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Ravi S, Devi AK, Manivannan P, Gochhait D, Kar R, Siddaraju N. The urgency of Burkitt lymphoma diagnosis in fluid cytology-A tertiary care experience. Cytopathology 2024; 35:275-282. [PMID: 38095270 DOI: 10.1111/cyt.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/04/2023] [Accepted: 11/25/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Burkitt lymphoma (BL) is an aggressive high-grade B-cell non-Hodgkin lymphoma commonly diagnosed in young age and is known to involve extra nodal sites. But the involvement of body fluids by BL is an uncommon presentation. Rapid diagnosis of BL is vital to prevent complications like tumour lysis syndrome. Cytological examination of body fluids continues to be an indispensable tool for rapid diagnosis of BL. OBJECTIVES In this study, we aim to study the clinical, cytomorphological and immunophenotypic characteristics of BL involving serous effusions and other fluids. MATERIALS AND METHODS In this retrospective study, 17 cases reported as BL in fluid cytology from 2016 to 2022 were collected and reviewed. We performed a comprehensive analysis of the clinical data, cytomorphological features, immunophenotyping data along with the haematological workup of these cases. We have also compared with the histopathological diagnosis for those cases where biopsy was available. RESULTS BL more commonly involved ascitic fluid (52%), followed by pleural fluid (4 cases) and cerebrospinal fluid (CSF; 4 cases). Primary diagnosis of BL in fluid was done in 88% of the cases. Bone marrow involvement was noted in two cases. Cytological smears showed discrete monomorphous population of medium-sized atypical lymphoid cells with frequent apoptotic bodies. Classic cytoplasmic punched out vacuoles were observed in 88% of the cases. Immunophenotyping data was available for 12 cases in which tumour cells showed positivity for CD20 (100%), CD10 (4 of 7 cases), BCL6 (3 of 5 cases) and cMYC (7 of 7 cases-100%) and were negative for Terminal deoxynucleotidyl transferase (TdT) (11 of 11 cases). Mean Ki67 labelling index was 95%. Histopathological diagnosis was available for 9 cases, and there was 100% agreement between cytological and histopathological diagnosis in 7 cases. CONCLUSION Precise diagnosis of BL can be rendered in body fluids by identification of classic cytomorphological features and by performing supportive ancillary tests in fluids for immunophenotyping.
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Affiliation(s)
- Soundarya Ravi
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Anu K Devi
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Prabhu Manivannan
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Debasis Gochhait
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Rakhee Kar
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Neelaiah Siddaraju
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Gochhait D, Patel B, Jinkala S, Rangarajan V, Kannan N, Durgadevi S, Siddaraju N. Preliminary cytomorphologic diagnosis of hematolymphoid malignancies in effusions: A cyto-histo correlation with lessons on restraint. J Cytol 2022; 39:59-65. [PMID: 35814877 PMCID: PMC9262001 DOI: 10.4103/joc.joc_204_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Effusions as part of hematologic neoplasms are rare and as a primary presentation, rarer. In standalone laboratories of developing countries, resorting to techniques such as flow cytometry or immunohisto/cytochemistry may not be possible. A near definitive diagnosis on cytomorphology would, therefore, be an ideal beginning. To that end, we compiled our cases of primary hematolymphoid effusions, devising reproducible reporting categories and looked at their concordance with the final histopathology. Subjects and Methods: Fifty-four cases of primary hematolymphoid effusions over 10 years with cytology-histopathology correlation were chosen. Post morphology assessment, the cases were organized into six categories: suspicious of hematolymphoid malignancy, non-Hodgkin lymphoma-high-grade (NHL-HG), low-grade NHL (NHL-LG), Burkitt lymphoma, acute leukemias, and plasma cell dyscrasias. Discordance with histology was assigned as major and minor based mainly on therapeutic implications. Results: Concordance was seen in a good number (81.5%) of cases. The NHL-HG and NHL-LG categories contributed to 33.3% each of major discordance. Tuberculosis and epithelial malignancies comprised the bulk of the major discordance. Overdiagnosis of a high-grade lymphoma for a histologically proven low-grade follicular lymphoma was the only case with minor discordance. Conclusion: The cytologic categories used are not foolproof for hematologic neoplasms but have a fairly good concordance. A scanty abnormal population should always be viewed with suspicion and definitive labels should be avoided. While morphologic examination is fraught with danger, a good assessment directs the judicious selection of ancillary methods, and hence cannot be supplanted.
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Sukumaran R, Nayak N, Nair RA, Kattoor J, Jacob PM, Narayanan G, Thankamony P. Hematolymphoid Neoplasms in Serous Effusions: Morphological Spectrum, Distribution, and Role of Ancillary Techniques—A Retrospective Analysis of 75 cases. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1731844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction Involvement of body fluids can occur at the time of diagnosis or during the disease course of hematolymphoid neoplasms. Cytodiagnosis of malignant effusion is important in effective clinical management.
