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Tajima K, Tanaka K, Takeda H, Moriya M, Ueki T, Ogata S, Maeda K, Yasuda T. Anticoagulant effects on the evaluation of CD23 expression in cells by monoclonal antibodies. Leuk Lymphoma 2022; 63:1742-1745. [PMID: 35147494 DOI: 10.1080/10428194.2022.2038379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Katsushi Tajima
- Department of Hematology, Yamagata Prefectural Central Hospital, Yamagata, Japan.,National Institute for Quantum Science and Technology, Chiba, Japan
| | - Kiwa Tanaka
- Department of Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Hikaru Takeda
- Department of Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Mika Moriya
- Department of Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Tetsuya Ueki
- Department of Laboratory Medicine, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Shinya Ogata
- Department of Pathology, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Kunihiko Maeda
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
| | - Takeshi Yasuda
- National Institute for Quantum Science and Technology, Chiba, Japan
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2
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Santamaria K, Desmots F, Leonard S, Caron G, Haas M, Delaloy C, Chatonnet F, Rossille D, Pignarre A, Monvoisin C, Seffals M, Lamaison C, Cogné M, Tarte K, Fest T. Committed Human CD23-Negative Light-Zone Germinal Center B Cells Delineate Transcriptional Program Supporting Plasma Cell Differentiation. Front Immunol 2021; 12:744573. [PMID: 34925321 PMCID: PMC8674954 DOI: 10.3389/fimmu.2021.744573] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022] Open
Abstract
B cell affinity maturation occurs in the germinal center (GC). Light-zone (LZ) GC B cells (BGC-cells) interact with follicular dendritic cells (FDCs) and compete for the limited, sequential help from T follicular helper cells needed to escape from apoptosis and complete their differentiation. The highest-affinity LZ BGC-cells enter the cell cycle and differentiate into PCs, following a dramatic epigenetic reorganization that induces transcriptome changes in general and the expression of the PRDM1 gene in particular. Human PC precursors are characterized by the loss of IL-4/STAT6 signaling and the absence of CD23 expression. Here, we studied the fate of human LZ BGC-cells as a function of their CD23 expression. We first showed that CD23 expression was restricted to the GC LZ, where it was primarily expressed by FDCs; less than 10% of tonsil LZ BGC-cells were positive. Sorted LZ BGC-cells left in culture and stimulated upregulated CD23 expression but were unable to differentiate into PCs – in contrast to cells that did not upregulate CD23 expression. An in-depth analysis (including single-cell gene expression) showed that stimulated CD23-negative LZ BGC-cells differentiated into plasmablasts and time course of gene expression changes delineates the transcriptional program that sustains PC differentiation. In particular, we identified a B cell proliferation signature supported by a transient MYC gene expression. Overall, the CD23 marker might be of value in answering questions about the differentiation of normal BGC-cells and allowed us to propose an instructive LZ BGC-cells maturation and fate model.
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Affiliation(s)
- Kathleen Santamaria
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France
| | - Fabienne Desmots
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Simon Leonard
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
| | - Gersende Caron
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Marion Haas
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Céline Delaloy
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France
| | - Fabrice Chatonnet
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Delphine Rossille
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Amandine Pignarre
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Céline Monvoisin
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France
| | - Marine Seffals
- University of Rennes 1, UMS Biosit, H2P2 Platform, Rennes, France
| | - Claire Lamaison
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France
| | - Michel Cogné
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Karin Tarte
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
| | - Thierry Fest
- UMR 1236, University of Rennes 1, INSERM, Établissement Français du Sang Bretagne, Rennes, France.,Pôle de Biologie, Rennes University Medical Center, Rennes, France
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3
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Insights from IgE Immune Surveillance in Allergy and Cancer for Anti-Tumour IgE Treatments. Cancers (Basel) 2021; 13:cancers13174460. [PMID: 34503270 PMCID: PMC8431713 DOI: 10.3390/cancers13174460] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/17/2022] Open
Abstract
IgE, the predominant antibody class of the allergic response, is known for its roles in protecting against parasites; however, a growing body of evidence indicates a significant role for IgE and its associated effector cells in tumour immunosurveillance, highlighted by the field of AllergoOncology and the successes of the first-in-class IgE cancer therapeutic MOv18. Supporting this concept, substantial epidemiological data ascribe potential roles for IgE, allergy, and atopy in protecting against specific tumour types, with a corresponding increased cancer risk associated with IgE immunodeficiency. Here, we consider how epidemiological data in combination with functional data reveals a complex interplay of IgE and allergy with cancer, which cannot be explained solely by one of the existing conventional hypotheses. We furthermore discuss how, in turn, such data may be used to inform future therapeutic approaches, including the clinical management of different patient groups. With epidemiological findings highlighting several high-risk cancer types protected against by high IgE levels, it is possible that use of IgE-based therapeutics for a range of malignant indications may offer efficacy to complement that of established IgG-class antibodies.
