|
1
|
Desmirean M, Rauch S, Jurj A, Pasca S, Iluta S, Teodorescu P, Berce C, Zimta AA, Turcas C, Tigu AB, Moldovan C, Paris I, Steinheber J, Richlitzki C, Constantinescu C, Sigurjonsson OE, Dima D, Petrushev B, Tomuleasa C. B Cells versus T Cells in the Tumor Microenvironment of Malignant Lymphomas. Are the Lymphocytes Playing the Roles of Muhammad Ali versus George Foreman in Zaire 1974? J Clin Med 2020; 9:jcm9113412. [PMID: 33114418 PMCID: PMC7693982 DOI: 10.3390/jcm9113412] [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: 09/05/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
Malignant lymphomas are a heterogeneous group of malignancies that develop both in nodal and extranodal sites. The different tissues involved and the highly variable clinicopathological characteristics are linked to the association between the lymphoid neoplastic cells and the tissues they infiltrate. The immune system has developed mechanisms to protect the normal tissue from malignant growth. In this review, we aim to explain how T lymphocyte-driven control is linked to tumor development and describe the tumor-suppressive components of the resistant framework. This manuscript brings forward a new insight with regard to intercellular and intracellular signaling, the immune microenvironment, the impact of therapy, and its predictive implications. A better understanding of the key components of the lymphoma environment is important to properly assess the role of both B and T lymphocytes, as well as their interplay, just as two legendary boxers face each other in a heavyweight title final, as was the case of Ali versus Foreman.
Collapse
Affiliation(s)
- Minodora Desmirean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
- Department of Pathology, Constantin Papilian Military Hospital, 400124 Cluj Napoca, Romania;
| | - Sebastian Rauch
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Ancuta Jurj
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Sergiu Pasca
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Sabina Iluta
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Cristian Berce
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (C.B.); (A.-A.Z.); (A.-B.T.); (C.M.); (B.P.)
| | - Alina-Andreea Zimta
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (C.B.); (A.-A.Z.); (A.-B.T.); (C.M.); (B.P.)
| | - Cristina Turcas
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Adrian-Bogdan Tigu
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (C.B.); (A.-A.Z.); (A.-B.T.); (C.M.); (B.P.)
| | - Cristian Moldovan
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (C.B.); (A.-A.Z.); (A.-B.T.); (C.M.); (B.P.)
| | - Irene Paris
- Department of Pathology, Constantin Papilian Military Hospital, 400124 Cluj Napoca, Romania;
| | - Jakob Steinheber
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Cedric Richlitzki
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
| | - Catalin Constantinescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
- Department of Anesthesia and Intensive Care, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania
| | - Olafur Eysteinn Sigurjonsson
- The Blood Bank, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland;
- School of Science and Engineering, Reykjavik University, 101 Reykjavik, Iceland
| | - Delia Dima
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj Napoca, Romania;
| | - Bobe Petrushev
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (C.B.); (A.-A.Z.); (A.-B.T.); (C.M.); (B.P.)
- Department of Pathology, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, 400124 Cluj Napoca, Romania
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.); (S.R.); (A.J.); (S.P.); (S.I.); (P.T.); (C.T.); (J.S.); (C.R.); (C.C.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj Napoca, Romania;
- Correspondence: ; Tel.: +40741337489
| |
Collapse
|
|
2
|
Iluta S, Termure DA, Petrushev B, Fetica B, Badea ME, Moldovan-Lazar M, Lenghel M, Csutak C, Roman A, Pasca S, Zimta AA, Jitaru C, Tomuleasa C, Roman RC. Clinical Remission in a 72-Year-Old Patient with a Massive Primary Cutaneous Peripheral T-Cell Lymphoma-NOS of the Eyelid, Following Combination Chemotherapy with Etoposide Plus COP. Diagnostics (Basel) 2020; 10:diagnostics10090629. [PMID: 32847118 PMCID: PMC7555261 DOI: 10.3390/diagnostics10090629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/14/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022] Open
Abstract
Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is the rarest subtype of primary cutaneous lymphoma, accounting for approximately 2% of cutaneous lymphomas. The rarity of primary cutaneous PTCL-NOS means that there is a paucity of data regarding clinical and histopathological features and its clinical course. This malignancy is an aggressive and life-threatening hematological malignancy that often presents mimicking other less severe plaque-like skin conditions. Due to the nonspecific nature of these lesions, CD4-positive cutaneous T-cell lymphoma (CTCL) is often misdiagnosed as either mycosis fungoides or Sezary syndrome. We describe a patient who presented with a large tumoral mass in the right frontal area, with involvement of the right upper eyelid and the ocular globe, causing loss of vision greatly impacting the quality of life. Biopsy revealed primary cutaneous PTCL-NOS, treated successfully with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus etoposide combination chemotherapy. As elderly patients are indicated to receive attenuated doses of chemotherapy, CHOP-based regimens represent viable options.
Collapse
Affiliation(s)
- Sabina Iluta
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (S.I.); (S.P.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj-Napoca, Romania;
| | - Dragos-Alexandru Termure
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (D.-A.T.); (M.M.-L.); (R.-C.R.)
