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Song J, Shang B, Pei Y, Shi M, Niu X, Dou L, Drokow EK, Xu F, Bai Y, Sun K. A higher percentage of leukemic blasts with vacuoles predicts unfavorable outcomes in patients with acute myeloid leukemia. Leuk Res 2021; 109:106638. [PMID: 34116372 DOI: 10.1016/j.leukres.2021.106638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
Cytoplasmic vacuoles, which are a morphological feature of dysplasia, can be observed under a microscope at initial diagnosis. Recently, this typical morphological feature has been found to be associated with impaired survival. To investigate the clinical significance of the grading of blasts with vacuoles in acute myeloid leukemia (AML), we retrospectively studied 152 patients newly diagnosed with non-M3 AML. The patients were categorized into three groups according to the percentage of blasts with vacuoles (>20 %, 11-20 %, 0-10 %). A high percentage of blasts with vacuoles (>20 %) was positively associated with the European Leukemia Net (2017-ELN) high-risk AML, a complex karyotype, TP53 and IDH1/2 mutations, and CD71 expression and negatively associated with the ELN low-risk category. Importantly, patients who had a higher percentage of blasts with vacuoles had a lower complete remission rate in response to first-cycle induction chemotherapy. The overall survival and event-free survival of patients who had a higher percentage of blasts with vacuoles were significantly shorter. Moreover, multivariate analysis showed that blast vacuolization was an independent high prognostic factor for AML. In conclusion, a higher percentage of leukemic blasts with vacuoles predicts worse outcomes in AML and may have potential as a prognostic marker.
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Affiliation(s)
- Juanjuan Song
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Baojun Shang
- Institute of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Yanru Pei
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Mingyue Shi
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Xiaona Niu
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Liurui Dou
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Emmanuel Kwateng Drokow
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Fangfang Xu
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Yanliang Bai
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China
| | - Kai Sun
- Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Henan, People's Republic of China.
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Behera G, Chhabra G, Mishra P, Sable M. Pediatric neuroblastic tumors: A critical evaluation of cytomorphological features for risk stratification on aspiration cytology. Diagn Cytopathol 2020; 48:464-474. [PMID: 32043835 DOI: 10.1002/dc.24389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neuroblastic tumor (NT) is the most common extracranial solid tumor of childhood with variable outcome which again depends on risk stratification related to distinct biology of the tumor. The use of fine-needle aspiration (FNA) material for evaluation of cytomorphological parameters and risk stratification in NTs using cytology prognostic score (PS) is limited in routine practice. METHODS We reviewed 38 FNA cytology cases diagnosed as pediatric small round cell tumor between time period June 2017 to December 2019 for clinical, cytomorphological and immunohistochemical features. RESULTS Ten out of 38 small round cell tumors were NTs. All 10 cases were further subclassified according to International Neuroblastoma Pathology Classification into undifferentiated neuroblastoma (n = 1), poorly differentiated neuroblastoma (n = 5), differentiating neuroblastoma (n = 2), and ganglioneuroblastoma (n = 2). Cytologic PS was done using the morphological criteria as described previously in literature. The patients were divided into favorable and unfavorable cytomorphological prognostic categories with a cut off scoring of 12. A score of more than 12 is associated with high risk morphology and advanced stage. All cases with PS > 12 (n-4) (unfavorable cytomorphology) had a poor outcome compared to six patients with PS < 12 (n-6) (favorable cytomorphology). CONCLUSION Aspiration cytology can be used as a first line investigation to evaluate the cytomorphological features for risk stratification and diagnosis in patients with NTs using cytological prognostic scoring system. A larger multi-centric validation study necessitates for cytological risk stratification.
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Affiliation(s)
- Gayatri Behera
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Gaurav Chhabra
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Pritinanda Mishra
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Mukund Sable
- Department of Pathology & Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
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D'Anza B, Kraseman SJ, Canto-Helwig C, Greene JS, Wood WE. FNA biopsy of pediatric cervicofacial masses and validation of clinical characteristics of malignancy. Int J Pediatr Otorhinolaryngol 2015; 79:1196-200. [PMID: 26092550 DOI: 10.1016/j.ijporl.2015.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pediatric head and neck masses can pose a diagnostic challenge due to their ubiquitous nature. The vast majority of masses are inflammatory, however malignancies do occur. This study is a review of fine needle aspiration biopsy (FNA-B) as a diagnostic technique at a single institution over a 13 year period. The objectives were to examine the sensitivity and specificity of FNA-B, correlate these results with clinical characteristics of each mass and determine if such characteristics are associated with malignancy. METHODS This was a retrospective case series of 143 consecutive pediatric patients who underwent FNA-B of 146 head and neck masses with subsequent follow up examinations from 2000 to 2012 (inclusive). We expected FNA-B to be a sensitive and specific method for determining malignancy. FNA-B diagnoses were confirmed with open biopsy pathology results and clinical follow up greater than 1 year. Physical exam characteristics of each mass including location, tenderness, firmness, and mobility were documented. Chi square and Fisher exact tests were used to determine statistical significance. RESULTS The sensitivity and specificity of FNA-B in determining malignancy were 87.5% and 100% respectively. Positive and negative predictive values were 100% and 99.1%, respectively. On univariate analysis of clinical descriptors associated with malignancy, non-mobile masses significantly correlated (p=0.0025), while the firmness and tenderness of a mass did not reach statistical significance. Of mass locations, the lateral neck had the strongest association with malignancy, but this relationship only demonstrated statistical significance when lymphomas were considered independently (p=0.0428). CONCLUSIONS Results demonstrate FNA-B to be an effective method for the diagnosis of pediatric head and neck masses. It maintained a high sensitivity and specificity with a large sample size, to date one of the largest in the pediatric otolaryngology literature. Also, the data offered statistical validation of classical signs of malignancy and showed fixed masses to have the highest correlation. Finally, the findings support lateral neck masses to warrant a higher degree of suspicion for malignancy compared to other compartments.