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4
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Plasmablasts derive from CD23- activated B cells after the extinction of IL-4/STAT6 signaling and IRF4 induction. Blood 2021; 137:1166-1180. [PMID: 33150420 DOI: 10.1182/blood.2020005083] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 10/19/2020] [Indexed: 01/07/2023] Open
Abstract
The terminal differentiation of B cells into antibody-secreting cells (ASCs) is a critical component of adaptive immune responses. However, it is a very sensitive process, and dysfunctions lead to a variety of lymphoproliferative neoplasias including germinal center-derived lymphomas. To better characterize the late genomic events that drive the ASC differentiation of human primary naive B cells, we used our in vitro differentiation system and a combination of RNA sequencing and Assay for Transposase-Accessible Chromatin with high-throughput sequencing (ATAC sequencing). We discovered 2 mechanisms that drive human terminal B-cell differentiation. First, after an initial response to interleukin-4 (IL-4), cells that were committed to an ASC fate downregulated the CD23 marker and IL-4 signaling, whereas cells that maintained IL-4 signaling did not differentiate. Second, human CD23- cells also increased IRF4 protein to levels required for ASC differentiation, but they did that independently of the ubiquitin-mediated degradation process previously described in mice. Finally, we showed that CD23- cells carried the imprint of their previous activated B-cell status, were precursors of plasmablasts, and had a phenotype similar to that of in vivo preplasmablasts. Altogether, our results provide an unprecedented genomic characterization of the fate decision between activated B cells and plasmablasts, which provides new insights into the pathological mechanisms that drive lymphoma biology.
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Ferastraoaru D, Schwartz D, Rosenstreich D. Increased Malignancy Rate in Children With IgE Deficiency: A Single-center Experience. J Pediatr Hematol Oncol 2021; 43:e472-e477. [PMID: 32769562 DOI: 10.1097/mph.0000000000001898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/25/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Immunoglobulin (Ig) E-deficient adults (IgE<2.5 kU/L) have increased susceptibility for developing malignancy. We evaluated the association between IgE deficiency and cancer diagnosis in children (age younger than 18 y), compared with those non-IgE-deficient (IgE≥2.5 kU/L). MATERIALS AND METHODS Information about malignancy diagnosis were compared between 4 cohorts of children who had IgE levels measured at our institution: IgE-deficient (IgE<2.5 kU/L), normal IgE (2.5 RESULTS Overall, 94/4586 (2%) children had IgE deficiency. A significantly higher malignancy rate was found in IgE-deficient children (3/94, 3.2%) compared with non-IgE-deficient cohort (13/4492, 0.3%, P<0.0001). Analysis of the groups with different IgE levels revealed a significantly higher rate of cancer in IgE-deficient children (3.2%) compared with those with normal (0.5%; odds ratio [OR]=7.84; 95% confidence interval [CI]: 1.94-31.61, P=0.004), high (0.2%; OR=25.80; 95% CI: 4.94-134.54, P=0.002), and very high IgE levels (0.2%; OR=42.17; 95% CI: 3.84-463.02, P<0.0001). All 3 IgE-deficient children had lymphoma. Malignancies in the other groups included lymphoma, leukemia, brain, liver, ovarian cancers. CONCLUSIONS Malignancy rate was higher in IgE-deficient children compared with those with normal, high, or very high IgE levels, supporting the hypothesis that IgE deficiency may be a marker for malignancy susceptibility in children. Larger, prospective studies are necessary to further evaluate this association.
