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Chang Y, Ma Y, Chang C, Li W. Analysis of immunophenotypic features in hyaline vascular type Castleman disease. Diagn Pathol 2023; 18:132. [PMID: 38062501 PMCID: PMC10702065 DOI: 10.1186/s13000-023-01421-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Studies suggested that the immunophenotype of hyaline vascular type Castleman disease (HVCD) lacked characteristics, which was easy to be confused with other diseases. METHODS From January 2010 to June 2022, 17 cases of HVCD were selected from the Department of Pathology of Shaanxi Provincial People's Hospital and the Department of Pathology of Shaanxi Provincial Cancer Hospital. 13 cases of reactive hyperplastic lymph nodes (RHL) and 11 cases of follicular lymphoma (FL) were selected as the control group. All cases were performed CD3, CD20, CD21 and BCL2 immunohistochemical staining. RESULTS (i) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the negative area of CD3 of germinal center. However, in 13 cases of RHL, the negative area of CD3 of germinal center was basically consistent with the negative area of germinal center of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the negative area of CD3 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of diseases was statistically significant (P < 0.05). (ii) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the follicular dendritic cell (FDC) meshworks expressed by CD21. However, in 13 cases of RHL, the FDC meshworks expressed by CD21 were basically consistent with the negative area of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the FDC meshworks expressed by CD21 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of disease was statistically significant (P < 0.05). CONCLUSIONS HVCD has unique immunophenotypic characteristics. The negative area of BCL2 of germinal center is significantly smaller than the negative area of CD3. The negative area of the BCL2 of germinal center is significantly smaller than the FDC meshworks expressed by CD21. These two immunophenotypic features in HVCD are very important in diagnosis and differential diagnosis.
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Affiliation(s)
- Yu Chang
- Department of Pathology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an, 710068, China
| | - Yu Ma
- Department of Pathology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an, 710068, China
| | - Chen Chang
- Department of Pathology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an, 710068, China
| | - Wensheng Li
- Department of Pathology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an, 710068, China.
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710068, China.
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2
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Magnoli F, Marchiori D, Facchi S, Martin V, Campiotti L, Merli M, Sessa F, Tibiletti MG, Uccella S. High frequency of BCL2 gene rearrangement-negative follicular lymphoma in northwestern Italy. Cancer Genet 2023; 274-275:1-9. [PMID: 36917896 DOI: 10.1016/j.cancergen.2023.03.001] [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: 06/13/2022] [Revised: 02/10/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
BCL2 rearrangement is reported to be an early pathogenetic event in follicular lymphoma (FL) and it is considered as a reliable marker in the follow up of the disease. We aimed to investigate the frequency of BCL2 rearrangement in FLs from northwestern Italy, to evaluate their clinicopathological features, and to investigate alternative genetic aberrations in BCL2-negative FLs. We collected a series of 76 consecutive FLs diagnosed between 2013 and 2016. All lymphomas underwent histopathological review. Interphasic fluorescent in situ hybridization (FISH) was performed with break apart probes targeting BCL2, IGH, BCL6 and MYC on paraffin embedded (PE) and fresh frozen (FF) specimens. 1p36 region and p53 locus in BLC2-negative cases were investigated using dual color probes. Karyotype analysis was available in a subset of cases. BCL2 rearrangements were detected in 39 cases (51,3%). Of the remaining 37, 6 showed IGH rearrangement, and were further tested: 1 showed variant BCL2 translocation, 1 had BCL6 rearrangement, and the other 4 were negative for further gene rearrangements. FISH on FF specimens detected small BCL2+ clones in cases otherwise categorized as BCL2-. 1p36 and p53 deletion were observed in 1 and 8 BCL2- FLs, respectively. Karyotype analysis documented 3q, 1p and BCL6 alternative abnormalities in 3 cases. In conclusion, BCL2 rearrangement is not a constant finding in FL, its frequency being probably affected by geographical factors. Thus, it should not be considered as a reliable molecular marker in the follow up of the disease, unless it is found to be present at the initial diagnosis of FL. Alternative genetic aberrations exist in BCL2-negative cases.
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Affiliation(s)
| | - Deborah Marchiori
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Sofia Facchi
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Vittoria Martin
- Institute of Pathology, Ente Ospedaliero Cantonale (EOC), Locarno, Switzerland
| | - Leonardo Campiotti
- Unit of Internal Medicine, Department of Medicine and Surgery, Università degli Studi dell'Insubria, Varese, Italy
| | - Michele Merli
- Unit of Hematology, ASST dei Sette Laghi, Varese, Italy
| | - Fausto Sessa
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Silvia Uccella
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanule, Milan, Italy; Pathology Service, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, Milan 20089, Italy.
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3
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Sesboue C, Galtier J, Jeanneau M, Chauvel A, Laharanne E, Amintas S, Merlio JP, Bouabdallah K, Gros FX, de Leval L, Gros A, Parrens M. Combined Reverse-Transcriptase Multiplex Ligation-Dependent Probe Amplification and Next-Generation Sequencing Analyses to Assign Unclassified BCL2 -/BCL6 - Nonrearranged Small B-Cell Lymphoid Neoplasms as Follicular or Nodal Marginal Zone Lymphoma. Mod Pathol 2023; 36:100043. [PMID: 36853790 DOI: 10.1016/j.modpat.2022.100043] [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: 04/28/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 01/11/2023]
Abstract
Distinguishing between follicular lymphoma (FL) and nodal marginal zone lymphoma (NMZL) can be difficult when morphologic and phenotypic features are unusual and characteristic cytogenetic rearrangements are absent. We evaluated the diagnostic contribution of ancillary techniques-including fluorescence in situ hybridization (FISH)-detected 1p36 deletion; reverse-transcriptase, multiplex, ligation-dependent probe amplification (RT-MLPA); and next-generation sequencing (NGS)-for tumors that remain unclassified according to standard criteria. After review, 50 CD5-negative small B-cell lymphoid neoplasms without BCL2 and BCL6 FISH rearrangements were diagnosed as FLs (n = 27), NMZLs (n = 5), or unclassified (n = 18) based on the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. FISH helped identify the 1p36 deletion in 3 FLs and 1 unclassified tumor. Most classified FLs had an RT-MLPA germinal center B-cell (GCB) signature (93%) or were noncontributive (7%). Classified NMZLs had an RT-MLPA activated B-cell signature (20%), had an unassigned signature (40%), or were noncontributive (40%). Among unclassified tumors, the RT-MLPA GCB signature was associated with mutations most commonly found in FLs (CREBBP, EZH2, STAT6, and/or TNFRSF14) (90%). An RT-MLPA-detected GCB signature and/or NGS-detected gene mutations were considered as FL identifiers for 13 tumors. An activated B-cell signature or NOTCH2 mutation supported NMZL diagnosis in 3 tumors. Combining the RT-MLPA and NGS findings successfully discriminated 89% of unclassified tumors in favor of one or the other diagnosis. NGS-detected mutations may be of therapeutic interest. Herein, we detected 3 EZH2 and 8 CREBBP mutations that might be eligible for targeted therapies.
