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Parkhi M, Premkumar M, Bal A, Das A, Jain S, Mitra S. Acute liver failure caused by lymphocyte-depleted Hodgkin lymphoma in tuberculosis and HIV-infected patient. Autops Case Rep 2024; 14:e2024490. [PMID: 38803484 PMCID: PMC11129859 DOI: 10.4322/acr.2024.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/04/2024] [Indexed: 05/29/2024]
Abstract
The lymphocyte-depleted classic Hodgkin lymphoma (LDCHL), the rarest subtype of classic Hodgkin lymphoma (CHL), is usually diagnosed at an advanced stage (stage IV) and one that unusually involves the liver, causing a rapidly progressive clinical course. We describe a 40-year-old immunocompromised man presenting with a progressive non-cholestatic jaundice and intermittent fever. The abdominal ultrasonography revealed a nodular liver with coarse echotexture and periportal hypodensities. The thoracic and abdominal contrast-enhanced computed tomography revealed right cervical and paraaortic lymphadenopathy, hepatosplenomegaly, diffuse mural thickening of duodenal and jejunal loops, and bilateral lobulated kidneys. Subsequently, he succumbed to his illness secondary to refractory septic shock. On postmortem examination, he was diagnosed with classic Hodgkin lymphoma (lymphocyte-depleted type) involving paraaortic and mediastinal lymph nodes based on morphology and immunochemistry findings. The lymphomatous process involved the liver (causing multiacinar confluent hepatic necrosis) and spleen, both showing tuberculous foci. This autopsy case depicts an uncommon case of acute liver failure due to infiltration of the liver by LDCHL in an HIV-infected patient. The findings of angiotropism and angioinvasion establish the pathological mechanism of liver failure (hepatocellular necrosis) in such cases.
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Affiliation(s)
- Mayur Parkhi
- Post Graduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Madhumita Premkumar
- Post Graduate Institute of Medical Education and Research, Department of Hepatology, Chandigarh, India
| | - Amanjit Bal
- Post Graduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Ashim Das
- Post Graduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
| | - Sanjay Jain
- Post Graduate Institute of Medical Education and Research, Department of Internal Medicine, Chandigarh, India
| | - Suvradeep Mitra
- Post Graduate Institute of Medical Education and Research, Department of Histopathology, Chandigarh, India
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2
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Peckham-Gregory EC, Boff LM, Schraw JM, Spector LG, Linabery AM, Erhardt EB, Ribeiro KB, Allen CE, Scheurer ME, Lupo PJ. Role of non-chromosomal birth defects on the risk of developing childhood Hodgkin lymphoma: A Children's Oncology Group study. Pediatr Blood Cancer 2024; 71:e30822. [PMID: 38146016 DOI: 10.1002/pbc.30822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Non-chromosomal birth defects are an important risk factor for several childhood cancers. However, these associations are less clear for Hodgkin lymphoma (HL). Therefore, we sought to more fully elucidate the association between non-chromosomal birth defects and HL risk. PROCEDURE Information on cases (n = 517) diagnosed with HL (ages of 0-14) at Children's Oncology Group Institutions for the period of 1989-2003 was obtained. Control children without a history of cancer (n = 784) were identified using random digit dialing and individually matched to cases on sex, race/ethnicity, age, and geographic location. Parents completed comprehensive interviews and answered questions including whether their child had been born with a non-chromosomal birth defect. To test the association between birth defects and HL risk, conditional logistic regression was applied to generate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS Children born with any non-chromosomal birth defect were not more likely to be diagnosed with HL at 0-14 years of age (aOR: 0.91; 95% CI: 0.69-1.21). No associations were detected between major or minor birth defects and HL (aOR: 1.34; 95% CI: 0.67-2.67 and aOR: 0.88; 95% CI: 0.57-1.34, respectively). Similarly, no association was observed for children born with any birth defect and EBV-positive HL (aOR: 0.57; 95% CI: 0.25-1.26). CONCLUSIONS Previous assessments of HL in children with non-chromosomal birth defects have been limited. Using data from the largest case-control study of HL in those <15 years of age, we did not observe strong associations between being born with a birth defect and HL risk.
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Affiliation(s)
- Erin C Peckham-Gregory
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Feigin Center, Houston, Texas, USA
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Lucas Maschietto Boff
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | - Jeremy M Schraw
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Feigin Center, Houston, Texas, USA
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Logan G Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Pediatrics, University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota, USA
| | - Amy M Linabery
- Department of Pediatrics, Neuroscience Institute, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Erik B Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico, USA
| | - Karina B Ribeiro
- Department of Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil
| | - Carl E Allen
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Feigin Center, Houston, Texas, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Feigin Center, Houston, Texas, USA
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Texas Children's Hospital, Feigin Center, Houston, Texas, USA
- Department of Pediatrics, Center for Epidemiology and Population Health, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
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3
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Scheijde-Vermeulen MA, Kester LA, Westera L, Tops BBJ, Meyer-Wentrup FAG. Integration of RNA Sequencing, Whole Exome Sequencing, and Flow Cytometry Into Routine Diagnostic Workup of Pediatric Lymphomas. J Transl Med 2024; 104:100267. [PMID: 37898291 DOI: 10.1016/j.labinv.2023.100267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/13/2023] [Accepted: 10/19/2023] [Indexed: 10/30/2023] Open
Abstract
The study was conducted to assess the feasibility of integrating state-of-the-art sequencing techniques and flow cytometry into diagnostic workup of pediatric lymphoma. RNA sequencing (RNAseq), whole exome sequencing, and flow cytometry were implemented into routine diagnostic workup of pediatric biopsies with lymphoma in the differential diagnosis. Within 1 year, biopsies from 110 children (122 specimens) were analyzed because of suspected malignant lymphoma. The experience with a standardized workflow combining histology and immunohistochemistry, flow cytometry, and next-generation sequencing technologies is reported. Flow cytometry was performed with fresh tissue in 83% (102/122) of specimens and allowed rapid diagnosis of T-cell and B-cell non-Hodgkin lymphomas. RNAseq was performed in all non-Hodgkin lymphoma biopsies and 42% (19/45) of Hodgkin lymphoma samples. RNAseq detected all but one of the translocations found by fluorescence in situ hybridization and PCR. RNAseq and whole exome sequencing identified additional genetic abnormalities not detected by conventional approaches. Finally, 3 cases are highlighted to exemplify how synergy between different diagnostic techniques and specialists can be achieved. This study demonstrates the feasibility and discusses the added value of integrating modern sequencing techniques and flow cytometry into a workflow for routine diagnostic workup of lymphoma. The inclusion of RNA and DNA sequencing not only supports diagnostics but also will lay the ground for the development of novel research-based treatment strategies for pediatric lymphoma patients.
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Affiliation(s)
| | - Lennart A Kester
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Liset Westera
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Bastiaan B J Tops
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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4
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Wong F, Doyle-McClam M, Pugh S, Dudney T, McCormack M, Kravitz J. Diagnostic and treatment dilemma during the coronavirus disease 2019 pandemic: a primary pulmonary lymphoma presenting as a cavitary mass in a patient with coronavirus disease 2019: a case report. J Med Case Rep 2023; 17:12. [PMID: 36635758 PMCID: PMC9836925 DOI: 10.1186/s13256-022-03745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 12/27/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND A radiological finding of a cavitary pulmonary lesion in a patient acutely infected with severe acute respiratory syndrome coronavirus-2 early during the coronavirus disease 2019 pandemic created a diagnostic and treatment dilemma, as invasive procedures with bronchoscopy and percutaneous needle lung biopsy posed an infection hazard to healthcare workers due to the associated risk of viral aerosolization. Available guidelines recommended delay of non-emergent procedures, but timely proceeding with those deemed urgent provided appropriate personal protective equipment and negative pressure isolation were available and exposure risk was not excessive. Thoughtful consideration by clinicians was required to avoid delay in diagnosis of a potential new malignancy and prevent unnecessary healthcare worker exposure to the virus. Additionally, acute severe acute respiratory syndrome coronavirus-2 infection in patients with malignancy complicated timing of oncologic treatment. CASE PRESENTATION A 26-year-old otherwise healthy Caucasian male initially presented with an enlarging right upper lobe cavitary pulmonary lesion despite antimicrobial therapy. During his hospitalization and evaluation, the patient was found to be acutely infected with severe acute respiratory syndrome coronavirus-2 without hypoxia or viral pneumonia. Bronchoscopy was deemed too high risk for viral aerosolization and healthcare worker infection. He underwent computed-tomography-guided percutaneous needle biopsy of the lesion by interventional radiology while on mechanical ventilation after elective intubation by anesthesiology. Biopsy revealed classic Hodgkin lymphoma consistent with primary pulmonary Hodgkin lymphoma. After collaboration with oncology, his treatment with combined chemotherapy and immunotherapy was delayed for 3 weeks following diagnosis to allow for viral clearance. CONCLUSION A careful multidisciplinary strategy is required to expeditiously diagnose and treat aggressive cancers of the respiratory tract in patients acutely infected with severe acute respiratory syndrome coronavirus-2 while observing practices to prevent healthcare worker infection during the ongoing coronavirus disease 2019 pandemic.