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Affiliation(s)
- Denisa Ferastraoaru
- Department of Internal Medicine/Allergy-Immunology, Albert Einstein College of Medicine/Montefiore Medical Center
| | | | - David Rosenstreich
- Department of Internal Medicine/Allergy-Immunology, Albert Einstein College of Medicine/Montefiore Medical Center
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6
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Barraclough A, Bishton M, Cheah CY, Villa D, Hawkes EA. The diagnostic and therapeutic challenges of Grade 3B follicular lymphoma. Br J Haematol 2021; 195:15-24. [PMID: 33704790 DOI: 10.1111/bjh.17404] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Grade 3B follicular lymphoma (G3B FL) is rare, accounting for only 5-10% of FLs. Not only has it been routinely excluded from clinical trials, but data published on diagnosis, outcomes, choice of therapies and role of imaging are conflicting. With the advent of increasingly diverse treatment options for low-grade (G1-3A) FL, and the molecular subcategorisation of high-grade B-cell lymphomas, characterisation and treatment of G3B FL is ever more important as extrapolation of data becomes more difficult. New data have emerged exploring unique genetic characteristics, specific features on positron emission tomography imaging, choice of therapy, and outcomes of G3B FL in the current era. The present review will summarise and appraise these new data, and offer recommendations based on current evidence.
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Affiliation(s)
- Allison Barraclough
- Department of Haematology, Austin Health, Melbourne, Vic., Australia.,Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Mark Bishton
- Department of Haematology, Nottingham City Hospital, Nottingham, UK
| | - Chan Y Cheah
- Department of Haematology, Sir Charles Gairdner Hospital, Perth, WA, Australia.,Medical School, University of Western Australia, Perth, WA, Australia
| | - Diego Villa
- Centre for Lymphoid Cancer, British Columbia Cancer and University of British Columbia, Vancouver, BC, Canada
| | - Eliza A Hawkes
- Department of Medical Oncology and Haematology, Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Vic., Australia.,Department of Medical Oncology and Haematology, Eastern Health, Melbourne, Vic., Australia
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7
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Linhares P, Carvalho B, Vaz R, Costa BM. Glioblastoma: Is There Any Blood Biomarker with True Clinical Relevance? Int J Mol Sci 2020; 21:E5809. [PMID: 32823572 PMCID: PMC7461098 DOI: 10.3390/ijms21165809] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023] Open
Abstract
Glioblastoma (GBM) is the most frequent malignant primary brain tumor in adults, characterized by a highly aggressive, inflammatory and angiogenic phenotype. It is a remarkably heterogeneous tumor at several levels, including histopathologically, radiographically and genetically. The 2016 update of the WHO Classification of Tumours of the Central Nervous System highlighted molecular parameters as paramount features for the diagnosis, namely IDH1/2 mutations that distinguish primary and secondary GBM. An ideal biomarker is a molecule that can be detected/quantified through simple non- or minimally invasive methods with the potential to assess cancer risk; promote early diagnosis; increase grading accuracy; and monitor disease evolution and treatment response, as well as fundamentally being restricted to one aspect. Blood-based biomarkers are particularly attractive due to their easy access and have been widely used for various cancer types. A number of serum biomarkers with multiple utilities for glioma have been reported that could classify glioma grades more precisely and provide prognostic value among these patients. At present, screening for gliomas has no clinical relevance. This is because of the low incidence, the lack of sensitive biomarkers in plasma, and the observation that gliomas may develop apparently de novo within few weeks or months. To the best of our knowledge, there is no routine use of a serum biomarker for clinical follow-up. The purpose of this paper is to review the serum biomarkers described in the literature related to glioblastoma and their possible relationship with clinical features.