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Affiliation(s)
- Come Sesboue
- Pathology Department, University Hospital of Bordeaux, Pessac, France.
| | - Jean Galtier
- Hematology and Cell Therapy Department, University Hospital of Bordeaux, Pessac, France
| | - Marie Jeanneau
- Pathology Department, University Hospital of Bordeaux, Pessac, France
| | - Annick Chauvel
- Pathology Department, University Hospital of Bordeaux, Pessac, France
| | - Elodie Laharanne
- Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Pessac, France; BRIC INSERM U1312, Trio 2, University of Bordeaux, Bordeaux, France
| | - Samuel Amintas
- Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Pessac, France; BRIC INSERM U1312, BioGo, University of Bordeaux, Bordeaux, France
| | - Jean-Philippe Merlio
- Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Pessac, France; BRIC INSERM U1312, Trio 2, University of Bordeaux, Bordeaux, France
| | - Krimo Bouabdallah
- Hematology and Cell Therapy Department, University Hospital of Bordeaux, Pessac, France
| | - François-Xavier Gros
- Hematology and Cell Therapy Department, University Hospital of Bordeaux, Pessac, France
| | | | - Audrey Gros
- Tumor Bank and Tumor Biology Laboratory, University Hospital of Bordeaux, Pessac, France; BRIC INSERM U1312, Trio 2, University of Bordeaux, Bordeaux, France
| | - Marie Parrens
- Pathology Department, University Hospital of Bordeaux, Pessac, France; BRIC INSERM U1312, Trio 2, University of Bordeaux, Bordeaux, France
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4
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Khanlari M, Chapman JR. Follicular lymphoma: updates for pathologists. J Pathol Transl Med 2021; 56:1-15. [PMID: 34942689 PMCID: PMC8743801 DOI: 10.4132/jptm.2021.09.29] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Follicular lymphoma (FL) is the most common indolent B-cell lymphoma and originates from germinal center B-cells (centrocytes and centroblasts) of the lymphoid follicle. Tumorigenesis is believed to initiate early in precursor B-cells in the bone marrow (BM) that acquire the t(14;18)(q32;q21). These cells later migrate to lymph nodes to continue their maturation through the germinal center reaction, at which time they acquire additional genetic and epigeneticabnormalities that promote lymphomagenesis. FLs are heterogeneous in terms of their clinicopathologic features. Most FLs are indolent and clinically characterized by peripheral lymphadenopathy with involvement of the spleen, BM, and peripheral blood in a substantial subset of patients, sometimes accompanied by constitutional symptoms and laboratory abnormalities. Diagnosis is established by the histopathologic identification of a B-cell proliferation usually distributed in an at least partially follicular pattern, typically, but not always, in a lymph node biopsy. The B-cell proliferation is biologically of germinal center cell origin, thus shows an expression of germinal center-associated antigens as detected by immunophenotyping. Although many cases of FLs are typical and histopathologic features are straightforward, the biologic and histopathologic variability of FL is wide, and an accurate diagnosis of FL over this disease spectrum requires knowledge of morphologic variants that can mimic other lymphomas, and rarely non-hematologic malignancies, clinically unique variants, and pitfalls in the interpretation of ancillary studies. The overall survival for most patients is prolonged, but relapses are frequent. The treatment landscape in FL now includes the application of immunotherapy and targeted therapy in addition to chemotherapy.
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Affiliation(s)
- Mahsa Khanlari
- Department of Pathology and Hematopathology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Corresponding Author: Mahsa Khanlari, MD, Department of Pathology and Hematopathology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA Tel: +1-901-595-0394, Fax: +1-901-595-3100, E-mail:
| | - Jennifer R. Chapman
- Department of Pathology, Division of Hematopathology, University of Miami, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospitals, Miami, FL, USA
- Corresponding Author: Jennifer R. Chapman, MD, Department of Pathology, University of Miami Hospital, 4th floor, room 4076, 1400 NW 12th Ave., Miami, FL 33138, USA Tel: +1-305-689-1332, E-mail:
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5
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Kıvrak H, Yüksel S, Ateş C, Merter M, Kaygusuz G, Özcan M, Kuzu I. The Relevance of Additional Immunohistochemical Markers on the Differential Diagnosis of Small B-Cell Lymphomas: A Case-control Study. Turk J Haematol 2021; 39:178-187. [PMID: 34619856 PMCID: PMC9421338 DOI: 10.4274/tjh.galenos.2021.2021.0349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Clinical and pathological differential diagnosis of small B-cell lymphomas (SBCLs) is still controversial and may be difficult due to their overlapping morphology, phenotype, and differentiation to plasma cells. We aimed to examine the expression of the immune receptor translocation-associated protein 1 (IRTA1), myeloid cell nuclear differentiation antigen (MNDA), lymphoid enhancer-binding factor-1 (LEF1), and stathmin 1 (STMN1) markers in SBCL cases involving different sites that may have plasma cell differentiation. Materials and Methods: We studied 154 tissue samples with lymphoma involvement from 116 patients and evaluated the staining distribution of the markers. Expressions were evaluated in 21 chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), 7 follicular lymphoma (FL), 14 nodal marginal zone lymphoma, 17 extranodal marginal zone lymphoma, 55 splenic marginal zone lymphoma, 22 marginal zone lymphoma-not otherwise specified, and 18 lymphoplasmacytic lymphoma/Waldenström macroglobulinemia cases by immunohistochemistry. Results: The results confirmed that LEF1 was the most sensitive and specific marker for CLL/SLL and STMN1 was the most sensitive and specific marker for FL (p<0.001). MNDA and IRTA1 were useful markers to distinguish marginal zone lymphomas. Conclusion: Our results suggest that LEF1 for CLL/SLL and STMN1 for FL are reliable markers. LEF1, MNDA, STMN1, and IRTA1 are helpful with other routinely used immunohistochemical markers in a diagnostic algorithm considering their limitations.