- Department of Preventive Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania;
| | - Bobe Petrushev
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (B.P.); (A.-A.Z.)
- Department of Pathology, Octavian Fodor Regional Institute of Gastroenterology and Hepatology, 400139 Cluj-Napoca, Romania
| | - Bogdan Fetica
- Department of Pathology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj-Napoca, Romania;
| | - Mindra-Eugenia Badea
- Department of Preventive Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania;
| | - Madalina Moldovan-Lazar
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (D.-A.T.); (M.M.-L.); (R.-C.R.)
| | - Manuela Lenghel
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj-Napoca, Romania; (M.L.); (C.C.); (A.R.)
| | - Csaba Csutak
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj-Napoca, Romania; (M.L.); (C.C.); (A.R.)
| | - Andrei Roman
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj-Napoca, Romania; (M.L.); (C.C.); (A.R.)
| | - Sergiu Pasca
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (S.I.); (S.P.)
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (B.P.); (A.-A.Z.)
| | - Alina-Andreea Zimta
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (B.P.); (A.-A.Z.)
| | - Ciprian Jitaru
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj-Napoca, Romania;
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (S.I.); (S.P.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400124 Cluj-Napoca, Romania;
- Medfuture Research Center for Advanced Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (B.P.); (A.-A.Z.)
- Correspondence:
| | - Rares-Calin Roman
- Department of Oral and Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania; (D.-A.T.); (M.M.-L.); (R.-C.R.)
| |
Collapse
|
|
3
|
Griesel C, Desmirean M, Esterhuizen T, Pasca S, Petrushev B, Selicean C, Roman A, Fetica B, Teodorescu P, Swanepoel C, Tomuleasa C, Grewal R. Differential Diagnosis of Malignant Lymphadenopathy Using Flow Cytometry on Fine Needle Aspirate: Report on 269 Cases. J Clin Med 2020; 9:jcm9010283. [PMID: 31968576 PMCID: PMC7019747 DOI: 10.3390/jcm9010283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/29/2022] Open
Abstract
Introduction: Fine needle aspiration (FNA) is frequently the first noninvasive test used for the diagnostic workup of lymphadenopathy. There have been many studies showing its usefulness, especially in conjunction with other techniques for the diagnosis of lymphoma, but it remains inferior to histological examination. The data regarding this subject have mostly been reported mostly from first-world countries, but are scarce for emerging economies. Thus, the current study assesses the agreement between fine needle aspiration flow cytometry (FNA FC) and histology in the aforementioned region. Material and Methods: We conducted a retrospective study including the FNA FC adenopathy diagnoses made between January 2011 and December 2016 at the Tygerberg Hospital, Cape Town, South Africa. Additional variables included were the histological diagnosis, sex and age of the included patients. Results: In the descriptive part of the current study, 269 FNA FC samples were included. The most frequent diagnoses made on these were represented by B-cell lymphoma, reactive adenopathy, no abnormality detected (NAD), and non-hematological malignancy. In the analytical part of the current study, there were 115 cases included that had both valid FNA FC and histological diagnoses. It could be observed that FNA FC can correctly diagnose B-cell lymphoma in most cases, but it is a poor diagnostic tool especially for Hodgkin lymphoma in this setting as only a four-color flow cytometer was available for diagnosis. Moreover, FNA FC diagnosis of reactive adenopathy and of no abnormalities detected was shown to frequently hide a malignant disease. Conclusion: In countries with scarce resources, FNA FC represents a useful diagnostic tool in the case of B-cell lymphoma, but may misdiagnose reactive adenopathy. Thus, FNA FC should be used in a case-specific manner, in addition to as a screening tool, with the knowledge that in cases with a high clinical suspicion of lymphoma, histological diagnosis is a necessity.
Collapse
Affiliation(s)
- Carla Griesel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Minodora Desmirean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Pathology, Constantin Papilian Military Hospital, 400001 Cluj Napoca, Romania
| | - Tonya Esterhuizen
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Sergiu Pasca
- Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania;
| | - Bobe Petrushev
- Department of Pathology, Octavian Fodor Regional Institute for Gastroenterology, 400111 Cluj Napoca, Romania;
| | - Cristina Selicean
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Andrei Roman
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania
| | - Bogdan Fetica
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Patric Teodorescu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
| | - Carmen Swanepoel
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
| | - Ciprian Tomuleasa
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 400124 Cluj Napoca, Romania; (M.D.)
- Department of Hematology, Ion Chiricuta Clinical Cancer Center, 400015 Cluj Napoca, Romania
- Correspondence:
| | - Ravnit Grewal
- National Health Laboratory Services, Tygerberg Hospital, Cape Town 7505, South Africa; (C.G.); (T.E.); (C.S.); (R.G.)
- Faculty of Natural Sciences, University of Western Cape, Belville 7535, South Africa
- The South African National Bioinformatics Institute, Medical Research Council, University of the Western Cape, Belville 7535, South Africa
| |
Collapse
|