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Affiliation(s)
- Paulo Linhares
- Neurosurgery Department, Centro Hospitalar São João, Alameda Prof Hernani Monteiro, 4200–319 Porto, Portugal; (P.L.); (R.V.)
- Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Oporto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Bruno Carvalho
- Neurosurgery Department, Centro Hospitalar São João, Alameda Prof Hernani Monteiro, 4200–319 Porto, Portugal; (P.L.); (R.V.)
- Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Oporto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Rui Vaz
- Neurosurgery Department, Centro Hospitalar São João, Alameda Prof Hernani Monteiro, 4200–319 Porto, Portugal; (P.L.); (R.V.)
- Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Oporto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Bruno M. Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal;
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, 4710-057 Braga, Portugal
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8
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CREBBP and STAT6 co-mutation and 16p13 and 1p36 loss define the t(14;18)-negative diffuse variant of follicular lymphoma. Blood Cancer J 2020; 10:69. [PMID: 32555149 PMCID: PMC7299932 DOI: 10.1038/s41408-020-0335-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022] Open
Abstract
The diffuse variant of follicular lymphoma (dFL) is a rare variant of FL lacking t(14;18) that was first described in 2009. In this study, we use a comprehensive approach to define unifying pathologic and genetic features through gold-standard pathologic review, FISH, SNP-microarray, and next-generation sequencing of 16 cases of dFL. We found unique morphologic features, including interstitial sclerosis, microfollicle formation, and rounded nuclear cytology, confirmed absence of t(14;18) and recurrent deletion of 1p36, and showed a novel association with deletion/CN-LOH of 16p13 (inclusive of CREBBP, CIITA, and SOCS1). Mutational profiling demonstrated near-uniform mutations in CREBBP and STAT6, with clonal dominance of CREBBP, among other mutations typical of germinal-center B-cell lymphomas. Frequent CREBBP and CIITA codeletion/mutation suggested a mechanism for immune evasion, while subclonal STAT6 activating mutations with concurrent SOCS1 loss suggested a mechanism of BCL-xL/BCL2L1 upregulation in the absence of BCL2 rearrangements. A review of the literature showed significant enrichment for 16p13 and 1p36 loss/CN-LOH, STAT6 mutation, and CREBBP and STAT6 comutation in dFL, as compared with conventional FL. With this comprehensive approach, our study demonstrates confirmatory and novel genetic associations that can aid in the diagnosis and subclassification of this rare type of lymphoma.
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9
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Ranheim EA. Pearls and pitfalls in the diagnostic workup of small lymph node biopsies. Mod Pathol 2019; 32:38-43. [PMID: 30600319 DOI: 10.1038/s41379-018-0151-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 11/09/2022]
Abstract
All pathology subspecialties are more frequently receiving small needle core biopsies for the diagnosis of new lesions. While this results in potential diagnostic pitfalls, the tools available for hematopathology, including extensive panels of immunostains, PRC-based clonality assessment, and flow cytometry often allow accurate diagnoses even with very small specimens. This review presents a brief approach to such biopsies, using morphologic cues as well as ancillary studies, which provides an experience-based framework for approaching these cases and coming to a clear diagnosis while avoiding diagnostic errors. The approach is divided into three parts based on H & E cell morphology.
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Affiliation(s)
- Erik A Ranheim
- Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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10
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11
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Ku M, Chong G, Hawkes EA. Tumour cell surface antigen targeted therapies in B-cell lymphomas: Beyond rituximab. Blood Rev 2017; 31:23-35. [DOI: 10.1016/j.blre.2016.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/26/2016] [Accepted: 08/02/2016] [Indexed: 01/16/2023]
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AlAkeely AG, Alkatan HM, Alsuhaibani AH, AlKhalidi H, Safieh LA, Coupland SE, Edward DP. Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. Br J Ophthalmol 2016; 101:933-939. [PMID: 27899370 DOI: 10.1136/bjophthalmol-2016-309030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 11/02/2016] [Accepted: 11/08/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIM Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment. METHODS A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence. RESULTS There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96%). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5% of the eyes. At presentation, the tumour was unilateral in 12 cases (50%). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96% of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, CONCLUSIONS: All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.
