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Fathima SD, Gururaj N, Sivapathasundharam B, Vennila AA, Keerthik Lavanya MK, Sarayushivani U. Histopathological significance of necrosis in oral lesions: A review. J Oral Maxillofac Pathol 2023; 27:340-347. [PMID: 37854904 PMCID: PMC10581306 DOI: 10.4103/jomfp.jomfp_39_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 10/20/2023] Open
Abstract
Necrosis is a localized area of tissue death followed by degradation of tissue by hydrolytic enzymes released from the dead cells, resulting in swelling of organelles, rupture of the plasma membrane, eventual cell lysis, and leakage of intracellular contents into the surrounding tissue. It is always accompanied by an inflammatory reaction. Necrosis is caused by various factors such as hypoxia, physical factors, chemical agents, immunological agents, and microbial agents. Still now, there is no literature review regarding the necrotic lesions of the oral cavity. In this paper, the oral lesions associated with necrosis are categorized under the headings such as odontogenic cysts, odontogenic tumors, salivary gland pathology, and epithelial malignancies. In addition, the histopathological significance of necrosis in oral lesions has been discussed. By suggesting that spotting necrosis in the histopathology aids in determining the diagnosis, tumor behavior, and prognosis of oral lesions.
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Affiliation(s)
- S Deenul Fathima
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
| | - N Gururaj
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
| | - B Sivapathasundharam
- Department of Oral and Maxillofacial Pathology, Priyadharshini Dental College and Hospital, Pandur, Tamil Nadu, India
| | - A Alagu Vennila
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
| | - M. K. Keerthik Lavanya
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
| | - U Sarayushivani
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
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Necrotizing Follicular Lymphoma of the Inguinal Region with Sternbergoid Cells: Clinical–Pathological Features of a Challenging Entity. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Follicular lymphoma (FL) is one of the most common B-cell malignancies worldwide. While the diagnosis of conventional cases is straightforward, rare clinical–pathological variants may be challenging due to their misleading morphology, aberrant phenotype and/or atypical presentation. To add to the spectrum of unusual FLs, we report on a rare disease pattern characterized by (i) inguinal presentation, (ii) massive necrosis, (iii) Hodgkin/Reed–Sternberg (HRS)-like cells, and (iv) adjacent areas of diffuse large B-cell lymphoma evolution. All cases occurred in elderly patients (median age at diagnosis: 69.5 years), disclosed a low stage at diagnosis (Ann Arbor stage IA-IIA), and had deceiving clinical features. Despite the alarming histology, excellent responses to conventional therapies were reported in all patients. In conclusion, necrotizing FL of the inguinal region is a rare neoplasm characterized by peculiar clinical and histological features. This lymphoma should always be considered in the differential diagnosis of massively necrotic inguinal lesions.
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Abstract
PURPOSE OF REVIEW Imaging features of lymphoma vary regionally. Awareness of site-specific key imaging characteristics of lymphoma can aid in rapid staging and assist in prompt treatment. FDG PET/CT and conventional MRI are readily available diagnostic modalities with excellent sensitivity and good specificity. Diagnostic specificity can be enhanced using emerging PET radiotracers, e.g., FLT and FET. RECENT FINDINGS Emerging research has shown higher dimensional analysis (radiomics and radiogenomics) of imaging data can yield information of the underlying genetic aberrations in lymphoma, which can aid in assessing real-time evolution of tumor. CT, PET/CT, MRI, and ultrasound accentuate the intrinsic qualities of lymphoma (e.g., FDG PET/CT for increased metabolic activity, FLT PET/CT for increased proliferation index, and DWI for increased cellularity) and play an essential role in its diagnosis and examination. Advanced radiogenomic analyses use radiomic parameters to deduce genetic variations of lymphoma, providing noninvasive, repeatable, and real-time surveillance of its genetic progression.