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Affiliation(s)
- Brian D'Anza
- Geisinger Medical Center, Department of Otolaryngology, 100 N. Academy Ave., Danville, PA 17822, USA.
| | - Stephen J Kraseman
- Naperville Ear, Nose & Throat Associates, 10W. Martin Ave, No. 260, Naperville, IL 60540, USA
| | - Cecilia Canto-Helwig
- Geisinger Medical Center, Department of Otolaryngology, 100 N. Academy Ave., Danville, PA 17822, USA
| | - J Scott Greene
- Geisinger Medical Center, Department of Otolaryngology, 100 N. Academy Ave., Danville, PA 17822, USA
| | - W Edward Wood
- Geisinger Medical Center, Department of Otolaryngology, 100 N. Academy Ave., Danville, PA 17822, USA
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Monaco SE, Teot LA. Cytopathology of pediatric malignancies: Where are we today with fine‐needle aspiration biopsies in pediatric oncology? Cancer Cytopathol 2014; 122:322-36. [DOI: 10.1002/cncy.21401] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/31/2013] [Accepted: 01/02/2014] [Indexed: 01/27/2023]
Affiliation(s)
- Sara E. Monaco
- Division of Cytopathology, Department of PathologyBoston Children's HospitalBoston Massachusetts
| | - Lisa A. Teot
- Division of Cytopathology, Department of PathologyBoston Children's HospitalBoston Massachusetts
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Cole CD, Wu HH. Fine-needle aspiration in pediatric patients 12 years of age and younger. Diagn Cytopathol 2013; 42:600-5. [DOI: 10.1002/dc.23085] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/01/2013] [Accepted: 12/03/2013] [Indexed: 12/12/2022]
Affiliation(s)
- Cristina D. Cole
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis Indiana
| | - Howard H. Wu
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis Indiana
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Ambrosio MR, Piccaluga PP, Ponzoni M, Rocca BJ, Malagnino V, Onorati M, De Falco G, Calbi V, Ogwang M, Naresh KN, Pileri SA, Doglioni C, Leoncini L, Lazzi S. The alteration of lipid metabolism in Burkitt lymphoma identifies a novel marker: adipophilin. PLoS One 2012; 7:e44315. [PMID: 22952953 PMCID: PMC3432109 DOI: 10.1371/journal.pone.0044315] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/01/2012] [Indexed: 11/24/2022] Open
Abstract
Background Recent evidence suggests that lipid pathway is altered in many human tumours. In Burkitt lymphoma this is reflected by the presence of lipid droplets which are visible in the cytoplasm of neoplastic cells in cytological preparations. These vacuoles are not identifiable in biopsy section as lipids are “lost” during tissue processing. Methods and Results In this study we investigated the expression of genes involved in lipid metabolism, at both RNA and protein level in Burkitt lymphoma and in other B-cell aggressive lymphoma cases. Gene expression profile indicated a significant over-expression of the adipophilin gene and marked up-regulation of other genes involved in lipid metabolism in Burkitt lymphoma. These findings were confirmed by immunohistochemistry on a series od additional histological samples: 45 out of 47 BL cases showed strong adipophilin expression, while only 3 cases of the 33 of the not-Burkitt lymphoma category showed weak adipophilin expression (p<0.05). Conclusions Our preliminary results suggest that lipid metabolism is altered in BL, and this leads to the accumulation of lipid vacuoles. These vacuoles may be specifically recognized by a monoclonal antibody against adipophilin, which may therefore be a useful marker for Burkitt lymphoma because of its peculiar expression pattern. Moreover this peptide might represent an interesting candidate for interventional strategies.
