrosarcoma. Methods:The clinical material,pathological and immunohistochemical characteristics(reactiontoLCA,CD3,CD20,CD45RO,CD79a,CD99,NSE,S-100,Syn,CgA,CK7,CK19,EMA,Coll-Ⅱ,Sarcomeric-Actin,Desmin,Ki-67,P53) of 2 cases of soft tissue mesenchymal chondrosarcoma in Jishuitan Hospital between 1995 and 2005 were reviewed and followed up. Results:The two patients were both females. The tumors were located in the low extremity muscles. The main roentgenographical appearance was stippled calcification in tumor and calcification at the edge of the tumor. The histological characteristic features showed undifferentiated small cells together with islands of chondrosarcoma;there was hemangiopericytoma-like arrangement of small cells.The tumor cells were positive for CD99,NSE,Syn,CgA;The cells in chondroid matrix were positive for S-100;chondroid matrix was positive for Coll-Ⅱ. All tumor cells were negative for LCA,CD3,CD20,CD45RO,CD79a,Sarcomeric-actin,Desmin and CK7,CK19, and EMA. The patient with followed radiotherapy was alive. and the other without radiotherapy dead. Conclusion: Mesenchymal chondrosarcoma of soft tissue has the characteristics of primary mesenchyme which differentiates to congenital cartilage. The pathological characteristics of bimophic pattern and roentgenographical appearance of tumor are useful for diagnosis.The prognosis is poor.

AIM: To detect sequence and mutation of K-ras oncogene in tissue and stool DNA of patients with colorectal cancer in order to provide a method of noninvasive and simple colorectal cancer diagnosis. METHODS: DNA was separated and purified from colorectal cancer tissue or stool of patient with colorectal cancer, then the K-ras gene was amplified by PCR and PCR products were cloned, the K-ras gene was sequenced, and the mutation was identified. The expression of color/colorectal cancer antigen was inspected by immunohistochemical technique. Stool sample of patient with colorectal cancer was detected with enzyme-linked immunosorbent assay (ELISA). RESULTS: K-ras gene sequence of the stool was completely same as that of the tissue of the patient;K-ras mutation was detected in one case. There was relativity between the mutation of K-ras gene and the pathology type of colorectal cancer and the expression level of colorectal cancer antigen in stool sample. CONCLUSION: It is feasible that colorectal tumors can be detected by a noninvasive method based on the molecular pathogenesis of the disease. Detecting K-ras gene mutations of stool DNA can provide bases for the screening, early detection, and prognosis to patients with colorectal cancer.

Background and purpose:Solitary plasmacytoma of bone(SBP) is a rare disease,reports releveant to this disease are rarely seen. The purpose of this study was to investigate the relation between the clinical features and the prognosis of solitary plasmacytoma of bone. Methods:We reviewed the data of 12 patients diagnosed with solitary plasmacytoma of bone from 1998 to 2007 in Peking University third hospital,the clinical features,treatment and prognosis of the patients were analyzed retrospectively. Results:The age ranged from 37-71 years(mean 49.6 years) ,the male/female ratio was 3 to 1. Immunophenotype analysis showed that 11(91.6%) cases were positive for CD79a,10(83.3%) positive forVS38C,and all negative for CD20. With 12 to 87 months follow-up(average 40?22 months) ,three cases(33%) developed to multiple myeloma,two of them died from infection,the median survival time was 73 months,the 3 year and 5 year survival rate were 90 percent and 75 percent respectively. Conclusion:Middle and old male are more likely to develop SP. The prognosis is good,but some of them can progress to multiple myeloma.

Objective To investigate the clinicopathological and prognosis features of enteropathy-associated T-cell lymphoma (EATL).Methods 21 cases of EATL,6 cases of peripheral T-cell lymphoma (PTCL) and 11 cases of natural-killer/T-cell lymphoma (NKTCL) were collected from January 2008 to May 2015.The immunophenotype of the tumor cell was tested by EnVision and as well as EBV-EBER for EB virus.Some patients were performed with follow-up data.Results 21 EATL patients included 14 males,7 females and the middle age was 55 years old (40-79 years old).15 patients affected the small bowel,4 cases affected colon,2 cases affected more than one site.18 cases were mono-morpholohic EATL while 3 cases were classical EATL.The expression rates of neoplastic cells for CD3ε,CD4,CD8,CD56,Granzyme B,TIA-1 were 95.24 ％ (20/21),20.00 ％ (3/15),73.68 ％ (14/19),85.71％ (18/21),64.71％ (11/17),88.89 ％ (16/18) respectively.The expression of EBER in EATL patients (0,0/21) was obviously lower than that in NKTCL patients (100 ％,11/11).17 EATL patients had follow-up data,and the middle survival time was 15 months.No different prognosis was found in the three kinds of T-NHL (P =0.697).Conclusions EATL usually occurs in elder male and jejunum.The diagnosis of EATL needs a lot of information,including clinical history,endoscopy,histomorphology,immunophenotype and EBV-EBER result.EATL has low mobidity and high malignancy,it still lacks impactful therapeutic regimen.