Objectives (1) The aims of the study were to determine the frequency of distribution of various hematolymphoid neoplasms involving body fluids, (2) to study the morphology of hematolymphoid neoplasms in fluids, and (3) to assess the role of ancillary techniques in the diagnosis.
Materials and Methods In this retrospective study, all cases of hematolymphoid neoplasms involving body fluids diagnosed from January 2016 to December 2018 were evaluated.
Results During the 3-year period, there were 75 cases of hematological malignancies involving body fluids. These included 48 male patients and 27 female patients. Pleural fluid was involved in majority of cases (56 cases; 74.67%), followed by ascitic fluid (17 cases; 22.67%), and pericardial fluid (2 cases; 2.67%). High cellularity, monotonous population of cells, high nuclear-cytoplasmic (N/C) ratio, indentation/irregularity of nuclear membrane, immature chromatin/irregular clumping of chromatin, increased mitosis, and karyorrhexis were the key features which helped to differentiate between reactive and neoplastic processes. There were 35 cases of B-cell neoplasms, 33 cases of T-cell neoplasms, and seven cases of myeloid neoplasms involving body cavity fluids. T-lymphoblastic lymphoma was the most common subtype (29 cases; 38.7%), followed by diffuse large B-cell lymphoma (DLBCL) (12 cases; 16%). In 53 cases, effusion was present in the initial presentation itself. Initial diagnosis was made in effusion cytology in 25 cases (33.33% of the total), with the help of flow cytometry in 20 cases, and immunohistochemistry (IHC) in cell blocks in five cases.
Conclusion Diagnosis of hematolymphoid neoplasms in body fluids based on correlation with clinical details, critical evaluation of cytology findings, and comparison with previous diagnosis along with the judicious use of ancillary techniques helps in deciding an early treatment plan.
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Affiliation(s)
- Renu Sukumaran
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Nileena Nayak
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Rekha A. Nair
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Jayasree Kattoor
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Priya Mary Jacob
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Geetha Narayanan
- Department of Medical Oncology, Regional Cancer, Centre, Thiruvananthapuram, Kerala, India
| | - Priyakumari Thankamony
- Department of Paediatric Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Wang X, Li X, Ding J, Long X, Zhang H, Zhang X, Jiang X, Xu T. 3D bioprinted glioma microenvironment for glioma vascularization. J Biomed Mater Res A 2020; 109:915-925. [PMID: 32779363 DOI: 10.1002/jbm.a.37082] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/16/2022]
Abstract
Glioblastoma is the most frequently diagnosed primary malignant brain tumor with unfavourable prognosis and high mortality. One of its key features is the extensive abnormal vascular network. Up to now, the mechanism of angiogenesis and the origin of tumor vascularization remain controversial. It is essential to establish an ideal preclinical tumor model to elucidate the mechanism of tumor vascularization, and the role of tumor cells in this process. In this study, both U118 cell and GSC23 cell exhibited good printability and cell proliferation. Compared with 3D-U118, 3D-GSC23 had a greater ability to form cell spheroids, to secrete vascular endothelial growth factor (VEGFA), and to form tubule-like structures in vitro. More importantly, 3D-glioma stem cells (GSC)23 cells had a greater power to transdifferentiate into functional endothelial cells, and blood vessels composed of tumor cells with an abnormal endothelial phenotype was observed in vivo. In summary, 3D bioprinted hydrogel scaffold provided a suitable tumor microenvironment (TME) for glioma cells and GSCs. This bioprinted model supported a novel TME for the research of glioma cells, especially GSCs in glioma vascularization and therapeutic targeting of tumor angiogenesis.