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Affiliation(s)
- Hale Kıvrak
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Seher Yüksel
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Can Ateş
- Aksaray University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Aksaray, Turkey.,Ankara University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| | - Mustafa Merter
- Fırat University Faculty of Medicine, Department of Hematology, Elazığ, Turkey.,Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Gülşah Kaygusuz
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
| | - Muhit Özcan
- Ankara University Faculty of Medicine, Department of Hematology, Ankara, Turkey
| | - Işınsu Kuzu
- Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey
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6
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Vadla P, Yeluri S, Deepthi G, Guttikonda VR, Taneeru S, Naramala S. Stathmin! An immunohistochemical analysis of the novel marker in Oral Squamous Cell Carcinoma and Oral Leukoplakia. Asian Pac J Cancer Prev 2020; 21:3317-3323. [PMID: 33247690 PMCID: PMC8033135 DOI: 10.31557/apjcp.2020.21.11.3317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Stathmin is an intracellular phosphoprotein that controls the microtubule dynamics by further regulating proper attachment and alignment of chromosomes in a dividing cell. Thus, any mutation or aberrantly expressed protein that reduces the fidelity of spindle assembly will enhance chromosomal instability contributing to aneuploidy. Oral Squamous Cell Carcinoma is an extensively studied malignancy that occurs due to accumulated genetic changes due to carcinogens. The current study is done to evaluate the stathmin role and its expression in OSCC and Oral epithelial dysplasia (OED). OBJECTIVE The aim of the present study is to evaluate the role of stathmin in OSCC and Oral dysplasia and also to correlate the expression of Stathmin with respect to the different histopathological grades of OED and OSCC. MATERIALS AND METHODS 30 neutral buffered formalin fixed, paraffin embedded (FFPE) tissues of Oral Leukoplakia/OED and 30 FFPE tissues of OSCC were subjected to immunohistochemistry with stathmin antibody. Five fields of each case with 300 cells were examined and a mean percentage of positive-stained slides were determined. The percentages were recorded accordingly with their respective histological grades. The results were analysed statistically. RESULTS The results of the present study demonstrated higher mean values of stathmin in tissues with OSCC (2.50) compared to leukoplakia (2.11) and normal tissues (0.00) with a high level of statistical significance (0.0001). There is also an increase in the percentage levels of stathmin with increase in the histological grade of differentiation in OSCC as well as leukoplakia. CONCLUSION The present study found a statistical correlation between increased grades of the disease with expression levels of stathmin. This confirms that stathmin expression can contribute to disease progression and that stathmin might have a potential role as an early diagnostic biomarker and can be a therapeutic target for OSCC. <br />.
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Affiliation(s)
- Purnima Vadla
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
| | - Sivaranjani Yeluri
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
| | - G Deepthi
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
| | | | - Sravya Taneeru
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
| | - Srikanth Naramala
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
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7
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Townsend W, Pasikowska M, Yallop D, Phillips EH, Patten PEM, Salisbury JR, Marcus R, Pepper A, Devereux S. The architecture of neoplastic follicles in follicular lymphoma; analysis of the relationship between the tumor and follicular helper T cells. Haematologica 2020; 105:1593-1603. [PMID: 31537685 PMCID: PMC7271595 DOI: 10.3324/haematol.2019.220160] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/18/2019] [Indexed: 12/15/2022] Open
Abstract
CD4+ T-follicular helper cells are essential for the survival, proliferation, and differentiation of germinal center B cells and have been implicated in the pathogenesis of follicular lymphoma (FL). To further define the role of these cells in FL, we used multiparameter confocal microscopy to compare the architecture of normal and neoplastic follicles and next generation sequencing to analyze the T-cell receptor repertoire in FL lymph nodes (LN). Multiparameter analysis of LN showed that the proportion of T-follic-ular helper cells (TFH) in normal and neoplastic follicles is the same and that the previously reported increase in TFH numbers in FL is thus due to an increase in the number and not content of follicles. As in normal germinal centers, TFH were shown to have a close spatial correlation with proliferating B cells in neoplastic follicles, where features of immunological synapse formation were observed. The number of TFH in FL correlate with the rate of B-cell proliferation and TFH co-localized to activation induced cytidine deaminase expressing proliferating B cells. T-cell receptor repertoire analysis of FL LN revealed that follicular areas are significantly more clonal when compared to the rest of the LN. These novel findings show that neoplastic follicles and germinal centers share important structural features and provide further evidence that TFH may play a role in driving B-cell proliferation and genomic evolution in TFH Our results also suggest that targeting this interaction would be an attractive therapeutic option.
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Affiliation(s)
- William Townsend
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, University College London Hospitals NHS Foundation Trust, London
| | - Marta Pasikowska
- Department of Haematological Medicine, Rayne Institute, King's College London, London
| | - Deborah Yallop
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
| | - Elizabeth H Phillips
- Department of Haematological Medicine, Rayne Institute, King's College London, London
| | - Piers E M Patten
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
| | | | - Robert Marcus
- Department of Haematology, King's College Hospital, London
| | - Andrea Pepper
- Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK
| | - Stephen Devereux
- Department of Haematological Medicine, Rayne Institute, King's College London, London
- Department of Haematology, King's College Hospital, London
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8
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Agostinelli C, Akarca AU, Ramsay A, Rizvi H, Rodriguez-Justo M, Pomplun S, Proctor I, Sabattini E, Linch D, Daw S, Pittaluga S, Pileri SA, Jaffe ES, Quintanilla-Martinez L, Marafioti T. Novel markers in pediatric-type follicular lymphoma. Virchows Arch 2019; 475:771-779. [PMID: 31686194 PMCID: PMC6881426 DOI: 10.1007/s00428-019-02681-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/29/2019] [Accepted: 05/31/2019] [Indexed: 12/19/2022]
Abstract
The aim of this study was to review the histopathological, phenotypic, and molecular characteristics of pediatric-type follicular lymphoma (PTFL) and to assess the diagnostic value of novel immunohistochemical markers in distinguishing PTFL from follicular hyperplasia (FH). A total of 13 nodal PTFLs were investigated using immunohistochemistry, fluorescence in situ hybridization (FISH), and PCR and were compared with a further 20 reactive lymph nodes showing FH. Morphologically, PTFL cases exhibited a follicular growth pattern with irregular lymphoid follicles in which the germinal centers were composed of numerous blastoid cells showing a starry-sky appearance. Immunohistochemistry highlighted preserved CD10 (13/13) and BCL6 (13/13) staining, CD20 (13/13) positivity, a K light chain predominance (7/13), and partial BCL2 expression in 6/13 cases (using antibodies 124, E17, and SP66). The germinal center (GC)–associated markers stathmin and LLT-1 were positive in most of the cases (12/13 and 12/13, respectively). Interestingly, FOXP-1 was uniformly positive in PTFL (12/13 cases) in contrast to reactive GCs in FH, where only a few isolated positive cells were observed. FISH revealed no evidence of BCL2, BCL6, or MYC rearrangements in the examined cases. By PCR, clonal immunoglobulin gene rearrangements were detected in 100% of the tested PTFL cases. Our study confirmed the unique morphological and immunophenotypic features of PTFL and suggests that FOXP-1 can represent a novel useful diagnostic marker in the differential diagnosis between PTFL and FH.