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Affiliation(s)
| | - Hind M Alkatan
- Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia.,Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Adel H Alsuhaibani
- Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hisham AlKhalidi
- Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Sarah E Coupland
- Department of Cellular Pathology, Royal Liverpool University Hospital, UK
| | - Deepak P Edward
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA
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Follicular Lymphoma: A Clinicopathological Analysis from a Tertiary Care Institute in Southern India. Mediterr J Hematol Infect Dis 2016; 8:e2016060. [PMID: 27872740 PMCID: PMC5111515 DOI: 10.4084/mjhid.2016.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/17/2016] [Indexed: 12/31/2022] Open
Abstract
Introduction Follicular lymphoma (FL) is an indolent lymphoproliferative disorder of B-cells with variable clinical behavior. It is the second most common subtype of Non-Hodgkin lymphoma in western countries but reported to have a lower incidence in Asia. Materials and methods Cases of FL diagnosed in the Department of Pathology of our Institute from January 2009 to June 2015 were included in the study. The clinicopathological parameters including staging, histological details, and immunohistochemical markers CD20, CD10 and BCL-2 were recorded in all the cases. Results Of the 497 cases of Non-Hodgkin Lymphoma reported during the study period, 36 (7.2%) cases were follicular lymphoma. The mean age was 50 years with male to female ratio of 3.2:1. Grade 1/2 was seen in 70% cases. 22 % cases had low grade with high proliferation index (Ki67 > 40%). Granulomatous response was seen in two cases. Diffuse large cell lymphoma component was present in four cases. Bone marrow involvement and peripheral blood spill were seen in 12 (37.5%) and six cases (18.8%) respectively. 72% cases were in stage 3 or 4. Conclusion The incidence of FL was lower in our study than other Indian studies. FL presented in the elderly, with male predominance and disseminated stage. The study highlights features of low grade with high proliferation index, granulomatous response, leukemic involvement, and transformation to high grade lymphoma.
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Characterization of a variant of t(14;18) negative nodal diffuse follicular lymphoma with CD23 expression, 1p36/TNFRSF14 abnormalities, and STAT6 mutations. Mod Pathol 2016; 29:570-81. [PMID: 26965583 DOI: 10.1038/modpathol.2016.51] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 01/08/2023]
Abstract
A predominantly diffuse growth pattern and CD23 co-expression are uncommon findings in nodal follicular lymphoma and can create diagnostic challenges. A single case series in 2009 (Katzenberger et al) proposed a unique morphologic variant of nodal follicular lymphoma, characterized by a predominantly diffuse architecture, lack of the t(14;18) IGH/BCL2 translocation, presence of 1p36 deletion, frequent inguinal lymph node involvement, CD23 co-expression, and low clinical stage. Other studies on CD23+ follicular lymphoma, while associating inguinal location, have not specifically described this architecture. In addition, no follow-up studies have correlated the histopathologic and cytogenetic/molecular features of these cases, and they remain a diagnostic problem. We identified 11 cases of diffuse, CD23+ follicular lymphoma with histopathologic features similar to those described by Katzenberger et al. Along with pertinent clinical information, we detail their histopathology, IGH/BCL2 translocation status, lymphoma-associated chromosomal gains/losses, and assessment of mutations in 220 lymphoma-associated genes by massively parallel sequencing. All cases showed a diffuse growth pattern around well- to ill-defined residual germinal centers, uniform CD23 expression, mixed centrocytic/centroblastic cytology, and expression of at least one germinal center marker. Ten of 11 involved inguinal lymph nodes, 5 solely. By fluorescence in situ hybridization analysis, the vast majority lacked IGH/BCL2 translocation (9/11). Deletion of 1p36 was observed in five cases and included TNFRSF14. Of the six cases lacking 1p36 deletion, TNFRSF14 mutations were identified in three, highlighting the strong association of 1p36/TNFRSF14 abnormalities with this follicular lymphoma variant. In addition, 9 of the 11 cases tested (82%) had STAT6 mutations and nuclear P-STAT6 expression was detectable in the mutated cases by immunohistochemistry. The proportion of STAT6 mutations is higher than recently reported in conventional follicular lymphoma (11%). These findings lend support for a clinicopathologic variant of t(14;18) negative nodal follicular lymphoma and suggests importance of the interleukin (IL)-4/JAK/STAT6 pathway in this variant.