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Affiliation(s)
- Fatima Wong
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
| | - Megan Doyle-McClam
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
| | - Spencer Pugh
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
| | - Tina Dudney
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
| | - Michael McCormack
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
| | - Jared Kravitz
- grid.267301.10000 0004 0386 9246Division of Pulmonary and Critical Care Medicine, Department of Medicine, Graduate School of Medicine, University of Tennessee Health Sciences Center Knoxville, Knoxville, TN USA
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5
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Pereira V, Boudjemaa S, Besson C, Leblanc T, Rigaud C, Leruste A, Garnier N, Lambilliotte A, Simonin M, Curtillet C, Bonneau-Lagacherie J, Coulomb A, Landman-Parker J. Epstein-Barr Virus in Childhood and Adolescent Classic Hodgkin Lymphoma in a French Cohort of 301 Patients. J Pediatr Hematol Oncol 2022; 44:e1033-e1038. [PMID: 35091521 DOI: 10.1097/mph.0000000000002403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to analyze the role of Epstein-Barr virus (EBV) in the bioclinical characteristics of patients treated for classic Hodgkin lymphoma (cHL) in France. METHODS Biopathologic data of 301 patients treated for a cHL in/or according to the EuroNet PHL-C1 trial between November 2008 and February 2013 were centrally reviewed. RESULTS Median age at diagnosis was 14 (3 to 18) years and the F/M ratio 0.86, 0.47 before 10 years and 0.9 from 11 to 18. CHL subtypes were nodular sclerosis for 266/301 (88%) patients, mixed cellularity for 22/301 (7%), lymphocyte rich for 2/301 (1%), and 11/301 were unclassified. EBV positivity by in situ hybridization was observed for 68/301 (23%) patients, significantly associated with mixed cellularity subtype and male sex, particularly overrepresented in boys below 10 years: 15/23 (65%) versus 28/139 among other male patients (20%). EBV viral load was detectable in 22 of 108 (22%) tested cases and was overrepresented in EBV cHL (13/28) versus non-EBV cHL (9/80) patients. Detailed semiquantitative histologic analysis showed a high number of B-cell residual follicles in EBV cHL relative to EBV-negative HL. CONCLUSION Distribution of EBV cHL in children and adolescents is associated with young age and male sex, suggesting a specific physiopathology and may require a differential therapeutic approach.
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Affiliation(s)
- Victor Pereira
- Department of Pediatric Hematology and Oncology, Besançon University Hospital, Besançon
| | | | - Caroline Besson
- Department of Hematology Versailles University Hospital, Versailles
| | - Thierry Leblanc
- Department of Pediatric Hematology and Immunology, APHP, Robert Debré Hospital
- Paris Diderot University
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif
| | - Amaury Leruste
- SIREDO, Pediatric Cancer Center, Institut Curie, PSL Research University, Paris
| | - Nathalie Garnier
- Department of Pediatric Hematology and Oncology, Pediatric Hematology and Oncology Institute, Hospices Civils de Lyon, Lyon
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Lille University Hospital, Lille
| | | | - Catherine Curtillet
- Department of Pediatric Hematology and Oncology, APHM, La Timone Hospital, Marseille
| | | | | | - Judith Landman-Parker
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, APHP, Sorbonne University, UMRs938
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6
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Li HN, Wang RC, Chen CH, Chen JP, Yang SF, Chen SW, Chuang SS. Distinctive patterns of marrow involvement by classic Hodgkin lymphoma are clues for diagnosis and subtyping. Virchows Arch 2022; 480:899-907. [PMID: 35122497 DOI: 10.1007/s00428-022-03273-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/23/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022]
Abstract
Classic Hodgkin lymphoma (CHL) is a lymphoid neoplasm deriving from B cells in a rich inflammatory background. There are four histological subtypes with different epidemiological features. Bone marrow involvement by CHL is infrequent, and subtyping CHL from the bone marrow is not suggested as there might be discordant histopathology between the primary tumors and bone marrow specimens. In this study, we aimed to identify the histopathological features of bone marrow involved by CHL and tried to correlate these features with their subtypes. Among the 23 recruited cases, the frequencies of mixed cellularity (MC; 48%, 11/23) and nodular sclerosis (NS; 44%, 10/23) were similar. There were two patterns of marrow involvement: pattern A (fibrous), space-occupying lesions with alternating hypo- and hypercellular areas against a fibrotic background with dilated sinusoids and pattern B (histiocyte-rich), ill-defined granuloma-like lesions in which histiocytes merged with normal hematopoietic and inflammatory cells. Pattern A was more frequent in patients with CHL-NS than CHL-MC (100% vs. 18.2%; p < 0.001). Diagnostic Hodgkin cells and Reed-Sternberg (HRS) cells were identified in all cases, while HRS variant lacunar cells were occasionally discovered, particularly in the CHL-NS subtype (NS 100% vs. MC 9%; p < 0.001). The frequency of EBV association was higher in MC (64%) than that in NS (36%) subtype, but not statistically significant. Of the two patterns of marrow involvement, pattern A was more commonly associated with the NS subtype and less frequently associated with EBV. Recognizing the patterns of marrow involvement is important for diagnosis and may contribute to the subtyping of CHL.
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Affiliation(s)
- Hsin-Ni Li
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Ren Ching Wang
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Chuan-Han Chen
- Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Sheau-Fang Yang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Pathology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shang-Wen Chen
- Division of Hemato-Oncology, Department of Internal Medicine, Lioying Chi-Mei Hospital, Tainan, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, 901 Chung-Hwa Road, Yong-Kang District, Tainan, 71004, Taiwan.
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7
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Zafar F, Sultana S, Zafar SMA. An unique case report: Unusual presentation of mediastinal lymph node tuberculosis in an adult. Indian J Tuberc 2020; 67:419-422. [PMID: 32825885 DOI: 10.1016/j.ijtb.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/02/2020] [Indexed: 11/25/2022]
Abstract
Tuberculosis (TB) is a serious public health problem in Bangladesh. National tuberculosis control program recognizes that almost half of the TB cases remain undiagnosed in the country. To increase case detection rate, it is very important to familiarize the physicians with unusual presentation of TB. We describe a 51 years old woman with a past medical history of Hypertension (HTN), Type 2 Diabetes Mellitus (DM), and Nonalcoholic steatohepatitis-chronic liver disease (NASH-CLD) who presented to us with low grade fever, anorexia, nausea, and recurrent vomiting for one month. Physical examination and laboratory tests revealed no significant abnormalities and symptoms were treated symptomatically. After about two months, the condition did not improve. All routine blood biochemistry and imaging reports were not suggestive of any disease except for high ESR and abnormal LFT (mild increase in ALP, ALT and moderate increase in GGTP). To exclude the differential diagnoses (such as abdominal TB), we advised computed tomography (CT) scan of chest and abdomen but the results came out normal. Her PPD came out positive but it was not confirmatory of TB as the patient was previously vaccinated with BCG vaccine. As the patient was immune-compromised we suggested starting Anti-TB drugs based on clinical judgment and in the context of Bangladesh being a TB endemic area. But the patient was not convinced to take anti-Tb drugs without definite diagnosis. After another month of persistent symptoms a repeat CT of the chest was advised that revealed multiple enlarged mediastinal lymph-nodes. As the patient had a history of CLD and high PT, Fine Needle Aspiration Cytology (FNAC) was deferred. Patient was started on Anti tubercular treatment and symptoms subsided within three weeks. Treatment was continued for one year. This case summarizes the unusual presentation of mediastinal lymph node Tuberculosis in an adult.