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Prieto Prieto JC, Vallejo Casas JA, Hatzimichael E, Fotopoulos A, Kiortsis DN, Sioka C. The contribution of metabolic parameters of FDG PET/CT prior and during therapy of adult patients with lymphomas. Ann Nucl Med 2020; 34:707-717. [DOI: 10.1007/s12149-020-01521-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
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Di QS, Xu T, Song Y, Zuo ZG, Cao FJ, Yu XJ, Tang JY, Zhang W, Li C, Wan GX, Cai XJ. High C-Reactive Protein to Albumin Ratio Predicts Inferior Clinical Outcomes in Extranodal Natural Killer T-Cell Lymphoma. Dose Response 2020; 18:1559325820917824. [PMID: 32284703 PMCID: PMC7139182 DOI: 10.1177/1559325820917824] [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: 11/05/2019] [Revised: 02/26/2020] [Accepted: 03/11/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: The prognostic value of C-reactive protein to albumin ratio (CAR) has been
identified in several cancers but not in extranodal natural killer T-cell
lymphoma (ENKTL) as yet. We aimed to evaluate the prognostic value of CAR in
ENKTL. Methods: A retrospective study with 246 patients with ENKTL was performed to determine
the prognostic value of pretreatment CAR and examine the prognostic
performance of CAR incorporating with International Prognostic Index (IPI)
or natural killer/T-cell lymphoma prognostic index (NKPI) by nomogram. Results: The Cox regression analyses showed that high CAR (>0.3) independently
predicted unfavorable progression-free survival (PFS, P =
.011) and overall survival (OS, P = .012). In the
stratification analysis, the CAR was able to separate patients into
different prognoses regarding both OS and PFS in Ann Arbor stage I+II as
well as III+IV, IPI score 0 to 1, and NKPI score 1 to 2 subgroups (all
P < .05). Additionally, the predictive accuracy of
the IPI-based nomogram incorporating CAR, albumin to globulin ratio (AGR),
and IPI for OS and PFS appeared to be lower than the NKPI-based nomogram
incorporating CAR, age, AGR, extranodal site, and NKPI. Conclusion: Pretreatment CAR is a simple and easily accessible parameter for
independently predicting OS and PFS in patients with ENKTL.
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Affiliation(s)
- Quan-Shu Di
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Tao Xu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ying Song
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Zhi-Gang Zuo
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Feng-Jun Cao
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiong-Jie Yu
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Ji-Ying Tang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Wei Zhang
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Chen Li
- Laboratory of Medicinal Plant, Institute of Basic Medical Sciences, School of Basic Medicine, Hubei University of Medicine, Shiyan, Hubei, China.,Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Biomedical Research Institute, Hubei University of Medicine, Shiyan, Hubei, China
| | - Guo-Xing Wan
- Department of Oncology, Renmin Hospital, Hubei, China
| | - Xiao-Jun Cai
- Department of Oncology, Renmin Hospital, Hubei, China
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Wang G, Chang Y, Wu X, Li X, Li L, Zhang M. Prognostic nomogram for overall survival in upper aerodigestive tract extranodal natural killer/T-cell lymphoma, nasal type, stages IE and IIE: A SEER-based study. Oncol Lett 2019; 18:3493-3500. [PMID: 31516567 PMCID: PMC6732941 DOI: 10.3892/ol.2019.10719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/13/2019] [Indexed: 12/19/2022] Open
Abstract
The present study aimed to develop a widely accepted prognostic nomogram for stage IE and IIE extranodal natural killer/T-cell lymphoma (ENKTCL) of the upper aerodigestive tract by using the Surveillance, Epidemiology, and End Results program database. A total of 396 patients with ENKTCL were included in the present study and were divided into training (n=280) and validation (n=116) cohorts. The Kaplan-Meier method and Cox regression model were used to evaluate the prognostic value of multiple clinical parameters on overall survival. The C-index and calibration curves were both used to determine the predictive and discriminatory capacities of the nomogram. In the training cohort, multivariate analysis demonstrated that age, primary site, radiation therapy and stage were independent prognostic factors. Nomograms with a C-index of 0.717 in the training cohort and a C-index of 0.737 in the validation cohort were developed. The calibration curves reported excellent consistency between predicted and real survival in patients with ENKTCL. In addition, a subgroup analysis of 264 patients who were receiving chemotherapy revealed that based on chemotherapy, supplementation with radiation therapy was significantly beneficial to patients survival. In conclusion, the present study demonstrated that this prognostic model may serve as a novel tool for improving prediction of survival outcomes and may therefore be used in clinical applications.