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Affiliation(s)
- Claudio Agostinelli
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Ayse U Akarca
- Department of Pathology, University College London, London, UK
| | - Alan Ramsay
- Department of Cellular Pathology, University College Hospital London, London, UK
| | - Hasan Rizvi
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Manuel Rodriguez-Justo
- Department of Pathology, University College London, London, UK.,Department of Cellular Pathology, University College Hospital London, London, UK
| | - Sabine Pomplun
- Department of Cellular Pathology, University College Hospital London, London, UK
| | - Ian Proctor
- Department of Cellular Pathology, University College Hospital London, London, UK
| | - Elena Sabattini
- Haematopathology Unit, Department of Experimental Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - David Linch
- Department of Haematology, University College London Cancer Institute, London, UK
| | - Stephen Daw
- Children and Young People's Cancer Service, University College Hospital London, London, UK
| | - Stefania Pittaluga
- Haematology section, Laboratory of Pathology, Center for Cancer Research National Cancer Institute, Bethesda, MD, USA
| | - Stefano A Pileri
- Division of Haematopathology, European Institute of Oncology, University Hospital of Tübingen, Institute of Pathology, Tübingen, Germany
| | - Elaine S Jaffe
- Haematology section, Laboratory of Pathology, Center for Cancer Research National Cancer Institute, Bethesda, MD, USA
| | | | - Teresa Marafioti
- Department of Pathology, University College London, London, UK. .,Department of Cellular Pathology, University College Hospital London, London, UK.
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9
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A rare case of primary conjunctival Follicular Lymphoma grade 3B. Hematol Transfus Cell Ther 2019; 41:178-180. [PMID: 31079662 PMCID: PMC6517620 DOI: 10.1016/j.htct.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/31/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022] Open
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10
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Magnoli F, Tibiletti MG, Uccella S. Unraveling Tumor Heterogeneity in an Apparently Monolithic Disease: BCL2 and Other Players in the Genetic Landscape of Nodal Follicular Lymphoma. Front Med (Lausanne) 2019; 6:44. [PMID: 30931307 PMCID: PMC6428742 DOI: 10.3389/fmed.2019.00044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/20/2019] [Indexed: 02/05/2023] Open
Abstract
Follicular lymphoma (FL) is the most common form of non-Hodgkin lymphoma in Western countries. Although traditionally considered a well-defined, easy to diagnose lymphoproliferative disorder, in the last few years it has become clear that it is in fact composed of many different clinicopathological entities, encompassing a variegated and complex genetic background. This has led to the inclusion of specific FL variants and separate entities in the latest update of the WHO classification. However, even in the context of classical FL, many aspects of intra- and inter-tumoral heterogeneity have been recognized, with a major influence on diagnosis and clinical practice at different time points during the course of the disease. This review focuses on the molecular cytogenetic heterogeneity in classical FL from precursors and early development to progression and transformation, in terms of both clonal heterogeneity and unusual genetic features. Several factors have been investigated and suggested to contribute to the broad spectrum of clinicopathological, phenotypic, and genetic features observed in otherwise morphologically classical cases. Among them, deregulation of the epigenetic machinery and interactions with tumor microenvironment seem to play a pivotal role, together with genetic aberrations involving well-known molecular pathways and mechanisms physiologically operating in the germinal center. In the era of personalized medicine, precision diagnostics based both on understanding of the complex interplay among all these factors and on novel developments will become crucial to predict the outcome and guide the treatment of FL patients.
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Affiliation(s)
- Francesca Magnoli
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy.,Department of Pathology, ASST Sette Laghi, Varese, Italy
| | | | - Silvia Uccella
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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11
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Raman spectroscopy discriminates malignant follicular lymphoma from benign follicular hyperplasia and from tumour metastasis. Talanta 2018; 194:763-770. [PMID: 30609603 DOI: 10.1016/j.talanta.2018.10.086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 02/08/2023]
Abstract
Raman spectroscopy is a non-destructive label-free technique providing biochemical tissue fingerprint. The objective of the present work was to test if Raman spectroscopy is a suitable tool to differentiate lymph nodes affected by different conditions, such as reactive follicular hyperplasia (benign), follicular lymphoma (low grade primary tumour), diffuse large B cell lymphoma (high grade primary tumour) and tumour metastasis (secondary tumours). Moreover, we tested its ability to discriminate follicular lymphomas by the tumour grade and the BCL2 protein expression. Lymph nodes collected from 20 patients, who underwent surgery for suspected malignancy, were investigated. Imaging of tissue areas from about 400 µm2 up to 2 mm2 was performed collecting Raman maps containing thousands of spectra. Partial least squares discriminant analysis (PLS-DA) - a bilinear classification method - was used to calculate lymph node classification models, in order to discriminate at first between benign and malignant tissues and successively among cancer types, grades and the BCL2 protein expression. This proof-of-concept study paves the way for the development of clinical optical biopsy tools for lymph node cancer diagnosis, complementary to histopathological assessment.