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Affiliation(s)
| | | | - Sk Md Abu Zafar
- Internal Medicine, Sir Salimullah Medical College & Hospital, Bangladesh
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8
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Hod K, Bronstein Y, Chodick G, Shpilberg O. Hemato-oncology Tourism in Israel: A Retrospective Review. JCO Glob Oncol 2020; 6:1314-1320. [PMID: 32822235 PMCID: PMC7456320 DOI: 10.1200/go.20.00098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Despite the significant increase in medical tourism worldwide, data on medical tourist (MT) clinical characteristics and treatment outcomes are lacking. Many MTs who choose Israel to receive medical services are individuals diagnosed with hematologic malignancies. The purpose of this study was to describe hemato-oncology MTs and to compare their disease characteristics and treatment outcomes to a control group of local (Israeli) hemato-oncology patients. MATERIALS AND METHODS In this retrospective review, we analyzed hospital records of all hemato-oncology tourists and Israeli patients diagnosed and/or treated at the Institute of Hematology, Assuta Medical Center, between 2014 and 2016. MT and local patient demographics, clinical characteristics, and treatment outcomes were compared. MT data were also analyzed according to their commitment to treatment in Israel. RESULTS Data on 110 MTs (median age, 51.0 years; 53.6% women) and 122 local patients (median age, 65.0 years; 41.8% women) diagnosed with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and multiple myeloma were analyzed. The most common hematologic malignancy in both MTs and local patients was NHL (54.5% and 73.0%, respectively). Among MTs, 32.7% were fully committed to treatment in Israel, 32.7% were partially committed, and 34.6% were not committed. In 25.9% of MTs, a review of their biopsy resulted in a more definitive or different diagnosis. The percentage of patients who achieved complete response to treatment was similar among MTs and local patients. CONCLUSION MTs often require a pathologic review of their initial diagnosis and are more likely to present with advanced stages of disease. Treatment of MTs according to the appropriate clinical parameters is expected to yield similar outcomes to those of local patients.
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Affiliation(s)
- Keren Hod
- Department of Academy and Research, Assuta Medical Center, Tel-Aviv, Israel
| | - Yotam Bronstein
- School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Chodick
- Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Shpilberg
- Institute of Hematology, Assuta Medical Center, Tel-Aviv, Israel.,Pre-Medicine Department, School of Health Sciences, Ariel University, Ariel, Israel
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9
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Griesel C, Desmirean M, Esterhuizen T, Pasca S, Petrushev B, Selicean C, Roman A, Fetica B, Teodorescu P, Swanepoel C, Tomuleasa C, Grewal R. Differential Diagnosis of Malignant Lymphadenopathy Using Flow Cytometry on Fine Needle Aspirate: Report on 269 Cases. J Clin Med 2020; 9:jcm9010283. [PMID: 31968576 PMCID: PMC7019747 DOI: 10.3390/jcm9010283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction: Fine needle aspiration (FNA) is frequently the first noninvasive test used for the diagnostic workup of lymphadenopathy. There have been many studies showing its usefulness, especially in conjunction with other techniques for the diagnosis of lymphoma, but it remains inferior to histological examination. The data regarding this subject have mostly been reported mostly from first-world countries, but are scarce for emerging economies. Thus, the current study assesses the agreement between fine needle aspiration flow cytometry (FNA FC) and histology in the aforementioned region. Material and Methods: We conducted a retrospective study including the FNA FC adenopathy diagnoses made between January 2011 and December 2016 at the Tygerberg Hospital, Cape Town, South Africa. Additional variables included were the histological diagnosis, sex and age of the included patients. Results: In the descriptive part of the current study, 269 FNA FC samples were included. The most frequent diagnoses made on these were represented by B-cell lymphoma, reactive adenopathy, no abnormality detected (NAD), and non-hematological malignancy. In the analytical part of the current study, there were 115 cases included that had both valid FNA FC and histological diagnoses. It could be observed that FNA FC can correctly diagnose B-cell lymphoma in most cases, but it is a poor diagnostic tool especially for Hodgkin lymphoma in this setting as only a four-color flow cytometer was available for diagnosis. Moreover, FNA FC diagnosis of reactive adenopathy and of no abnormalities detected was shown to frequently hide a malignant disease. Conclusion: In countries with scarce resources, FNA FC represents a useful diagnostic tool in the case of B-cell lymphoma, but may misdiagnose reactive adenopathy. Thus, FNA FC should be used in a case-specific manner, in addition to as a screening tool, with the knowledge that in cases with a high clinical suspicion of lymphoma, histological diagnosis is a necessity.
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Affiliation(s)
- Carla Griesel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Minodora Desmirean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Pathology, Constantin Papilian Military Hospital, 400001 Cluj Napoca, Romania
| | - Tonya Esterhuizen
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Sergiu Pasca
- Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania;
| | - Bobe Petrushev
- Department of Pathology, Octavian Fodor Regional Institute for Gastroenterology, 400111 Cluj Napoca, Romania;
| | - Cristina Selicean
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Andrei Roman
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania
| | - Bogdan Fetica
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Carmen Swanepoel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Correspondence:
| | - Ravnit Grewal
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
- Faculty of Natural Sciences, University of Western Cape, Belville 7535, South Africa
- The South African National Bioinformatics Institute, Medical Research Council, University of the Western Cape, Belville 7535, South Africa
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Schneider J, Volkmer I, Engel K, Emmer A, Staege MS. Expression of A New Endogenous Retrovirus-Associated Transcript in Hodgkin Lymphoma Cells. Int J Mol Sci 2019; 20:ijms20215320. [PMID: 31731509 PMCID: PMC6862598 DOI: 10.3390/ijms20215320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 12/20/2022] Open
Abstract
During characterization of a cDNA library from the Hodgkin lymphoma (HL) cell line L-1236, we discovered a new transcript derived from chromosome 1 at the long intergenic non-protein coding RNA 1768 (LINC01768)/colony stimulating factor 1 (CSF1) region. The first exon of this transcript from Hodgkin lymphoma cells (THOLE) starts in the predicted exon 4 of LINC01768 and is part of an endogenous retrovirus (ERV) from the HUERS-P1/LTR8 family. High expression of THOLE was only detectable in HL cell line L-1236. The expression of THOLE in L-1236 cell is another example for ERV/LTR-associated gene expression in HL cells. At the genome level, the HUERS-P1/LTR8 region including THOLE is only present in Hominoidea. The influence of ERV/LTRs on gene expression might explain the characteristic phenotype of human HL.
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Affiliation(s)
- Jana Schneider
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Martin Luther University Halle-Wittenberg, 06097 Halle, Germany; (J.S.); (I.V.); (K.E.)
| | - Ines Volkmer
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Martin Luther University Halle-Wittenberg, 06097 Halle, Germany; (J.S.); (I.V.); (K.E.)
| | - Kristina Engel
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Martin Luther University Halle-Wittenberg, 06097 Halle, Germany; (J.S.); (I.V.); (K.E.)
| | - Alexander Emmer
- Department of Neurology, Martin Luther University Halle-Wittenberg, 06097 Halle, Germany
| | - Martin S. Staege
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Martin Luther University Halle-Wittenberg, 06097 Halle, Germany; (J.S.); (I.V.); (K.E.)