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15
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Kazlouskaya V, Spizuoco A, Junkins-Hopkins JM. Two cases of systemic mantle cell lymphoma involving the skin. Indian Dermatol Online J 2016; 7:49-52. [PMID: 26951614 PMCID: PMC4763582 DOI: 10.4103/2229-5178.174317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mantle cell lymphoma (MCL) is a form of non-Hodgkin lymphoma that rarely affects skin. Cutaneous involvement is non-specific but usually indicates widespread disease. Herein we present two cases of MCL with secondary skin involvement. One case presented as an acneiform eruption on the face and had aberrant expression of bcl-2 and bcl-6 with weak CD5 expression. The second presented with multiple tumors on the abdomen and thighs. In both cases expression of Cyclin-D1 by the tumor cells was seen. Both patients died shortly after the diagnosis was established.
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Affiliation(s)
| | - Amy Spizuoco
- Ackerman Academy of Dermatopathology, New York, USA
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16
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Menter T, Dirnhofer S, Tzankov A. LEF1: a highly specific marker for the diagnosis of chronic lymphocytic B cell leukaemia/small lymphocytic B cell lymphoma. J Clin Pathol 2015; 68:473-8. [PMID: 25713417 DOI: 10.1136/jclinpath-2015-202862] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/05/2015] [Indexed: 11/03/2022]
Abstract
AIMS Chronic lymphocytic B cell leukaemia (CLL)/small lymphocytic B cell lymphoma (SLL) has proven to be not a uniform entity but to consist of various disease subtypes. CLL might also pose diagnostic challenges by demonstrating an uncommon immunohistochemical profile. Recently, the role of lymphocyte enhancer-binding factor 1 (LEF1) in CLL was elucidated being highly expressed and seeming to have a prognostic value. Our aim was to test the applicability of LEF1 as marker for CLL in a diagnostic setting. METHODS We investigated LEF1 expression in lymphomas by immunohistochemistry on tissue microarrays containing several lymphoma entities (altogether 720 cases, including 61 CLL cases). We also separated CLL cases by zeta-chain-associated protein kinase 70 (ZAP70) and CD38 stainings and fluorescence in situ hybridisation analyses for TP53 deletions and trisomy 12 into respective groups and correlated data with LEF1 expression. RESULTS The area under the receiver operating characteristic curve for LEF1 as a diagnostic marker for CLL was 0.815 (95% CI 0.742 to 0.888). The relevant diagnostic cut-off value for LEF1 positivity determined by the Youden's index was 10% (specificity 92%, sensitivity 70%). The majority of CLL cases (70%) expressed LEF1. Eighteen per cent of (transformed) diffuse large B cell lymphoma cases also expressed LEF1. In most other lymphoma entities, LEF1 was negative. There was a positive correlation of LEF1 staining with ZAP70 expression (Spearman's rho: 0.438, p<0.001), but not with CD38 expression, TP53 deletions or trisomy 12. CONCLUSIONS LEF1 is a useful marker in the differential diagnosis of CLL in difficult cases. It shows a high specificity (92%) and a reasonable sensitivity (70%) for this entity.