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Affiliation(s)
- Xuanzhi Wang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China
| | - Xinda Li
- Department of Mechanical Engineering, Biomanufacturing Center, Tsinghua University, Beijing, China
| | - Jinju Ding
- Center for Medical Device Evaluation, National Medical Products Administration, Beijing, China
| | - Xiaoyan Long
- Department of research and development, East China Institute of Digital Medical Engineering, Shangrao, People's Republic of China
| | - Haitao Zhang
- Department of research and development, East China Institute of Digital Medical Engineering, Shangrao, People's Republic of China
| | - Xinzhi Zhang
- Department of research and development, Medprin Regenerative Medical Technologies Co., Ltd, Shenzhen, People's Republic of China
| | - Xiaochun Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China
| | - Tao Xu
- Department of Mechanical Engineering, Biomanufacturing Center, Tsinghua University, Beijing, China.,Department of Precision Medicine and Healthcare, Tsinghua-Berkeley Shenzhen Institute, Shenzhen, China
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Diagnostic impact of ascites cytology in 941 patients: malignancy rates and time of detection in ovarian cancer relative to other tumor types. Arch Gynecol Obstet 2020; 301:1521-1532. [PMID: 32347356 DOI: 10.1007/s00404-020-05553-y] [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: 12/20/2019] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Cytological analysis of ascitic fluid is an important tool for diagnosis, staging, and prognostic assessment in patients with cancer, but more detailed information is needed regarding malignancy rates and the time sequence in which ascites develops for different sites of cancer origin. Especially, an increased early tumor diagnosis may improve the acceptance for cytological examinations for the tumor patients in oncological practice. METHODS Ascites specimens from patients who were treated at Bayreuth Hospital from 2006 to 2015 were reevaluated retrospectively and correlated with clinical reports. RESULTS 580 of all 941 ascitis specimens (61.6%) were from patients with malignancies with predominant appearance of gastrointestinal and gynecological tumors in 516/580 (89%) patients. Histologically, 549 (94.6%) were carcinomas, 23 (4%) hematological malignancies, 5 (0.9%) mesotheliomas and 3 (0.5%) were melanomas. Malignant ascitic fluid was noted in 298 of the 580 (51.4%) patients with cancer, thus the overall malignancy rate in the ascites specimens examined was 298/941 (31.7%). The most frequent malignancy rate for gynecological tumors we obtained in ovarian cancer with 85.7% and in the upper gastrointestinal tract with 77.8% for Barrett's carcinoma and 61,4% for gastric carcinoma. Regarding time of detection, malignant ascitic fluid was noted as a separate finding, prior or simultaneous to the histological diagnosis of cancer in 225/298 patients (75.5%). An outstanding earliest occurrence was found in ovarian carcinoma in 94.9% and in the gastrointestinal tract in pancreatic carcinoma in 66.7%. CONCLUSIONS Tumor staging was the main important clinical question in our single center study of ascitic fluid, especially for patients with gastrointestinal and gynecological malignomas. The highest malignancy rate and earliest time of tumor detection caused the leading importance for ovarian tumors in malignant ascitic fluid. Moreover, the application of immunostains in our study allowed in 75.5% of all tumor patients a correct initial diagnosis, which is important for further clinical therapy.
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Hsiao CH, Yao CJ, Lai GM, Lee LM, Whang-Peng J, Shih PH. Honokiol induces apoptotic cell death by oxidative burst and mitochondrial hyperpolarization of bladder cancer cells. Exp Ther Med 2019; 17:4213-4222. [PMID: 30988795 DOI: 10.3892/etm.2019.7419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/07/2019] [Indexed: 12/20/2022] Open
Abstract
Bladder cancer is one of the most common types of malignant tumor worldwide. Current treatments, including chemo-/radiotherapy, only have limited efficacy on bladder cancer progression. Honokiol is an active component of Magnolia officinalis with multiple biological effects that may provide promising health benefits. In the present study, the anti-cancer properties of honokiol against bladder cancer cells were investigated by flow cytometric analysis. The results revealed that honokiol exhibited significant anti-proliferative effects on bladder cancer cell lines, particularly on BFTC-905 human transitional cell carcinoma cells. Furthermore, honokiol at low doses (≤25 µM) induced cell cycle arrest in G0/G1 phase, while it induced significant apoptotic cell death at high doses (≥50 µM; P<0.05). Furthermore, a significant accumulation of reactive oxygen species was identified in honokiol-treated cells. In addition, honokiol induced hyperpolarization of the mitochondrial membrane, which may lead to mitochondrial dysfunction. Finally, caspase-3/7 activation was identified in high-dose honokiol-treated bladder cancer cells. These results suggest that honokiol induces apoptosis via the mitochondrial pathway and honokiol-containing traditional herbal remedies may have a potential clinical application in the treatment of bladder cancer.
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Affiliation(s)
- Chi-Hao Hsiao
- Department of Urology, Wan Fang Hospital, Taipei 11696, Taiwan R.O.C.,Department of Urology, School of Medicine, College of Medicine, Taipei 11031, Taiwan R.O.C.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei 11031, Taiwan R.O.C
| | - Chih-Jung Yao
- Cancer Center, Wan Fang Hospital, Taipei 11696, Taiwan R.O.C.,Center of Excellence for Cancer Research, Taipei Medical University, Taipei 11031, Taiwan R.O.C
| | - Gi-Ming Lai
- Cancer Center, Wan Fang Hospital, Taipei 11696, Taiwan R.O.C.,Center of Excellence for Cancer Research, Taipei Medical University, Taipei 11031, Taiwan R.O.C
| | - Liang-Ming Lee
- Department of Urology, Wan Fang Hospital, Taipei 11696, Taiwan R.O.C.,Department of Urology, School of Medicine, College of Medicine, Taipei 11031, Taiwan R.O.C
| | - Jacqueline Whang-Peng
- Cancer Center, Wan Fang Hospital, Taipei 11696, Taiwan R.O.C.,Center of Excellence for Cancer Research, Taipei Medical University, Taipei 11031, Taiwan R.O.C
| | - Ping-Hsiao Shih
- Center for Cell Therapy, Department of Medical Research, China Medical University Hospital, Taichung 40447, Taiwan R.O.C
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