- Correspondence: ; Tel.: +49-345-557-7280; Fax: +49-345-557-7275
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Zou DM, Zhou DB, Zhang Y, Wang W, Zhang W. Clinical characteristics and prognostic factors in Chinese patients with classical Hodgkin's lymphoma involving extranodal sites: a retrospective single-center. ACTA ACUST UNITED AC 2019; 24:661-668. [PMID: 31537183 DOI: 10.1080/16078454.2019.1668161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: To analyze the clinical characteristics and prognostic factors in Chinese patients with classical Hodgkin's lymphoma (cHL) involving extranodal sites. Methods: Clinical features and outcomes of 68 patients diagnosed with cHL involving extranodal sites from April 2003 to November 2017 were analyzed retrospectively. The data was compared with that of 76 cHL patients without extranodal involvement in the same period. Results: (1) Extranodal involvement was common in Chinese cHL patients. The most common sites were lung (44.1%) and bone (33.8%), followed by bone marrow, liver, pericardium, pleura and other sites. (2) With a median follow-up period of 4.58 years, the 5-year overall survival (OS) of 68 patients with extranodal involvement was significantly poorer than that of 76 patients with only nodal involvement (81.4% vs. 92.8%, p = 0.018). (3) In univariate analysis, lymphocytopenia (p = 0.027), elevated lactate dehydrogenase (LDH) (p = 0.026) and involved lymph node region (LNR) ≥4 (p = 0.044) predicted inferior freedom from progression (FFP) with significant difference. Elder age (p = 0.010), elevated LDH (p = 0.013), elevated platelet (p = 0.044), involved LNR ≥ 4 (p = 0.047) were also statistically significant in OS. Extranodal sites and number of extranodal sites showed no significant difference in FFP and OS. Factors with p-value smaller than 0.100 were evaluated in multivariate analysis, turning out that lymphocytopenia was the only independent adverse prognostic factor in FFP (p = 0.039; HR = 2.595) and OS (p = 0.028; HR = 4.993). Conclusion: Extranodal involvement was frequent in Chinese cHL patients, with lung to be the most commonly involved site. Lymphocytopenia was the only independent adverse prognostic factor.
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Affiliation(s)
- Dong-Mei Zou
- Peking Union Medical College Hospital; Department of Hematology, Peking Union Medical College Hospital, Wangfujing , Beijing , People's Republic of China
| | - Dao-Bin Zhou
- Peking Union Medical College Hospital; Department of Hematology, Peking Union Medical College Hospital, Wangfujing , Beijing , People's Republic of China
| | - Yan Zhang
- Peking Union Medical College Hospital; Department of Hematology, Peking Union Medical College Hospital, Wangfujing , Beijing , People's Republic of China
| | - Wei Wang
- Peking Union Medical College Hospital; Department of Hematology, Peking Union Medical College Hospital, Wangfujing , Beijing , People's Republic of China
| | - Wei Zhang
- Peking Union Medical College Hospital; Department of Hematology, Peking Union Medical College Hospital, Wangfujing , Beijing , People's Republic of China
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Salvarani C, Brown RD, Christianson TJH, Huston J, Ansell SM, Giannini C, Hunder GG. Primary central nervous system vasculitis associated with lymphoma. Neurology 2018; 90:e847-e855. [PMID: 29429967 DOI: 10.1212/wnl.0000000000005062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/04/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To record the clinical findings, response to therapy, and course of patients with primary CNS vasculitis (PCNSV) associated with lymphoma. PATIENTS AND METHODS We reviewed the histories of 936 patients with a diagnosis of any type of vasculitis and lymphoma who were seen at the Mayo Clinic over a 32-year period. Ten patients with both PCNSV and lymphoma were identified. We compared the findings in these 10 patients with those from 158 patients with PCNSV without lymphoma seen over 29 years. RESULTS Ten of a total of 168 (5.9%) patients with PCNSV also had a history of lymphoma: 6 with Hodgkin lymphoma (HL) and 4 with non-HL (NHL). A granulomatous vasculitis was found in all 8 patients with cerebral biopsies, accompanied by vascular deposits of β-amyloid peptide in 2. In 7 patients, medical diagnostic workup for PCNSV revealed the lymphoma. Compared to the 158 patients with PCNSV without lymphoma, patients with lymphoma were more frequently male (p = 0.04), had increased gadolinium leptomeningeal enhancement (p = 0.03) at presentation, and had more neurologic disability at last follow-up (p = 0.01). No significant differences in treatment response were observed in the 2 groups (p = 0.202). Considering all 168 patients, increased disability at last follow-up was associated with increasing age at diagnosis (odds ratio [OR] 1.4), lymphoma (OR 5.9), and cerebral infarction (OR 3.2), while reduced disability was associated with gadolinium-enhanced lesions (OR 0.43) and amyloid angiopathy (OR O.23). CONCLUSIONS Lymphoma may be diagnosed simultaneously with PCNSV, suggesting an immunologic paraneoplastic mechanism.
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Affiliation(s)
- Carlo Salvarani
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN.
| | - Robert D Brown
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
| | - Teresa J H Christianson
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
| | - John Huston
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
| | - Stephen M Ansell
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
| | - Caterina Giannini
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
| | - Gene G Hunder
- From the Departments of Neurology (R.D.B.), Biomedical Statistics and Informatics (T.J.H.C.), Radiology (J.H.), Hematology (S.M.A.), Anatomic Pathology (C.G.), and Rheumatology (G.G.H.), Mayo Clinic, Rochester, MN; and Rheumatology Division (C.S.), Azienda USL-IRCCS di Reggio Emilia e Università di Modena e Reggio Emilia, Italy. Dr. Salvarani is currently a visiting clinician at the Department of Neurology, Mayo Clinic, Rochester, MN
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Grewal R, Irimie A, Naidoo N, Mohamed N, Petrushev B, Chetty M, Tomuleasa C, Abayomi EA. Hodgkin's lymphoma and its association with EBV and HIV infection. Crit Rev Clin Lab Sci 2018; 55:102-114. [PMID: 29316828 DOI: 10.1080/10408363.2017.1422692] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hodgkin's lymphoma (HL) constitutes a clonal expansion of what appears to be malignant B cells. Viruses are involved in its pathogenesis, such as the Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV). Since these viral infections have been shown to play key roles in the pathogenesis of HL, countries with a prevalence of HIV and EBV represent interesting population targets to study the pathogenesis of HL, linking the evolution of the disease with viral infections. Usually, patients present with late stage disease often involving the bone marrow at the time of diagnosis. The present paper discusses the role of viral infection in African countries, as HL is considered to be a malignant disease characterized by an inflammatory reaction to an aberrant B cell clone that is well known as the Reed-Sternberg cell (HRS).
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Affiliation(s)
- Ravnit Grewal
- a Department of Pathology, Division of Haematopathology , National Health Laboratory Service, Stellenbosch University , Cape Town , South Africa
| | - Alexandra Irimie
- b School of Dentistry , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Nasheen Naidoo
- a Department of Pathology, Division of Haematopathology , National Health Laboratory Service, Stellenbosch University , Cape Town , South Africa
| | - Nooroudien Mohamed
- c Department of Pathology, Division of Anatomical Pathology , National Health Laboratory Service/Stellenbosch University , Cape Town , South Africa
| | - Bobe Petrushev
- d Department of Pathology , Ion Chiricuta Oncology Institute , Cluj Napoca , Romania
| | - Manogari Chetty
- e Department of Oral and Molecular Biology, Faculty of Dentistry , University of the Western Cape , Cape Town , South Africa
| | - Ciprian Tomuleasa
- f Department of Hematology/Research Center for Functional Genomics and Translational Medicine , Iuliu Hatieganu University of Medicine and Pharmacy - Ion Chiricuta Oncology Institute , Cluj Napoca , Romania
| | - Emmanuel-Akinola Abayomi
- a Department of Pathology, Division of Haematopathology , National Health Laboratory Service, Stellenbosch University , Cape Town , South Africa
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Nomograms for predicting the overall and cancer-specific survival of patients with classical Hodgkin lymphoma: a SEER-based study. Oncotarget 2017; 8:92978-92988. [PMID: 29190971 PMCID: PMC5696237 DOI: 10.18632/oncotarget.21722] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/27/2017] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to establish nomograms, based on significant clinicopathologic parameters, for predicting the overall survival (OS) and the cancer-specific survival (CSS) of patients with classical Hodgkin lymphoma (CHL). The data of 43,330 CHL patients, diagnosed between 1983 and 2014, were obtainedfrom the database of the Surveillance, Epidemiology, and End Results (SEER) program. These patients were randomly divided into training (n = 30,339) and validation (n = 12,991) cohorts. The Kaplan-Meier method and Cox proportional hazards regression model were used to evaluate the prognostic effects of multiple clinicopathologic parameters on survival. Significant prognostic factors were combined to build nomograms. The predictive performance of nomograms was evaluated using the index of concordance (C-index) and calibration curves. In the training cohort, on univariate and multivariate analyses, age at diagnosis, gender, race, Ann Arbor stage, and histological type significantly correlated with the survival outcomes. These characteristics were used to establish nomograms. The nomograms showed good accuracy in predicting 1-, 5-, and 10-year OS and CSS, with a C-index of 0.794 (95% confidence interval [CI], 0.789-0.799) for OS and 0.760 (95% CI, 0.753-0.767) for CSS. In the validation cohort, the C-index for nomogram-based predictions was 0.787 (95% CI, 0.779-0.795) for OS and 0.769 (95% CI, 0.758-0.780) for CSS. All calibration curves revealed excellent consistency between predicted and actual survival. In summary, novel nomograms were established and validated to predict OS and CSS for patients with CHL. These new prognostic models could aid in improved prediction of survival outcomes leading to reasonable treatment recommendations.