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Affiliation(s)
- Gangjian Wang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Yu Chang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Xiaolong Wu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Xin Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Ling Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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Kahle XU, Montes de Jesus FM, Kwee TC, van Meerten T, Diepstra A, Rosati S, Glaudemans AWJM, Noordzij W, Plattel WJ, Nijland M. Relationship between semiquantitative 18F-fluorodeoxyglucose positron emission tomography metrics and necrosis in classical Hodgkin lymphoma. Sci Rep 2019; 9:11073. [PMID: 31363153 PMCID: PMC6667466 DOI: 10.1038/s41598-019-47453-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 07/16/2019] [Indexed: 11/08/2022] Open
Abstract
Semiquantitative 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) parameters have been proposed as prognostic markers in classical Hodgkin lymphoma (cHL). In non-Hodgkin lymphoma necrosis as assessed by 18F-FDG PET or computed tomography (CT) (necrosisvisual) correlates with an adverse prognosis. We investigated whether semiquantitative 18F-FDG PET metrics correlate with necrosisvisual, determined the incidence of necrosisvisual and explored the prognostic impact of these factors in cHL. From 87 cHL cases treated with ABVD, (escalated) BEACOPP or CHOP chemotherapy between 2010 and 2017, 71 had both a NEDPAS/EARL accredited 18F-FDG PET and a contrast enhanced CT scan. Semiquantitative 18F-FDG PET parameters were determined using Hermes Hybrid 3D software. Necrosisvisual, defined by photopenic tumor areas on 18F-FDG PET and attenuation values between 10 and 30 Hounsfield units (HUs) on CT, was assessed blinded to outcome. Univariate Cox regression survival analyses of progression free survival (PFS) were performed. Necrosisvisual was observed in 18.3% of cHL patients. Bulky disease (tumor mass >10 cm in any direction) (P = 0.002) and TLG (P = 0.041) but no other semiquantitative parameters were significantly associated with necrosisvisual. In exploratory univariate survival analysis for PFS the covariates IPS, bulky disease, MTV and TLG were prognostic, while necrosisvisual was not.
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Affiliation(s)
- X U Kahle
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - F M Montes de Jesus
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T C Kwee
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T van Meerten
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A Diepstra
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S Rosati
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W Noordzij
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W J Plattel
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Nijland
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Guo B, Tan X, Ke Q, Cen H. Prognostic value of baseline metabolic tumor volume and total lesion glycolysis in patients with lymphoma: A meta-analysis. PLoS One 2019; 14:e0210224. [PMID: 30625203 PMCID: PMC6326501 DOI: 10.1371/journal.pone.0210224] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/17/2018] [Indexed: 01/11/2023] Open
Abstract
Whether baseline metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured by FDG-PET/CT affected prognosis of patients with lymphoma was controversial. We searched PubMed, EMBASE and Cochrane to identify studies assessing the effect of baseline TMTV and TLG on the survival of lymphoma patients. Pooled hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) were calculated, along with 95% confidence intervals (CI). Twenty-seven eligible studies including 2,729 patients were analysed. Patients with high baseline TMTV showed a worse prognosis with an HR of 3.05 (95% CI 2.55–3.64, p<0.00001) for PFS and an HR of 3.07 (95% CI 2.47–3.82, p<0.00001) for OS. Patients with high baseline TLG also showed a worse prognosis with an HR of 3.44 (95% CI 2.37–5.01, p<0.00001) for PFS and an HR of 3.08 (95% CI 1.84–5.16, p<0.00001) for OS. A high baseline TMTV was significantly associated with worse survival in DLBCL patients treated with R-CHOP (OS, pooled HR = 3.52; PFS, pooled HR = 2.93). A high baseline TLG was significantly associated with worse survival in DLBCL patients treated with R-CHOP (OS, pooled HR = 3.06; PFS, pooled HR = 2.93). The negative effect of high baseline TMTV on PFS was demonstrated in HL (pooled HR = 3.89). A high baseline TMTV was significantly associated with worse survival in ENKL patients (OS, pooled HR = 2.24; PFS, pooled HR = 3.25). A high baseline TLG was significantly associated with worse survival in ENKL patients (OS, pooled HR = 2.58; PFS, pooled HR = 2.99). High baseline TMTV or TLG predict significantly worse PFS and OS in patients with lymphoma. Future studies are warranted to explore whether TMTV or TLG could be integrated into various prognostic models for clinical decision making.
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Affiliation(s)
- Baoping Guo
- Department of Chemotherapy, Guangxi Cancer Hospital and of Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, People’s Republic of China
| | - Xiaohong Tan
- Department of Chemotherapy, Guangxi Cancer Hospital and of Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, People’s Republic of China
| | - Qing Ke
- Department of Chemotherapy, Guangxi Cancer Hospital and of Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, People’s Republic of China
| | - Hong Cen
- Department of Chemotherapy, Guangxi Cancer Hospital and of Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, People’s Republic of China
- * E-mail:
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