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12
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Comparison of Myocyte Enhancer Factor 2B Versus Other Germinal Center-associated Antigens in the Differential Diagnosis of B-Cell Non-Hodgkin Lymphomas. Am J Surg Pathol 2018; 42:342-350. [DOI: 10.1097/pas.0000000000001015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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13
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Verdanet E, Dereure O, René C, Tempier A, Benammar-Hafidi A, Gallo M, Frouin E, Durand L, Gazagne I, Costes-Martineau V, Cacheux V, Szablewski V. Diagnostic value of STMN1, LMO2, HGAL, AID expression and 1p36 chromosomal abnormalities in primary cutaneous B cell lymphomas. Histopathology 2017; 71:648-660. [PMID: 28594133 DOI: 10.1111/his.13279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/05/2017] [Indexed: 12/31/2022]
Abstract
AIMS Distinction between primary cutaneous follicular lymphoma (PCFL) and primary cutaneous marginal zone lymphoma (PCMZL) is challenging, as clear-cut immunophenotypical and cytogenetic criteria to segregate both entities are lacking. METHODS AND RESULTS To characterize PCFL and PCMZL more clearly and to define criteria helpful for the differential diagnosis, we compared expression of immunohistochemical markers [LIM-only transcription factor 2 (LMO2), human germinal centre-associated lymphoma (HGAL), stathmin 1 (STMN1), activation-induced cytidine deaminase (AID), myeloid cell nuclear differentiation antigen (MNDA)] and the presence of cytogenetic abnormalities described previously in nodal follicular lymphoma [B cell lymphoma 2 (BCL2) and BCL6 breaks, 1p36 chromosomal region deletion (del 1p36)] in a series of 48 cutaneous follicular and marginal zone lymphomas [cutaneous follicular lymphoma (CFL) and cutaneous marginal zone lymphoma (CMZL)]. Immunostaining for STMN1, LMO2, HGAL and AID allowed the distinction between CFL and CMZL, and STMN1 was the most sensitive marker (100% CFL, 0% CMZL). LMO2, HGAL and AID were positive in 93.2%, 82.1% and 86.2% CFL (all CMZL-negative). MNDA was expressed in both entities without significant difference (10.3% CFL, 30.8% CMZL, P = 0.18). BCL2, BCL6 breaks and the del 1p36 were present in 16.7%, 10.7% and 18.5% CFL and no CMZL. Finally, three and 29 CFL were reclassified as secondary cutaneous follicular lymphomas (SCFL) and PCFL without significant differences concerning phenotypical and cytogenetic features. BCL2, BCL6 breaks and the del 1p36 were present in 11.1%, 8% and 16.7% PCFL and did not impact the prognosis. CONCLUSION LMO2, HGAL, STMN1 and AID, but not MNDA, are discriminant for the recognition between CFL and CMZL. BCL2, BCL6 rearrangements and the del 1p36 have a role in the pathogenesis of PCFL, the latest being the most common alteration.
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Affiliation(s)
- Evelyne Verdanet
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Olivier Dereure
- Faculté de Médecine, Université Montpellier 1, Montpellier, France.,Département de Dermatologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Céline René
- Faculté de Médecine, Université Montpellier 1, Montpellier, France.,Département d'Immunologie, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Ariane Tempier
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Assia Benammar-Hafidi
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Mathieu Gallo
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Eric Frouin
- Service Anatomie et Cytologie Pathologiques, CHU Poitiers, Poitiers, France
| | - Luc Durand
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,MEDIPATH, Grabels, France
| | - Isabelle Gazagne
- Faculté de Médecine, Université Montpellier 1, Montpellier, France.,Département d'Hématologie biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Valérie Costes-Martineau
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
| | - Valère Cacheux
- Faculté de Médecine, Université Montpellier 1, Montpellier, France.,Département d'Hématologie biologique, CHU Montpellier, Hôpital Saint Eloi, Montpellier, France
| | - Vanessa Szablewski
- Département de Biopathologie, CHU Montpellier, Hôpital Gui De Chauliac, Montpellier, France.,Faculté de Médecine, Université Montpellier 1, Montpellier, France
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14
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Machado-Neto JA, de Melo Campos P, Favaro P, Lazarini M, da Silva Santos Duarte A, Lorand-Metze I, Costa FF, Saad STO, Traina F. Stathmin 1 inhibition amplifies ruxolitinib-induced apoptosis in JAK2V617F cells. Oncotarget 2016; 6:29573-84. [PMID: 26356819 PMCID: PMC4745747 DOI: 10.18632/oncotarget.4998] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 08/11/2015] [Indexed: 12/21/2022] Open
Abstract
The JAK/STAT pathway is constitutively activated in myeloproliferative neoplasms and can be inhibited by ruxolitinib, a selective JAK1/2 inhibitor. The JAK2(V617F) mutation leads to constitutive STAT3 phosphorylation and potentially leads to inhibition of Stathmin 1 activity via STAT3. In support of this hypothesis, we found that, in HEL JAK2(V617F) cells, ruxolitinib treatment decreased STAT3 and Stathmin 1 association, induced Stathmin 1 activation and microtubule instability. Silencing of Stathmin 1 significantly reduced cell proliferation and clonal growth, and increased apoptosis induced by ruxolitinib. Stathmin 1 silencing also prevented ruxolitinib-induced microtubule instability. To phenocopy the effect of Stathmin 1 inhibition, cells were treated with paclitaxel, a microtubule-stabilizing drug, in association or not with ruxolitinib; combined treatment significantly increased apoptosis, when compared to monotherapy. Notably, Stathmin 1 mRNA levels were highly expressed in CD34(+) cells from primary myelofibrosis patients. We then proposed that an undesired effect of ruxolitinib treatment may constitute Stathmin 1 activation and microtubule instability in JAK2(V617F) cells. Induction of microtubule stability, through Stathmin 1 silencing or paclitaxel treatment, combined with ruxolitinib could be an effective strategy for promoting apoptosis in JAK2(V617F) cells.
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Affiliation(s)
- João Agostinho Machado-Neto
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Paula de Melo Campos
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Patricia Favaro
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil.,Current address: Department of Biological Sciences, Federal University of São Paulo, Diadema, São Paulo, Brazil
| | - Mariana Lazarini
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil.,Current address: Department of Biological Sciences, Federal University of São Paulo, Diadema, São Paulo, Brazil
| | - Adriana da Silva Santos Duarte
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Irene Lorand-Metze
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Fernando Ferreira Costa
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Sara Teresinha Olalla Saad
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Fabiola Traina
- Hematology and Hemotherapy Center, University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil.,Current address: Department of Internal Medicine, University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
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15
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Szablewski V, Ingen-Housz-Oro S, Baia M, Delfau-Larue MH, Copie-Bergman C, Ortonne N. Primary Cutaneous Follicle Center Lymphomas Expressing BCL2 Protein Frequently Harbor BCL2 Gene Break and May Present 1p36 Deletion: A Study of 20 Cases. Am J Surg Pathol 2016; 40:127-36. [PMID: 26658664 DOI: 10.1097/pas.0000000000000567] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The classification of cutaneous follicular lymphoma (CFL) into primary cutaneous follicle center lymphoma (PCFCL) or secondary cutaneous follicular lymphoma (SCFL) is challenging. SCFL is suspected when tumor cells express BCL2 protein, reflecting a BCL2 translocation. However, BCL2 expression is difficult to assess in CFLs because of numerous BCL2+ reactive T cells. To investigate these issues and to further characterize PCFCL, we studied a series of 25 CFLs without any extracutaneous disease at diagnosis, selected on the basis of BCL2 protein expression using 2 BCL2 antibodies (clones 124 and E17) and BOB1/BCL2 double immunostaining. All cases were studied using interphase fluorescence in situ hybridization with BCL2, BCL6, IGH, IGK, IGL breakapart, IGH-BCL2 fusion, and 1p36/1q25 dual-color probes. Nineteen CFLs were BCL2 positive, and 6 were negative. After a medium follow-up of 24 (6 to 96) months, 5 cases were reclassified as SCFL and were excluded from a part of our analyses. Among BCL2+ PCFCLs, 60% (9/15) demonstrated a BCL2 break. BCL2-break-positive cases had a tendency to occur in the head and neck and showed the classical phenotype of nodal follicular lymphoma (CD10+, BCL6+, BCL2+, STMN+) compared with BCL2-break-negative PCFCLs. Del 1p36 was observed in 1 PCFCL. No significant clinical differences were observed between BCL2+ or BCL2- PCFCL. In conclusion, we show that a subset of PCFCLs harbor similar genetic alterations, as observed in nodal follicular lymphomas, including BCL2 breaks and 1p36 deletion. As BCL2 protein expression is usually associated with the presence of a BCL2 translocation, fluorescence in situ hybridization should be performed to confirm this hypothesis.