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Matsumoto I, Uchida K, Chambers JK, Nibe K, Sato Y, Hamasu T, Nakayama H. Hodgkin's-like lymphoma in a ferret (Mustela putorius furo). J Vet Med Sci 2017; 79:1660-1663. [PMID: 28804091 PMCID: PMC5658555 DOI: 10.1292/jvms.17-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 7-year-old castrated male ferret developed unilateral cervical lymphadenomegaly over a
1-month period. Histological examination revealed proliferation of tumor cells in a
diffuse and partially nodular pattern. The tumor cells were predominantly Hodgkin cells
and binucleated Reed-Sternberg cells, characterized by abundant, clear, vacuolated
cytoplasm, pleomorphic, ovoid nuclei with thick nuclear membranes and distinct nucleoli.
Multinucleated cells, resembling lymphocytic and histiocytic (L&H) cells, were also
observed. Immunohistochemically, the tumor cells expressed Pax-5, BLA-36 and vimentin. A
small population of the tumor cells expressed CD20. This case showed proliferation of
Hodgkin/Reed-Sternberg cells in conjunction with L&H cells that were histologically
analogous to feline Hodgkin’s-like lymphoma. However, Pax-5 and BLA-36 expression along
with rare CD20 expression were consistent with classical Hodgkin’s lymphoma in humans.
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Affiliation(s)
- Isao Matsumoto
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - James Kenn Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazumi Nibe
- Japan Animal Referral Medical Center, 2-5-8, Kuji, Takatsu, Kawasaki-shi, Kanagawa 213-0023, Japan
| | - Yu Sato
- Minato Ohori Animal Hospital, 2-9-29, Ohtemon, Chuo-ku, Fukuoka-shi, Fukuoka 810-0074, Japan
| | - Taku Hamasu
- Minato Ohori Animal Hospital, 2-9-29, Ohtemon, Chuo-ku, Fukuoka-shi, Fukuoka 810-0074, Japan
| | - Hiroyuki Nakayama
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Thakkar DN, Kodidela S, Sandhiya S, Dubashi B, Dkhar SA. A Polymorphism Located Near PMAIP1/Noxa Gene Influences Susceptibility to Hodgkin Lymphoma Development in South India. Asian Pac J Cancer Prev 2017; 18:2477-2483. [PMID: 28952280 PMCID: PMC5720654 DOI: 10.22034/apjcp.2017.18.9.2477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Single nucleotide polymorphisms (SNPs) in DNA repair and Toll-like receptor (TLR) genes have been reported to be associated with Hodgkin Lymphoma (HL) risk. Since such associations may be ethnicity dependent, polymorphisms in TLR4 rs1554973, Xeroderma pigmentosum C (XPC) rs2228000, rs2228001 and a variant near PMAIP1/Noxa gene rs8093763 were here investigated with regard to HL susceptibility in a south Indian population. Normative frequencies of SNPs were established and compared with data for 1000 genome populations. Methods: We conducted a case control study consisting of 200 healthy volunteers and 101 cases with HL. DNA samples were genotyped using real-time PCR. Linkage disequilibrium (LD) analysis between rs2228000 and rs2228001 was performed using HaploView (version 4.2). Results: Among the studied variants, we observed that a variant rs8093763 located near PMAIP1/Noxa gene was associated with HL risk (OR=1.72 and 95% CI=1.004-2.93). The major allele frequencies of XPC (rs2228000 and rs2228001), TLR4 (rs1554973) and PMAIP1/NOXA (rs8093763) variants were 79%, 66%, 67% and 59% respectively. The studied frequencies were significantly different from 1000 genome populations. Conclusion: The results suggest that a variant rs8093763 located near the PMAIP1/Noxa gene may modify risk of HL. We found variation in distribution of polymorphic frequencies between the study population and 1000 genome populations. The results may help identify individual risk of development of HL in our south Indian population.
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Affiliation(s)
- Dimpal N Thakkar
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.
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Bacher U, Binder M. Modifying therapy in patients with advanced Hodgkin's lymphoma by integrating early metabolic response by interim PET-CT. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:S19. [PMID: 27867987 DOI: 10.21037/atm.2016.10.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ulrike Bacher
- Department of Hematology and Medical Oncology, University Medicine Goettingen (UMG), Goettingen, Germany
| | - Mascha Binder
- Department of Oncology and Hematology, Hubertus Wald Cancer Center Hamburg, University Hospital Hamburg-Eppendorf (UKE), Hamburg, Germany
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Montgomery ND, Coward WB, Johnson S, Yuan J, Gulley ML, Mathews SP, Kaiser-Rogers K, Rao KW, Sanger WG, Sanmann JN, Fedoriw Y. Karyotypic abnormalities associated with Epstein–Barr virus status in classical Hodgkin lymphoma. Cancer Genet 2016; 209:408-416. [DOI: 10.1016/j.cancergen.2016.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 12/31/2022]
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David JA, Huang JZ. Diagnostic Utility of Flow Cytometry Analysis of Reactive T Cells in Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Am J Clin Pathol 2016; 145:107-15. [PMID: 26712878 DOI: 10.1093/ajcp/aqv017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study aims to define the diagnostic utility of flow cytometric features of T cells in nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). METHODS Cases were retrospectively identified based on diagnosis with NLPHL (n = 30 samples), classic Hodgkin lymphoma (CHL; n = 33), and reactive lymphoid hyperplasia (RLH; n = 43). Pathology slides were reviewed. Flow cytometry list mode data were reanalyzed. RESULTS The mean proportion of CD4 + CD8 + T cells (8.4%) in cases of NLPHL was significantly higher than seen in CHL (1.0%) or RLH (0.6%). Of the T cells, 28.4% were CD57 + in NLPHL, significantly higher (P < .05) than in CHL (3.2%) or RLH (3.2%). Based on receiver operating characteristic curve analysis, when using a cutoff of 3.0% of CD4 + CD8 + T cells, the diagnostic sensitivity for NLPHL is 83.3% with a specificity of 97.4%. The diagnostic sensitivity was 96.7% with a specificity of 98.7% when using a cutoff of 12% for CD57 + T cells. CONCLUSIONS Increased portions of CD57 + T cells and CD4 + CD8 + T cells are highly suggestive of the possibility of NLPHL. In addition, NLPHL diagnosis appears unlikely if neither CD57 + T cells nor CD4 + CD8 + T cells are increased. Future prospective studies including cases of progressive transformation of germinal center and T-cell/histiocyte-rich large B-cell lymphoma will further define the utility of flow cytometry of T cells in NLPHL.
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Affiliation(s)
- James A David
- From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - James Z Huang
- From the Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI; Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI.