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Affiliation(s)
- Maria R. Ambrosio
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
| | - Pier P. Piccaluga
- Molecular Pathology Laboratory, Haematopathology Unit, Department of Haematology and Oncology "L. and A. Seràgnoli", S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Maurilio Ponzoni
- Pathology Unit, Department of Oncology, University Scientific Institute San Raffaele, Milan, Italy
| | - Bruno J. Rocca
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
| | - Valeria Malagnino
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
| | - Monica Onorati
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
| | - Giulia De Falco
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
| | | | | | - Kikkeri N. Naresh
- Department of Histopathology, Hammersmith Hospital Campus, Imperial College, London, United Kingdom
| | - Stefano A. Pileri
- Molecular Pathology Laboratory, Haematopathology Unit, Department of Haematology and Oncology "L. and A. Seràgnoli", S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Claudio Doglioni
- Pathology Unit, Department of Oncology, University Scientific Institute San Raffaele, Milan, Italy
| | - Lorenzo Leoncini
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
- * E-mail:
| | - Stefano Lazzi
- Department of Human Pathology and Oncology, Anatomical Pathology Section, University of Siena, Siena, Italy
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Klijanienko J, Couturier J, Brisse H, Pierron G, Fréneaux P, Berger F, Maciorowski Z, Sastre-Garau X, Michon J, Schleiermacher G. Diagnostic and prognostic information obtained on fine-needle aspirates of primary neuroblastic tumors. Cancer Cytopathol 2011; 119:411-23. [DOI: 10.1002/cncy.20173] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 05/11/2011] [Accepted: 05/12/2011] [Indexed: 12/31/2022]
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Razack R, Michelow P, Leiman G, Harnekar A, Poole J, Wessels G, Hesseling P, Stefan C, Louw M, Schubert PT, Clarke H, Wright CA. An interinstitutional review of the value of FNAB in pediatric oncology in resource-limited countries. Diagn Cytopathol 2011; 40:770-6. [DOI: 10.1002/dc.21624] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Accepted: 11/18/2010] [Indexed: 12/13/2022]
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Bellan C, Stefano L, Giulia DF, Rogena EA, Lorenzo L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2010; 28:53-6. [PMID: 19844983 DOI: 10.1002/hon.916] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an 'aggressive B-cell non-Hodgkin's lymphoma', characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of 'B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma', now listed in the updated WHO classification.
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Affiliation(s)
- Cristiana Bellan
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
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Suciu V, Fabre M, Klijanienko J, Pohar-Marinsek Z, Vielh P. Childhood tumours. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00033-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bellan C, Stefano L, Giulia DF, Rogena EA, Lorenzo L. Burkitt lymphoma versus diffuse large B-cell lymphoma: a practical approach. Hematol Oncol 2009; 27:182-5. [PMID: 19670467 DOI: 10.1002/hon.914] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Burkitt Lymphoma (BL) is listed in the World Health Organization (WHO) classification of lymphoid tumours as an "aggressive B-cell non-Hodgkin's lymphoma", characterized by a high degree of proliferation of the malignant cells and deregulation of the c-MYC gene. The main diagnostic challenge in BL is to distinguish it from diffuse large B-cell lymphoma (DLBCL). While in children BL and DLBCL types probably do not differ clinically, and the differential diagnosis between BL and DLBCL may theoretically appear clear-cut, in adults daily practice shows the existence of cases that have morphological features, immunophenotypic and cytogenetics intermediate between DLBCL and BL, and cannot be classified with certainty in these categories. Distinguishing between BL and DLBCL is critical, as the two diseases require different management. This review summarizes the current practical approach, including the use of a large panel of antibodies, and cytogenetic and molecular diagnostic techniques, to distinguish between BL, DLBCL and the provisional category of "B-cell lymphoma, unclassificable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma", now listed in the updated WHO classification.
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Affiliation(s)
- Cristiana Bellan
- Department of Human Pathology and Oncology, University of Siena, Siena, Italy
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Michelow P, Meyers T, Dubb M, Wright C. The utility of fine needle aspiration in HIV positive children. Cytopathology 2008; 19:86-93. [DOI: 10.1111/j.1365-2303.2007.00474.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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13
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Gois WAFD, Correa CAA, Alves EMDO, Tubino P. Punção aspirativa por agulha fina no diagnóstico de linfadenopatias e tumores sólidos em crianças e adolescentes. Rev Col Bras Cir 2008. [DOI: 10.1590/s0100-69912008000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a importância diagnóstica da punção aspirativa por agulha fina (PAAF) em crianças e adolescentes portadores de linfadenopatias e tumores sólidos. MÉTODOS: Análise retrospectiva dos pacientes com idade igual ou inferior a 18 anos, atendidos no Centro de Pediatria Cirúrgica do Hospital Universitário de Brasília, Universidade de Brasília, no período de julho de 2000 a julho de 2005. Foram calculados: sensibilidade, especificidade, precisão (acurácia) diagnóstica, valor preditivo positivo e valor preditivo negativo. RESULTADOS: Em 50 pacientes estudados, os resultados da PAAF mostraram sensibilidade de 90,9%; especificidade de 100%, precisão diagnóstica de 95% e valores preditivos positivo e negativo de 100% e 90%, respectivamente. CONCLUSÃO: Em nossa experiência, a PAAF é um método preciso, simples e seguro, útil no diagnóstico de linfadenopatias e tumores sólidos em crianças e adolescentes.
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Affiliation(s)
| | | | | | - Paulo Tubino
- Universidade de Brasília; Universidade de Brasília
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