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Affiliation(s)
- Vanessa Szablewski
- *Pathology Department, CHU Montpellier, Gui de Chauliac Hospital, Montpellier †Dermatology Department §Immunology and Hematology Department ¶Pathology Department, AP-HP, Groupe Henri Mondor-Albert Chenevier ‡INSERM, U955 team 9 ∥Medical University, Paris Est Creteil university (UPEC), UMR-S, Créteil, France
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16
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Llibre A, López-Macías C, Marafioti T, Mehta H, Partridge A, Kanzig C, Rivellese F, Galson JD, Walker LJ, Milne P, Phillips RE, Kelly DF, Freeman GJ, El Shikh ME, Klenerman P, Willberg CB. LLT1 and CD161 Expression in Human Germinal Centers Promotes B Cell Activation and CXCR4 Downregulation. THE JOURNAL OF IMMUNOLOGY 2016; 196:2085-94. [PMID: 26829983 PMCID: PMC4760235 DOI: 10.4049/jimmunol.1502462] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/03/2016] [Indexed: 01/08/2023]
Abstract
Germinal centers (GCs) are microanatomical structures critical for the development of high-affinity Abs and B cell memory. They are organized into two zones, light and dark, with coordinated roles, controlled by local signaling. The innate lectin-like transcript 1 (LLT1) is known to be expressed on B cells, but its functional role in the GC reaction has not been explored. In this study, we report high expression of LLT1 on GC-associated B cells, early plasmablasts, and GC-derived lymphomas. LLT1 expression was readily induced via BCR, CD40, and CpG stimulation on B cells. Unexpectedly, we found high expression of the LLT1 ligand, CD161, on follicular dendritic cells. Triggering of LLT1 supported B cell activation, CD83 upregulation, and CXCR4 downregulation. Overall, these data suggest that LLT1–CD161 interactions play a novel and important role in B cell maturation within the GC in humans.
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Affiliation(s)
- Alba Llibre
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom
| | - Constantino López-Macías
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI," Mexican Institute for Social Security, 06720 Mexico City, Mexico
| | - Teresa Marafioti
- Department of Histopathology, University College London, London WC1E 6JJ, United Kingdom
| | - Hema Mehta
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom
| | - Amy Partridge
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom
| | - Carina Kanzig
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom
| | - Felice Rivellese
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Jacob D Galson
- Oxford Vaccine Group, Department of Paediatrics, National Institute for Health Research, Oxford Biomedical Research Centre, University of Oxford, Oxford OX3 7LJ, United Kingdom
| | - Lucy J Walker
- Newcastle University, Newcastle upon Tyne NE1 7RU, United Kingdom
| | - Paul Milne
- Newcastle University, Newcastle upon Tyne NE1 7RU, United Kingdom
| | - Rodney E Phillips
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom
| | - Dominic F Kelly
- Oxford Vaccine Group, Department of Paediatrics, National Institute for Health Research, Oxford Biomedical Research Centre, University of Oxford, Oxford OX3 7LJ, United Kingdom
| | - Gordon J Freeman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215; and
| | - Mohey Eldin El Shikh
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom;
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom; Oxford National Institute for Health Research Biomedical Research Centre, Oxford OX3 9DU, United Kingdom
| | - Christian B Willberg
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford OX1 3SY, United Kindgom; Oxford National Institute for Health Research Biomedical Research Centre, Oxford OX3 9DU, United Kingdom
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17
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Leich E, Hoster E, Wartenberg M, Unterhalt M, Siebert R, Koch K, Klapper W, Engelhard M, Puppe B, Horn H, Staiger AM, Stuhlmann-Laeisz C, Bernd HW, Feller AC, Hummel M, Lenze D, Stein H, Hartmann S, Hansmann ML, Möller P, Hiddemann W, Dreyling M, Ott G, Rosenwald A. Similar clinical features in follicular lymphomas with and without breaks in the BCL2 locus. Leukemia 2015; 30:854-60. [PMID: 26621338 DOI: 10.1038/leu.2015.330] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 11/05/2015] [Accepted: 11/13/2015] [Indexed: 01/18/2023]
Abstract
Approximately 15% of follicular lymphomas (FLs) lack breaks in the BCL2 locus. The aim of this study was to better define molecular and clinical features of BCL2-breakpoint/t(14;18)-negative FLs. We studied the presence of BCL2, BCL6 and MYC breaks by fluorescence in situ hybridization and the expression of BCL2, MUM1, CD10, P53 and Ki67 in large clinical trial cohorts of 540 advanced-stage FL cases and 116 early-stage disease FL patients treated with chemotherapy regimens and radiation, respectively. A total of 86% and 53% of advanced- and early-stage FLs were BCL2-breakpoint-positive, respectively. BCL2 was expressed in almost all FLs with BCL2 break and also in 86% and 69% of BCL2-breakpoint-negative advanced- and early-stage FLs, respectively. CD10 expression was significantly reduced in BCL2-breakpoint-negative FLs of all stages and MUM1 and Ki67 expression were significantly increased in BCL2-break-negative early-stage FLs. Patient characteristics did not differ between FLs with and without BCL2 breaks and neither did survival times in advanced-stage FLs. These results suggest that the molecular profile differs to some extent between FLs with and without BCL2 breaks and support the notion that FLs with and without BCL2 breaks belong to the same lymphoma entity.