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Affiliation(s)
- Thomas Menter
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Stephan Dirnhofer
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
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Miyoshi H, Sato K, Yoshida M, Kimura Y, Kiyasu J, Ichikawa A, Ishibashi Y, Arakawa F, Nakamura Y, Nakashima S, Niino D, Sugita Y, Ohshima K. CD5-positive follicular lymphoma characterized by CD25, MUM1, low frequency of t(14;18) and poor prognosis. Pathol Int 2014; 64:95-103. [DOI: 10.1111/pin.12145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 01/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Kensaku Sato
- Biostatistics Center; School of Medicine; Kurume University; Kurume Japan
| | - Maki Yoshida
- Department of Pathology; Kurume University; Kurume Japan
| | - Yoshizo Kimura
- Department of Pathology; Kurume University; Kurume Japan
| | - Junichi Kiyasu
- Department of Pathology; Kurume University; Kurume Japan
| | - Ayako Ichikawa
- Department of Pathology; Kurume University; Kurume Japan
| | | | - Fumiko Arakawa
- Department of Pathology; Kurume University; Kurume Japan
| | | | | | - Daisuke Niino
- Department of Pathology; Kurume University; Kurume Japan
| | - Yasuo Sugita
- Department of Pathology; Kurume University; Kurume Japan
| | - Koichi Ohshima
- Department of Pathology; Kurume University; Kurume Japan
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Duarte IX, Domeny-Duarte P, Wludarski SCL, Natkunam Y, Bacchi CE. Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients. Mod Pathol 2013; 26:1183-96. [PMID: 23599146 DOI: 10.1038/modpathol.2013.50] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 01/27/2013] [Accepted: 01/27/2013] [Indexed: 11/09/2022]
Abstract
Follicular lymphoma is clinically heterogenous, and therefore necessitates the identification of prognostic markers to stratify risk groups and optimize clinical management. It is relatively rare in patients younger than 40 years, and the clinicopathologic characteristics and biological behavior in this age group are poorly understood. In the current study, samples from a cohort of 200 patients between 19 and 40 years were evaluated retrospectively with respect to clinical, histologic, and genetic features. These were then correlated with clinical outcome. The median age at presentation was 35 years with a slight female prepoderance (56%). Most of the cases are presented with nodal disease (90%). Concomitant follicular lymphoma and diffuse large B-cell lymphoma were observed in 7 (4%) patients. Immunohistologic studies showed the expression of CD10 (91%), BCL6 (97%), BCL2 (95%), MUM1/IRF4 (12%), MDM2 (17%), and CD23 (25%). BCL2 rearrangement was present in 74%, and BCL6 in 20%. The estimated overall survival of patients was 13 years (mean). The presence of anemia, elevated lactose dehydrogenase, bone marrow involvement, and high-risk follicular lymphoma international prognostic index correlated with adverse overall survival. Our findings revealed that follicular lymphoma in young adults demonstrate similarities with that of older adults, including the frequency of presentation at various anatomic sites, grade, and adverse prognostic factors.