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Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) are the 2 types of lymphoma that represent the third most common childhood malignancy. Multiple etiological factors are involved in lymphoma pathogenesis, including viral infection, immune deficiencies, environmental agents, and genetic factors. Strong arguments supporting a genetic linkage between the susceptibility to lymphomas and human leukocyte antigens (HLA) are reported and give an idea about susceptibility or protection from the disease. METHODS Seventy-one cases were included in this study: 36 cases of non-Hodgkin lymphoma and 35 patients with Hodgkin lymphoma. Their ages ranged from 4 to 18 years. The control group consisted of 70 unrelated healthy individuals, with a mean age of 5 to 17 years. The genotype of HLA-A, HLA-B, HLA-DR, and HLA-DQ alleles was typed by means of PCR sequence-specific priming. RESULTS HLA-B*18, HLA-DRB1*03, *07, and HLA-DQB1*02 were significantly increased in patients with lymphomas when compared with controls, whereas HLA-DRB1*13 and DQB1*03 were significantly decreased when compared with controls. CONCLUSIONS These results indicate that HLA-B*18, DRB1*03, *07, and DQB1*02 may contribute to lymphoma susceptibility, whereas HLA-DRB1*13 and DQB1*03 may confer protection to lymphoma in the Algerian population.
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Glaser SL, Clarke CA, Keegan THM, Chang ET, Weisenburger DD. Time Trends in Rates of Hodgkin Lymphoma Histologic Subtypes: True Incidence Changes or Evolving Diagnostic Practice? Cancer Epidemiol Biomarkers Prev 2015; 24:1474-88. [PMID: 26215294 PMCID: PMC4592457 DOI: 10.1158/1055-9965.epi-15-0281] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/20/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Histologic subtypes of classical Hodgkin lymphoma [cHL; e.g., nodular sclerosis, mixed cellularity, not otherwise specified (NOS)] are epidemiologically and prognostically distinctive. Therefore, unexplained, ongoing incidence rate declines for mixed cellularity and increases for NOS require examination. METHODS We analyzed detailed histology-specific Hodgkin lymphoma incidence rates in 1992 through 2011 U.S. SEER data (n = 21,372) and reviewed a regional subset of 2007 through 2011 NOS pathology reports for insight into diagnostic practices. RESULTS cHL rates were stable until 2007, then decreased for whites [annual percent change (APC) and 95% confidence interval (CI), -3.6% (-5.6% to -1.5%)]. Nodular sclerosis rates declined after 2007 by 5.9% annually, with variation by gender, age, and race/ethnicity. In 1992 through 2011, mixed cellularity rates declined [APC -4.0% (-4.7% to -3.3%)], whereas NOS rates rose [5.3% (4.5%-6.2%)] overall and in most patient groups. The 2007-2011 NOS age-specific rates were more similar to mixed cellularity rates for 1992-1996 than 2007-2011. Trends in combined rates were minimal, supporting increasing misclassification of mixed cellularity, lymphocyte depletion, and specific nodular sclerosis subtypes as NOS. Eighty-eight of 165 reviewed NOS pathology reports addressed classification choice. Twenty (12.1%) justified the classification, 21 (12.7%) described insufficient biopsy material, and coders missed specific subtype information for 27 (16.4%). CONCLUSION Recent nodular sclerosis rate declines largely represent true incidence changes. Long-term rate decreases for mixed cellularity and other less common subtypes, and increases for NOS (comprising ∼30% of cHL cases in 2011), likely reflect changes in diagnostic and/or classification practice. IMPACT Diminishing histologic subtyping undermines future surveillance and epidemiologic study of Hodgkin lymphoma. Guideline-based use of excisional biopsies and more coding quality control are warranted.
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Affiliation(s)
- Sally L Glaser
- Cancer Prevention Institute of California, Fremont, California. Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California.
| | - Christina A Clarke
- Cancer Prevention Institute of California, Fremont, California. Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California
| | - Theresa H M Keegan
- Cancer Prevention Institute of California, Fremont, California. Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California
| | - Ellen T Chang
- Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California. Health Sciences Practice, Exponent, Inc., Menlo Park, California
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Maggialetti N, Ferrari C, Minoia C, Asabella AN, Ficco M, Loseto G, De Tullio G, de Fazio V, Calabrese A, Guarini A, Rubini G, Brunese L. Role of WB-MR/DWIBS compared to (18)F-FDG PET/CT in the therapy response assessment of lymphoma. Radiol Med 2015; 121:132-43. [PMID: 26349573 DOI: 10.1007/s11547-015-0581-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 08/25/2015] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study prospectively evaluated whole-body magnetic resonance/diffusion-weighted imaging with body signal suppression (WB-MR/DWIBS) reliability compared to (18)F-FDG PET/CT in the treatment response assessment of classic Hodgkin lymphomas (HL) and aggressive non-Hodgkin lymphomas (aNHL). MATERIALS AND METHODS Twenty-seven consecutive patients were prospectively enrolled at the time of diagnosis. Eighteen (11 HL and seven aNHL) were considered for the analysis. They received chemo/radiotherapy as induction and completed post-treatment evaluation performing both (18)F-FDG PET/CT and WB-MR/DWIBS. The revised response criteria for malignant lymphomas were used to assess the response to treatment. We evaluated the agreement between the two methods by Cohen's K test. Post-therapy WB-MR/DWIBS sensitivity, specificity, PPV, NPV and accuracy were then calculated, considering the 12 months of follow-up period as the gold standard. RESULTS By using an evaluation on a lesion-by-lesion basis, WB-MR/DWIBS and (18)F-FDG PET/CT showed an overall good agreement (K = 0.796, 95% IC = 0.651-0.941), especially in the evaluation of the nodal basins in aNHL (K = 0.937, 95% IC = 0.814-1). In reference to the revised response criteria for malignant lymphomas, the two methods showed a good agreement (K = 0.824, 95% IC = 0.493-1). Post-therapy sensitivity, specificity, PPV, NPV and accuracy of WB-MR/DWIBS were 43, 91, 75, 71 and 72%, respectively. CONCLUSION WB-MR/DWIBS seems to be an appropriate method for the post-treatment assessment of patients affected by HL and aNHL. The small discrepancies between the two methods found within HL could be due to the biological and metabolic behavior of this group of diseases. Larger prospective studies are necessary to better define the role of WB-MR/DWIBS in this setting of patients.
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Affiliation(s)
- Nicola Maggialetti
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy.
| | - Cristina Ferrari
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Carla Minoia
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Artor Niccoli Asabella
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Michele Ficco
- Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giacomo Loseto
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giacomina De Tullio
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Vincenza de Fazio
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Angela Calabrese
- Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Attilio Guarini
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giuseppe Rubini
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Brunese
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
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Mack TM, Norman JE, Rappaport E, Cozen W. Childhood determination of Hodgkin lymphoma among U.S. servicemen. Cancer Epidemiol Biomarkers Prev 2015; 24:1707-15. [PMID: 26324069 DOI: 10.1158/1055-9965.epi-15-0145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 08/24/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hodgkin lymphoma in young adults is inexplicably linked to economic development. METHODS We conducted a nested case-control study of the 656 servicemen with Hodgkin lymphoma diagnosed between ages 17 to 32 while on active duty in the U.S. military during 1950-68. Controls, chosen randomly from the servicemen on duty at the time, were matched on service, birth year, and induction date. Information came from preinduction records and military records for the period ending at onset or the equivalent date. RESULTS Risk was independently increased with small sib-ship size [OR, 2.3; confidence interval (CI), 1.6-3.5], low birth order (OR, 1.9; CI, 1.4-2.6), and an interval of at least 5 years between birth and that of a previous or subsequent sibling (OR, 2.1; CI, 1.5-3.1). Other factors independently and significantly associated with elevated risk of Hodgkin lymphoma were: tallness, high body mass index, more education (but not higher income) in the county of birth, BB or AB blood type, and past infectious mononucleosis (but a deficit of other childhood viral infections). Early fatherhood conveyed high risk (OR, 2.6; CI, 1.4-4.8), especially if with a high-risk sibling configuration. Factors unrelated to risk included personal education, preinduction or military occupation, induction test score, and rank. Findings were similar for nodular sclerosis and mixed cell histologic subtypes. CONCLUSIONS Protection from the environment in childhood, but not in adulthood, increases the likelihood of young adult Hodgkin lymphoma, which may result from nonspecific isolation from early infections and/or exposure to late infection by a specific but unidentified ubiquitous childhood virus. IMPACT Events in childhood protect against later Hodgkin lymphoma.