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Affiliation(s)
- E Leich
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken (CCC MF), Würzburg, Germany
| | - E Hoster
- Institute of Medical Informatics, Biometry, and Epidemiology, University of Munich, Munich, Germany
| | - M Wartenberg
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken (CCC MF), Würzburg, Germany
| | - M Unterhalt
- Department of Internal Medicine III, University Hospital Munich, Munich, Germany
| | - R Siebert
- Institute of Human Genetics, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - K Koch
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - W Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Engelhard
- Department for Radiotherapy, University Hospital Essen, Essen, Germany
| | - B Puppe
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken (CCC MF), Würzburg, Germany
| | - H Horn
- Margarete Fischer-Bosch Institute of Clinical Pharmacology, Robert-Bosch-Krankenhaus, Stuttgart and University of Tübingen, Tübingen, Germany
| | - A M Staiger
- Margarete Fischer-Bosch Institute of Clinical Pharmacology, Robert-Bosch-Krankenhaus, Stuttgart and University of Tübingen, Tübingen, Germany
| | - C Stuhlmann-Laeisz
- Institute of Human Genetics, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein, Kiel, Germany
| | - H W Bernd
- Institute of Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - A C Feller
- Institute of Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - M Hummel
- Institute of Pathology, Campus Benjamin Franklin, Charité Universitätsmedizin, Berlin, Germany
| | - D Lenze
- Institute of Pathology, Campus Benjamin Franklin, Charité Universitätsmedizin, Berlin, Germany
| | - H Stein
- Pathodiagnostik Berlin, Berlin, Germany
| | - S Hartmann
- Institute of Pathology, University Hospital Frankfurt am, Frankfurt, Germany
| | - M L Hansmann
- Institute of Pathology, University Hospital Frankfurt am, Frankfurt, Germany
| | - P Möller
- Institute of Pathology, University Hospital Ulm, Ulm, Germany
| | - W Hiddemann
- Department of Internal Medicine III, University Hospital Munich, Munich, Germany
| | - M Dreyling
- Department of Internal Medicine III, University Hospital Munich, Munich, Germany
| | - G Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - A Rosenwald
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken (CCC MF), Würzburg, Germany
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18
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Xerri L, Dirnhofer S, Quintanilla-Martinez L, Sander B, Chan JKC, Campo E, Swerdlow SH, Ott G. The heterogeneity of follicular lymphomas: from early development to transformation. Virchows Arch 2015; 468:127-39. [PMID: 26481245 DOI: 10.1007/s00428-015-1864-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/10/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022]
Abstract
Follicular lymphoma (FL) is a lymphoma composed of germinal center B cells, i.e., centroblasts and centrocytes, that almost always show at least a focal follicular growth pattern. Most cases have a characteristic CD5-, CD10+, BCL6+, and BCL2+ immunophenotype, and 85 % of cases exhibit the hallmark translocation t(14;18)(q32;q21) involving BCL2 and IGH. Although the typical clinicopathological findings of FL are well recognized, cases with unusual clinical, morphologic, immunophenotypic, and genetic features may pose problems in diagnosis and nomenclature. In the slide workshop organized by the European Association for Haematopathology (EAHP) and the Society for Hematopathology (SH) held in Istanbul, Turkey, unusual variants of FL were discussed based on the submitted cases, including early lesions, localized extranodal presentation, uncommon immunophenotype, rare genetic alterations, diffuse variant, and marginal zone differentiation. Interesting features such as blastoid morphology and unusual progression forms were presented, aiming to understand the genetic basis of transformation. In this report, novel findings and diagnostic challenges emerging from the submitted cases will be highlighted, and new terminologies for some of these lesions are proposed.
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Affiliation(s)
- Luc Xerri
- Department of Bio-Pathology, Institut Paoli-Calmettes, Aix-Marseille University, Marseille, France.
| | - Stephan Dirnhofer
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Birgitta Sander
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet and Karolinska University Hospital Huddinge, Stockholm, Sweden
| | | | - Elias Campo
- Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Steven H Swerdlow
- Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Hospital and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
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19
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Machado-Neto JA, Saad STO, Traina F. Stathmin 1 in normal and malignant hematopoiesis. BMB Rep 2015; 47:660-5. [PMID: 24667172 PMCID: PMC4345509 DOI: 10.5483/bmbrep.2014.47.12.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Indexed: 12/18/2022] Open
Abstract
Stathmin 1 is a microtubule destabilizer that plays an important role in cell cycle progression, segregation of chromosomes, clonogenicity, cell motility and survival. Stathmin 1 overexpression has been reported in malignant hematopoietic cells and Stathmin 1 inhibition reduces the highly proliferative potential of leukemia cell lines. However, during the differentiation of primary hematopoietic cells, Stathmin 1 expression decreases in parallel to decreases in the proliferative potential of early hematopoietic progenitors. The scope of the present review is to survey the current knowledge and highlight future perspectives for Stathmin 1 in normal and malignant hematopoiesis, with regard to the expression, function and clinical implications of this protein. [BMB Reports 2014; 47(12): 660-665]
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Affiliation(s)
- João Agostinho Machado-Neto
- Hematology and Hemotherapy Center-University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Sara Teresinha Olalla Saad
- Hematology and Hemotherapy Center-University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Fabiola Traina
- Hematology and Hemotherapy Center-University of Campinas/Hemocentro-Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas; Department of Internal Medicine, University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil
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20
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Abstract
AIMS To investigate potential diagnostic pitfalls associated with the identification of low grade lymphoma in the orbit and lacrimal gland region. METHODS To systemically review all cases diagnosed as low grade lymphoma of orbit and lacrimal gland within a 2 year period at a specialist ophthalmic centre. To ascertain the frequency of diagnostic errors in this group of cases, in particular to look for known pitfalls associated with follicular colonisation by marginal zone lymphoma and the recently identified atypical variant of follicular lymphoma (FL). A series of 21 cases were reviewed. RESULTS We identified two diagnostic errors; one case of extra nodal marginal zone lymphoma (ENMZL) which showed follicular colonisation and was misinterpreted as a FL and a case of missed mantle cell lymphoma (MCL). We identified no cases of atypical FL. CONCLUSION Within the orbit and lacrimal gland the term "low grade lymphoma" encompasses the following types of lymphoma: ENMZL, FL, MCL and chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). The typical and atypical immunophenotype of these entities is discussed. The diagnosis of ENMZL, by far the most common low grade lymphoma to occur in these areas, is to some extent a difficult diagnosis and is often one of exclusion. The pitfalls of follicular colonisation and the concept of atypical follicular lymphoma are discussed.