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Affiliation(s)
- Ivison X Duarte
- Laboratório Bacchi/Consultoria em Patologia, Botucatu, Brazil
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Okaly GVP, Nargund AR, E V, Jayanna PK, Juvva CR, Prabhudesai S. Chronic lymphoproliferative disorders at an Indian tertiary cancer centre - the panel sufficiency in the diagnosis of chronic lymphocytic leukaemia. J Clin Diagn Res 2013; 7:1366-71. [PMID: 23998067 PMCID: PMC3749637 DOI: 10.7860/jcdr/2013/5088.3130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 04/26/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Flow cytometry has come to occupy the vanguard of the high through put diagnostic techniques that have been used to differentiate between various chronic lymphoproliferative disorders (CLPD). However, economic considerations have created the need for minimal consensus panels that can yield maximum information at reasonable costs. AIMS To collect, analyse and correlate the morphologic, immunophenotypic, and the cytogenetic data from the cases of chronic lymphoproliferative disorders, which were diagnosed at an Indian speciality cancer centre. METHODS AND MATERIAL The morphology was recorded after staining the samples with the Leishman or the MGG stains. The lineage assignment was done by using three colour flow cytometry with a primary panel of antibodies. For the cytogenetic studies, the short term culture of the sample cells were arrested by using colcemid and they were G-banded by using trypsin and Giemsa stain. FISH studies were conducted by using a CLL-specific diagnostic kit. RESULTS AND CONCLUSIONS A total of 66 cases were evaluated, which had a median age of 64.5 years and a sex ratio of 2.3:1. Of these 66 cases, 40 cases were of CLL and 9 cases were of atypical CLL. 17 cases were classified as CLPD and these included 13 cases of Non-Hodgkin's Lymphoma, two cases of Hairy Cell Leukaemia, one case of Follicular Lymphoma and one case of Prolymphocytic Leukaemia. In immunophenotyping, the lack of expression of CD22 had the highest correlation with a definitive diagnosis of CLL. Cytogenetics demonstrated a classical follicular lymphoma abnormality, t (14; 18) (q32; q21), in one case. A basic minimal panel is sufficient for the routine diagnosis of CLL. However, the stratification of CLPD requires the use of more extensive panels.
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Affiliation(s)
- Geeta V Patil Okaly
- Consultant Pathologist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | | | - Venkataswamy E
- Senior Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Prashanth K Jayanna
- Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Chandra Rao Juvva
- Research Scientist, Triesta Rerearch & Development, Bangalore, Karnataka, India
| | - Shilpa Prabhudesai
- Consultant Pathologist, Triesta Rerearch & Development, Bangalore, Karnataka, India
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Bibliography. Lymphoma. Current world literature. Curr Opin Oncol 2011; 23:537-41. [PMID: 21836468 DOI: 10.1097/cco.0b013e32834b18ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Buonaccorsi JN, Kroft SH, Harrington AM, VanTuinen P, Olteanu H. Clinicopathologic analysis of the impact of CD23 expression in plasma cell myeloma with t(11;14)(q13;q32). Ann Diagn Pathol 2011; 15:385-8. [PMID: 21724429 DOI: 10.1016/j.anndiagpath.2011.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 04/07/2011] [Indexed: 11/19/2022]
Abstract
A recent study has shown that 10% of plasma cell myelomas (PCMs) express CD23 and that expression is associated with abnormalities of chromosome 11, mainly t(11;14)(q13;q32); however, only 40% of t(11;14)(+) PCMs express CD23. Because these results were generated in a limited patient cohort and because the clinical relevance of CD23 expression in PCMs with t(11;14)(q13;q32) has not been fully characterized, we addressed this question in a large series of patients with t(11;14)(+) PCM. Forty-two bone marrow biopsies from patients with t(11;14)(+) PCM were evaluated for CD23 expression by immunohistochemistry. CD23 expression was correlated with laboratory and clinical data and outcome after autologous stem cell transplantation, including event-free survival and overall survival (OS). Plasma cell myelomas with t(11;14)(q13;q32) were frequently CD20(+) (46.4%) and CD56(-) (53.8%) and had a nonhyperdiploid karyotype (97.6%) with frequent 13q deletion (33.3%). Of 42 cases, 19 (45.2%) expressed CD23. CD23(+) PCMs were more likely to present with platelet counts less than 150 × 10(3)/μL (100% vs 50%, P = .006). There were no significant differences in other laboratory or presenting clinical data. The median event-free survival in patients treated with autologous stem cell transplantation (n = 29) was similar regardless of CD23 status, whereas the median OS (all patients) was longer in CD23(-) than in CD23(+) PCMs: not reached vs 3365 days (P = .08). Our findings suggest that patients with t(11;14)(+)/CD23(+) PCM present with lower platelet counts and may have a shorter OS than those with t(11;14)(+)/CD23(-) PCM.
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New developments in the pathology of malignant lymphoma: a review of the literature published from November 2010–January 2011. J Hematop 2011. [DOI: 10.1007/s12308-011-0086-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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