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Affiliation(s)
- Thomas M Mack
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
| | - James E Norman
- Medical Follow-up Agency (Retired), National Research Council, Washington, DC
| | - Edward Rappaport
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Wendy Cozen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
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Satoh T, Wada R, Yajima N, Imaizumi T, Yagihashi S. Tumor microenvironment and RIG-I signaling molecules in Epstein Barr virus-positive and -negative classical Hodgkin lymphoma of the elderly. J Clin Exp Hematop 2015; 54:75-84. [PMID: 24942949 DOI: 10.3960/jslrt.54.75] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Classical Hodgkin lymphoma (CHL) is a B-cell neoplasm characterized by Hodgkin and Reed-Sternberg (HRS) cells. Its prevalence exhibits a bimodal pattern of peaking in young adults and the elderly. There is an association with Epstein-Barr virus (EBV) infection in about 50% of cases of CHL of the elderly, and the outcome of these patients is unfavorable. It is not well known how the latent infection of EBV is involved in the pathophysiology of CHL of the elderly. To address this issue, we examined the tumor microenvironment (TME) and the expression of molecules related to EBV infection in HRS cells in 10 EBV-positive CHL and 7 EBV-negative CHL patients older than 50 years. In EBV-positive CHL, we found an increased population of FOXP3(+) cells, while that of granzyme B(+) cells was reduced, compared with those in EBV-negative CHL. The expression of inhibitory chemokine CCL20 was increased in EBV-positive HRS cells compared with that in EBV-negative HRS cells. In addition, despite increased expression of a pattern recognition receptor, RIG-I, in intracellular innate immunity, there was no evidence of interferon regulatory factor 3 activation or interferon-ß induction in EBV-positive HRS cells in CHL of the elderly. The disease recurred frequently (50%) in EBV-positive CHL. The current study thus suggests the possibility that the latent infection of EBV alters the expression of chemokines and the innate immunity response in HRS cells and modulates TME to an immunosuppressive state, which may account for the unfavorable disease course in CHL of the elderly.
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Affiliation(s)
- Tsugumi Satoh
- Department of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine
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26
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Gru AA, Lu D. Concurrent malignant melanoma and cutaneous involvement by classical Hodgkin lymphoma (CHL) in a 63 year-old man. Diagn Pathol 2013; 8:135. [PMID: 23938065 PMCID: PMC3765467 DOI: 10.1186/1746-1596-8-135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 06/21/2013] [Indexed: 12/26/2022] Open
Abstract
Abstract Classical Hodgkin lymphoma (CHL) is a lymphoproliferative disorder that has a bimodal age distribution, affecting young and elderly individuals, and is curable in more than 90% of patients. Here we report the coexistence of cutaneous CHL and malignant melanoma as the presentation of papules and a plaque, in an individual with remote history of systemic CHL. One of the biopsies showed a mononuclear cell infiltrate with Reed-Sternberg (RS) like cells that were positive for CD30 and CD15, but negative for CD45. A second concurrent biopsy showed an atypical melanocytic proliferation with significant pagetoid spreading and diffuse Melan-A staining. Based on morphology alone, it is almost impossible to distinguish CHL from other primary cutaneous lymphoproliferative disorders, such as CD30+ lymphoproliferative disorder (lymphomatoid papulosis (LyP) and primary cutaneous anaplastic large-cell lymphoma), or even tumor stage mycosis fungoides when the epidermotropism is minimal. Additionally, bizarre melanocytic cells can also appear similar to RS cells. Our case illustrates the first case report of malignant melanoma and CHL in a patient presenting simultaneously. Virtual slides The virtual slide(s) for this article can be found here:
http://www.diagnosticpathology.diagnomx.eu/vs/8979757349937225
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27
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Development of Hodgkin lymphoma in homozygotic triplets with constitutional deletion in MKL1. Blood 2013; 121:4807. [PMID: 23744493 DOI: 10.1182/blood-2013-02-469031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Crump C, Sundquist K, Sieh W, Winkleby MA, Sundquist J. Perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood. Am J Epidemiol 2012; 176:1147-58. [PMID: 23171883 PMCID: PMC3571233 DOI: 10.1093/aje/kws212] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 04/11/2012] [Indexed: 11/12/2022] Open
Abstract
The incidence of Hodgkin lymphoma has increased among adolescents and young adults in recent decades, but the relevant risk factors in early life are still unknown. A national cohort study was conducted of 3,571,574 individuals born in Sweden in 1973-2008 and followed up for Hodgkin lymphoma incidence through 2009, to examine perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood (ages 0-37 years). There were 943 Hodgkin lymphoma cases identified in 66.3 million person-years of follow-up. High fetal growth was associated with an increased risk of Hodgkin lymphoma after adjustment for gestational age at birth and other potential confounders (P(trend) = 0.005). Family history of Hodgkin lymphoma in a sibling or parent also was strongly associated with an increased risk, with adjusted hazard ratios = 8.83 (95% confidence interval: 3.67, 21.30) and 7.19 (95% confidence interval: 3.58, 14.44), respectively. No association was found between gestational age at birth, birth order, twinning, parental age, or parental education and Hodgkin lymphoma. These findings did not vary by age at Hodgkin lymphoma diagnosis. Similar associations were found for nodular sclerosis and mixed cellularity subtypes. These findings suggest that perinatal factors including possible growth factor pathways may contribute to the risk of Hodgkin lymphoma in childhood through young adulthood.
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Affiliation(s)
- Casey Crump
- Department of Medicine, Stanford University, Stanford, CA, USA.
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Analyzing primary Hodgkin and Reed-Sternberg cells to capture the molecular and cellular pathogenesis of classical Hodgkin lymphoma. Blood 2012; 120:4609-20. [DOI: 10.1182/blood-2012-05-428896] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
The pathogenesis of classical Hodgkin lymphoma (cHL), the most common lymphoma in the young, is still enigmatic, largely because its Hodgkin and Reed-Sternberg (HRS) tumor cells are rare in the involved lymph node and therefore difficult to analyze. Here, by overcoming this technical challenge and performing, for the first time, a genome-wide transcriptional analysis of microdissected HRS cells compared with other B-cell lymphomas, cHL lines, and normal B-cell subsets, we show that they differ extensively from the usually studied cHL cell lines, that the lost B-cell identity of cHLs is not linked to the acquisition of a plasma cell-like gene expression program, and that Epstein-Barr virus infection of HRS cells has a minor transcriptional influence on the established cHL clone. Moreover, although cHL appears a distinct lymphoma entity overall, HRS cells of its histologic subtypes diverged in their similarity to other related lymphomas. Unexpectedly, we identified 2 molecular subgroups of cHL associated with differential strengths of the transcription factor activity of the NOTCH1, MYC, and IRF4 proto-oncogenes. Finally, HRS cells display deregulated expression of several genes potentially highly relevant to lymphoma pathogenesis, including silencing of the apoptosis-inducer BIK and of INPP5D, an inhibitor of the PI3K-driven oncogenic pathway.
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Ranuncolo SM, Pittaluga S, Evbuomwan MO, Jaffe ES, Lewis BA. Hodgkin lymphoma requires stabilized NIK and constitutive RelB expression for survival. Blood 2012; 120:3756-63. [PMID: 22968463 PMCID: PMC3488888 DOI: 10.1182/blood-2012-01-405951] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 08/27/2012] [Indexed: 02/07/2023] Open
Abstract
We have analyzed the role of the REL family members in Hodgkin lymphoma (HL). shRNA targeting of each REL member showed that HL was uniquely dependent on relB, in contrast to several other B-cell lymphomas. In addition, relA and c-rel shRNA expression also decreased HL cell viability. In exploring relB activation further, we found stable NF-κB inducing kinase (NIK) protein in several HL cell lines and that NIK shRNA also affected HL cell line viability. More importantly, 49 of 50 HL patient biopsies showed stable NIK protein, indicating that NIK and the noncanonical pathway are very prevalent in HL. Lastly, we have used a NIK inhibitor that reduced HL but not other B-cell lymphoma cell viability. These data show that HL is uniquely dependent on relB and that the noncanonical pathway can be a therapeutic target for HL. Furthermore, these results show that multiple REL family members participate in the maintenance of a HL phenotype.