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Affiliation(s)
- Sepideh Amin
- Institute of Ophthalmology, University College London , London , United Kingdom and
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21
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Li Y, Hu S, Zuo Z, Hong M, Lin P, Li S, Konoplev S, Wang Z, Khoury JD, Young KH, Medeiros LJ, Yin CC. CD5-positive follicular lymphoma: clinicopathologic correlations and outcome in 88 cases. Mod Pathol 2015; 28:787-98. [PMID: 25743023 DOI: 10.1038/modpathol.2015.42] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/20/2015] [Accepted: 01/21/2015] [Indexed: 11/09/2022]
Abstract
Follicular lymphoma is a low-grade B-cell lymphoma of germinal center B-cell origin that typically lacks CD5 expression. We describe the clinicopathologic features of 88 cases of CD5+ follicular lymphoma (53 men, 35 women; median age, 60 years; range, 31-86). Follicular lymphoma was diagnosed initially in lymph nodes in 66 and extranodal sites in 22 patients. Eighty-one patients had lymphadenopathy, 66 had more than one involved site, 46 had bone marrow involvement, and 7 had splenomegaly. Staging information was available for 84 patients: 52 stage IV, 18 stage III, 12 stage II, and 2 stage I. Sixty-one cases were grade 1 or 2 and 27 were grade 3. The median proliferation index (Ki-67) was 30%. CD5 expression was detected by flow cytometry in 69, immunohistochemistry in 8, and both methods in 11 cases. The presence of t(14;18)(q32;q21)/IGH-BCL2 or other BCL2 translocation was detected in 28/44 (64%) cases. A total of 38 (43%) patients also had diffuse large B-cell lymphoma, concurrent with (n=20), subsequent to (n=13), or developing before CD5+ follicular lymphoma (n=5). All patients received chemotherapy; 12 also received stem-cell transplantation. With a median follow-up of 55 months (range, 0.5-207), 15 patients died, 46 were alive with disease, and 20 were in clinical remission. Compared with a matched group of patients with CD5- follicular lymphoma, patients with CD5+ follicular lymphoma more commonly had an International Prognostic Index >2 (35/80 vs 10/99, P<0.001), more often developed diffuse large B-cell lymphoma (38/88 vs 17/99; P<0.001), and had a shorter median progression-free survival (44 vs 89 months, P=0.0042). Higher Ki-67 and International Prognostic Index were identified as poor prognostic factors in both the groups. We conclude that CD5 expression in follicular lymphoma is associated with a higher International Prognostic Index, higher rate of transformation to diffuse large B-cell lymphoma, and shorter progression-free survival.
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Affiliation(s)
- Yu Li
- 1] Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA [2] Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Shimin Hu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Zhuang Zuo
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ming Hong
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Sergej Konoplev
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Zhen Wang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Ken H Young
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, USA
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22
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Zhang X(M, Aguilera N. New Immunohistochemistry for B-Cell Lymphoma and Hodgkin Lymphoma. Arch Pathol Lab Med 2014; 138:1666-72. [DOI: 10.5858/arpa.2014-0058-ra] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context
B-cell non-Hodgkin lymphoma is a heterogeneous group of lymphoproliferative malignancies with different clinical behaviors and treatments. It is important to differentiate individual B-cell lymphoma to apply the best treatment and management. Morphology and immunohistochemistry are the primary tools used for diagnosing lymphoma. There is a characteristic pattern of expression with immunohistochemical antibodies in most well-defined B-cell lymphomas. Some cases of B-cell lymphoma, however, show unusual morphologic and immunophenotypic features. The new and sometimes more specific antibodies have been developed recently, which may further define those lymphomas. Only with use of the antibodies over time does their true nature and specificity become evident.
Objectives
To present new antibodies for B-cell lymphoma that enhance the probability for diagnosis or can act as alternate markers in unusual cases, in which a B-cell lymphoma does not present with characteristic immunohistochemical staining, and to present prognostic markers that allow for better management of patients with specific B-cell lymphomas.
Data Sources
Data were obtained from literature review and figures from slides in personal practice.
Conclusions
The immunohistochemical antibodies presented in this article increase our ability to understand, diagnosis, and manage patients with B-cell lymphoma.
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Affiliation(s)
- Xiaohong (Mary) Zhang
- From the Department of Laboratory Medicine, Geisinger Medical Laboratories, Wilkes-Barre, Pennsylvania (Dr Zhang)
| | - Nadine Aguilera
- and the Department of Pathology, University of Virginia Health System, Charlottesville (Dr Aguilera)
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23
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Machado-Neto JA, de Melo Campos P, Favaro P, Lazarini M, Lorand-Metze I, Costa FF, Olalla Saad ST, Traina F. Stathmin 1 is involved in the highly proliferative phenotype of high-risk myelodysplastic syndromes and acute leukemia cells. Leuk Res 2013; 38:251-7. [PMID: 24355524 DOI: 10.1016/j.leukres.2013.11.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 11/18/2013] [Accepted: 11/20/2013] [Indexed: 02/02/2023]
Abstract
Stathmin 1 is an important cytoplasmic microtubule-destabilizing protein that plays critical roles in proliferation and accurate chromosome segregation through regulation of microtubule dynamics. High levels of Stathmin 1 expression have been reported in leukemia and solid tumors. However, Stathmin 1 has not been studied in myelodysplastic syndrome cells. We, herein, report that significantly higher Stathmin 1 levels were observed in proliferating hematopoietic cells, in high-risk MDS and acute leukemia cells. In addition, Stathmin 1 silencing in U937 and Namalwa leukemia cells reduced cell proliferation and clonogenicity. Our data suggest that Stathmin 1 expression may be related to the highly proliferative phenotype of hematopoietic cells and add new insights into the participation of Stathmin 1 in hematological malignancies.
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Affiliation(s)
- João Agostinho Machado-Neto
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Paula de Melo Campos
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Patricia Favaro
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil; Department of Biological Sciences, Federal University of São Paulo, Diadema, São Paulo, Brazil
| | - Mariana Lazarini
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Irene Lorand-Metze
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Fernando Ferreira Costa
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Sara Teresinha Olalla Saad
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil
| | - Fabiola Traina
- Hematology and Hemotherapy Center - University of Campinas/Hemocentro - Unicamp, Instituto Nacional de Ciência e Tecnologia do Sangue, Campinas, São Paulo, Brazil; Department of Internal Medicine, University of São Paulo at Ribeirão Preto Medical School, Ribeirão Preto, São Paulo, Brazil.
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24
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New developments in the pathology of malignant lymphoma: a review of the literature published from January 2013 to April 2013. J Hematop 2013. [DOI: 10.1007/s12308-013-0185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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