Objective To elucidate clinical pathological features of primary mediastinal B-cell lymphoma (PMBL) and its difference compared with diffuse large B-cell lymphoma,not otherwise specified (DLBCL,NOS).Methods The clinical histories and pathological datas of 24 PMBL cases and 31 cases of DLBCL,NOS as the control group were collected.Immunohistochemical staining and a follow-up study was conducted.Results The distribution of gender showed significant difference when the age of onset of PMBL patients was obviously younger with the medial age of 30 years old (P ＜ 0.001).All cases presented as a huge mass in mediastinal site with compression symptoms.PMBL was similar to DLBCL in the morphology of tumor cells but fibrosis of various degrees was common,more than 70.8 ％ (17/24) cases had the collagen bundles split.CD23 positive rate (40.0 ％,6/15) in PMBL was significantly higher than the control group (3.2 ％,1/31)(P =0.003).Conclusion PMBL frequently occurs in young female people,mostly happens in mediastinal site and adjacent area,but rarely has distant dissemination.PMBL has the characteristics of various degrees of collagen fiber hyperplasia,and CD23 positive could be used to differentiate PMBL from DLBCL,NOS.

Objective:To explore the clinical application of NanoString fluorescent barcode technology in the molecular subtyping of diffuse large B-cell lymphoma (DLBCL), and to analyze the correlation between the cell-of-origin subtype and prognosis of patients.Methods:The tumor tissue samples of 12 patients with DLBCL at the Third People's Hospital of Datong of Shanxi Province and 8 patients with DLBCL at Peking University, Health Science Center between January 2014 and December 2019 were collected. According to Hans algorithm, all patients were divided into 1 case of germinal center-derived B-cell (GCB) type and 19 cases of non-GCB type. NanoString platform was used to analyze the expression level differences of 15 genes-related to Lymph2Cx molecular subtyping of all samples at mRNA level. Hierarchical clustering was used to subgroup 20 DLBCL cases and to contrast the prognosis in different subgroups according to the subtyping.Results:NanoString fluorescent barcode technology was used to detect samples of 20 DLBCL cases and hierarchical clustering analysis was performed, and then subtyping results showed that 11 cases were GCB-like type and 9 cases were activated B cell (ABC)-like type. Based on Hans algorithm, 10 GCB-like cases were non-GCB type. According to the survival analysis, GCB-like group had a better overall survival compared with that in ABC-like group ( P=0.019). Conclusion:NanoString fluorescent barcode technology can be successfully applied to the cell-of-origin subtyping of DLBCL, and the molecular subtyping strategy can effectively predict the prognosis of patients.

Objective To study the frequency of diffuse large B-cell lymphoma (DLBCL) with multi-genetic alteration, and its correlation with c-myc, bcl-2 and bcl-6 protein expression. Methods 50 cases diagnosed with DLBCL from January 2012 to December 2016 were collected. The expression of c-myc, bcl-2 and bcl-6 was analyzed by immunohistochemistry. Interphase fluorescence in situ hybridization (I-FISH) analysis was performed to identify the genetic alteration of c-myc, bcl-2 and bcl-6. Results In all cases, there were 27 males and 23 females with a median age of 50 years (range: 3-85 years). 23 (46.00 %) cases were defined as primary nodal DLBCL and 27 (54.00 %) cases were primary extra-nodal DLBCL, with gastrointestinal tract (48.15 %, 13/27) being the most common site of involvement. c-myc protein expression was detected in 94.00 % (47/50) cases, in which 82.00 % (41/47) cases exhibited high levels of c-myc expression with positive nuclear staining observed in over 40.00 % of tumor cells. The positive rate of bcl-2 protein was 84.00 % (42/50), 76 % (38/50) cases presented with high-level bcl-2 expression. Concurrent high expression of c-myc and bcl-2 were presented in 18 cases (36.00%). FISH analysis demonstrated c-myc gene rearrangement in 7 cases (14.00 %) and amplification in 2 cases (4.00 %). bcl-2 gene rearrangement was detected in 6 cases (12.00 %) and 4 cases (8.00 %) exhibited gene amplification. bcl-6 gene rearrangement was identified in 8 cases (16.00%), amplification in 3 cases (6.00%), and 1 case concomitantly harbored the rearrangement and amplification of bcl-6. Multi-genetic alterations were defined in 4 cases with 3 cases fulfilling the criteria for double-hit lymphoma (DHL) and 1 case for triple-hit lymphoma (THL). For the cases with concomitant high-level expression of c-myc and bcl-2 proteins, 3 cases (16.67 %) was detected with multi-genetic alterations, including 2 cases for DHL and 1 case for THL. Conclusions The proportion of DLBCL with multi-genetic alterations is 8.00 % in this study. The genetic alterations are not consistently correlated with the protein expression. The molecular genetic testing is reliable for the identification of DHL.