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Affiliation(s)
- Stella M Ranuncolo
- Transcriptional Regulation and Biochemistry Unit, Metabolism Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20852, USA
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31
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Sobol G, Mizia-Malarz A, Woś H. Serum concentrations of proangiogenic cytokines (VEGF, bFGF) depending on the histopathological types of Hodgkin lymphoma in children – preliminary report. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/s0001-5814(12)70008-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Maraldo MV, Brodin NP, Vogelius IR, Aznar MC, Munck Af Rosenschöld P, Petersen PM, Specht L. Risk of developing cardiovascular disease after involved node radiotherapy versus mantle field for Hodgkin lymphoma. Int J Radiat Oncol Biol Phys 2012; 83:1232-7. [PMID: 22270170 DOI: 10.1016/j.ijrobp.2011.09.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 09/07/2011] [Accepted: 09/09/2011] [Indexed: 12/25/2022]
Abstract
PURPOSE Hodgkin lymphoma (HL) survivors are known to have increased cardiac mortality and morbidity. The risk of developing cardiovascular disease after involved node radiotherapy (INRT) is currently unresolved, inasmuch as present clinical data are derived from patients treated with the outdated mantle field (MF) technique. METHODS AND MATERIALS We included all adolescents and young adults with supradiaphragmatic, clinical Stage I-II HL treated at our institution from 2006 to 2010 (29 patients). All patients were treated with chemotherapy and INRT to 30 to 36 Gy. We then simulated a MF plan for each patient with a prescribed dose of 36 Gy. A logistic dose-response curve for the 25-year absolute excess risk of cardiovascular disease was derived and applied to each patient using the individual dose-volume histograms. RESULTS The mean doses to the heart, four heart valves, and coronary arteries were significantly lower for INRT than for MF treatment. However, the range in doses with INRT treatment was substantial, and for a subgroup of patients, with lymphoma below the fourth thoracic vertebrae, we estimated a 25-year absolute excess risk of any cardiac event of as much as 5.1%. CONCLUSIONS Our study demonstrates a potential for individualizing treatment by selecting the patients for whom INRT provides sufficient cardiac protection for current technology; and a subgroup of patients, who still receive high cardiac doses, who would benefit from more advanced radiation technique.
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Affiliation(s)
- Maja V Maraldo
- Department of Radiation Oncology, Rigshospitalet, Copenhagen, Denmark.
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Sohlbach K, Moll R, Goßmann J, Nowak O, Barth P, Neubauer A, Huynh MQ. β-Catenin signaling: no relevance in Hodgkin lymphoma? Leuk Lymphoma 2011; 53:996-8. [PMID: 22023520 DOI: 10.3109/10428194.2011.634046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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34
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Lee IS. Epstein-Barr Virus-Associated Classical Hodgkin Lymphoma and Its Therapeutic Strategies. Biomol Ther (Seoul) 2011. [DOI: 10.4062/biomolther.2011.19.4.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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35
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Eberle FC, Rodriguez-Canales J, Wei L, Hanson JC, Killian JK, Sun HW, Adams LG, Hewitt SM, Wilson WH, Pittaluga S, Meltzer PS, Staudt LM, Emmert-Buck MR, Jaffe ES. Methylation profiling of mediastinal gray zone lymphoma reveals a distinctive signature with elements shared by classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma. Haematologica 2011; 96:558-66. [PMID: 21454882 DOI: 10.3324/haematol.2010.033167] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mediastinal gray zone lymphoma is a newly recognized entity with transitional morphological and immunophenotypic features between the nodular sclerosis subtype of Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma. Diagnostic criteria for mediastinal gray zone lymphoma are still challenging, and the optimal therapy is as yet undetermined. Epigenetic changes have been implicated in the loss of the B-cell program in classical Hodgkin's lymphoma, and might provide a basis for the immunophenotypic alterations seen in mediastinal gray zone lymphoma. DESIGN AND METHODS We performed a large-scale DNA methylation analysis of microdissected tumor cells to investigate the biological underpinnings of mediastinal gray zone lymphoma and its association with the related entities classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma, making comparisons with the presumptively less related diffuse large B-cell lymphoma. RESULTS Principal component analysis demonstrated that mediastinal gray zone lymphoma has a distinct epigenetic profile intermediate between classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma but remarkably different from that of diffuse large B-cell lymphoma. Analysis of common hypo- and hypermethylated CpG targets in mediastinal gray zone lymphoma, classical Hodgkin's lymphoma, primary mediastinal large B-cell lymphoma and diffuse large B-cell lymphoma was performed and confirmed the findings of the principal component analysis. Based on the epigenetic profiles we were able to establish class prediction models utilizing genes such as HOXA5, MMP9, EPHA7 and DAPK1 which could distinguish between mediastinal gray zone lymphoma, classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma with a final combined prediction of 100%. CONCLUSIONS Our data confirm a close relationship between mediastinal gray zone lymphoma and both classical Hodgkin's lymphoma and primary mediastinal large B-cell lymphoma. However, important differences were observed as well, allowing a clear distinction from both parent entities. Thus, mediastinal gray zone lymphoma cannot be assigned to either classical Hodgkin's lymphoma or primary mediastinal large B-cell lymphoma, validating the decision to create an intermediate category in the World Health Organization classification.
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Affiliation(s)
- Franziska C Eberle
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Rodriguez-Canales J, Eberle FC, Jaffe ES, Emmert-Buck MR. Why is it crucial to reintegrate pathology into cancer research? Bioessays 2011; 33:490-8. [PMID: 21590787 DOI: 10.1002/bies.201100017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The integration of pathology with molecular biology is vital if we are to enhance the translational value of cancer research. Pathology represents a bridge between medicine and basic biology, it remains the gold standard for cancer diagnosis, and it plays an important role in discovery studies. In the past, pathology and cancer research were closely associated; however, the molecular biology revolution has shifted the focus of investigators toward the molecular alterations of tumors. The reductionist approach taken in molecular studies is producing great insight into the inner workings of neoplasia, but it can also minimize the importance of histopathology and of understanding the disease as a whole. In turn, pathologists can underestimate the role of molecular studies in developing new ancillary techniques for clinical diagnosis. A multidisciplinary approach that integrates pathology and molecular biology within a translational research system is needed. This process will require overcoming cultural barriers and can be achieved through education, a more effective incorporation of pathology into biological research, and conversely an integration of biological research into the pathology laboratory.
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Affiliation(s)
- Jaime Rodriguez-Canales
- Laser Capture Microdissection Core and Pathogenetics Unit, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Banerjee D. Recent Advances in the Pathobiology of Hodgkin's Lymphoma: Potential Impact on Diagnostic, Predictive, and Therapeutic Strategies. Adv Hematol 2011; 2011:439456. [PMID: 21318045 PMCID: PMC3034907 DOI: 10.1155/2011/439456] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 10/04/2010] [Accepted: 11/12/2010] [Indexed: 12/20/2022] Open
Abstract
From its first description by Thomas Hodgkin in 1832, Hodgkin's disease, now called Hodgkin's lymphoma, has continued to be a fascinating neoplasm even to this day. In this review, historical aspects, epidemiology, diagnosis, tumor biology, new observations related to host-microenvironment interactions, gene copy number variation, and gene expression profiling in this complex neoplasm are described, with an exploration of chemoresistance mechanisms and potential novel therapies for refractory disease.
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Affiliation(s)
- Diponkar Banerjee
- Centre for Translational and Applied Genomics (CTAG), Department of Pathology, British Columbia Cancer Agency (BCCA), 600 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 4E6
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada V6T 2B5
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Andersson E, Schain F, Sjöberg J, Björkholm M, Claesson HE. Interleukin-13 stimulation of the mediastinal B-cell lymphoma cell line Karpas-1106P induces a phenotype resembling the Hodgkin lymphoma cell line L1236. Exp Hematol 2010; 38:116-23. [DOI: 10.1016/j.exphem.2009.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 10/23/2009] [Accepted: 11/16/2009] [Indexed: 11/30/2022]
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