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Sharma V, Bagrodia V. Fungating nasal mass as a rare presenting manifestation of relapsed mantle cell lymphoma. BMJ Case Rep 2023; 16:e256156. [PMID: 37748816 PMCID: PMC10533649 DOI: 10.1136/bcr-2023-256156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Affiliation(s)
- Vishnu Sharma
- Department of General Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - Vansh Bagrodia
- Department of General Medicine, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
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Lee FC, Chang JL, Chen HM, Tsai WC, Hsiao PJ. Mantle Cell Lymphoma Presenting as Acute Abdominal Syndrome: A Rare Case Report and Literature Review. Healthcare (Basel) 2021; 9:1000. [PMID: 34442137 PMCID: PMC8391909 DOI: 10.3390/healthcare9081000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Acute abdominal syndrome can be caused by several possible reasons. The most common causes are perforation of a gastroduodenal ulcer, peritonitis, intestinal obstructions, and perforation of an appendix or fallopian tube. Fever and pain can be caused by an appendicitis or sigmoiditis. Appendiceal lymphoma is a rare disease that is usually found incidentally during appendectomy. Most of the cases are non-Hodgkin's lymphomas. Mantle cell lymphoma is an aggressive B-cell non-Hodgkin's lymphoma with a poorer prognosis than other B-cell lymphomas; thus, a definitive diagnosis is essential. CASE SUMMARY A 60-year-old man presented with right lower quadrant pain. He denied any nausea, vomiting or anorexia and was afebrile. The physical examination revealed right lower quadrant abdomen tenderness. The computed tomography scan revealed periappendiceal fatty stranding with a swollen appendix, approximately 2 cm in diameter and prominent paraaortic, portacaval and mesenteric lymph nodes. A diagnosis of acute appendicitis was made, and laparoscopic appendectomy was performed immediately. The subsequent pathological examination revealed severe congestion with lymphoid hyperplasia. The immunohistochemistry stains revealed positive staining for cluster of differentiation (CD) CD20, B-cell lymphoma-2 (Bcl-2), cyclin D1, SRY-box transcription factor-11 (SOX-11), immunoglobulin D (IgD) and immunoglobulin M (IgM) but negative staining for CD3, CD5, CD10 and CD23. 18F-FDG positron emission tomography showed peripheral lymph node involvement, while the bone marrow biopsy showed negative findings. Therefore, a diagnosis of mantle cell lymphoma, Ann Arbor stage IVA, was made. The patient received postoperative combination chemotherapy and remained in a stable condition over a 1-year follow-up period. CONCLUSION We report an uncommon case that initially presented as acute appendicitis, for which a final diagnosis of mantle cell lymphoma was made. In comparison with other B-cell lymphomas, mantle cell lymphoma has a poorer prognosis, and positive immunochemical staining of cyclin D1 and SOX-11 is useful for differentiating mantle cell lymphoma from other appendiceal lymphomas and treating patients appropriately. Physicians and nursing staff should be also aware of the associated complications and management in these patients.
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Affiliation(s)
- Fu-Chou Lee
- Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan;
| | - Junn-Liang Chang
- Department of Pathology and Laboratory Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan;
| | - Hung-Ming Chen
- Division of Hematology and Oncology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan;
- Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wan-Chen Tsai
- Division of General Surgery, Department of Surgery, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan;
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
- Department of Life Sciences, National Central University, Taoyuan 325, Taiwan
- Big Data Research Center, Fu-Jen Catholic University, New Taipei City 242, Taiwan
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Small S, Barnea Slonim L, Williams C, Karmali R. B Cell Lymphomas of the GI Tract. Curr Gastroenterol Rep 2021; 23:9. [PMID: 33963950 DOI: 10.1007/s11894-021-00811-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE OF THE REVIEW Primary GI lymphomas of B cell origin are a diverse group of lymphomas. In this article, we provide an overview of the diagnosis, pathologic and molecular features, and management of these varied lymphomas. RECENT FINDINGS The most common primary GI lymphomas are diffuse large B cell lymphoma (DLBCL) and marginal zone lymphomas (MZL), but follicular lymphomas (FL), mantle cell lymphomas (MCL), post-transplant lymphoproliferative disorders (PTLD), and Burkitt lymphoma of the GI tract also occur. Many features of these lymphomas are similar to their nodal counterparts, but certain clinical and biological aspects are unique. Diagnostic and treatment strategies for these lymphomas continue to evolve over time. There are ongoing discoveries about the unique pathophysiology, molecular characteristics, and complications of primary B cell GI lymphomas that are already leading to improvements in management of this histologically diverse set of lymphomas.
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Affiliation(s)
- Sara Small
- Division of Hematology/Oncology, Northwestern University, Chicago, IL, USA
| | | | - Corinne Williams
- Robert H. Lurie Comprehensive Cancer Center, 675 N. St. Clair St.Fl 21 Ste. 100, Chicago, IL, 60611, USA
| | - Reem Karmali
- Division of Hematology/Oncology, Northwestern University, Chicago, IL, USA.
- Robert H. Lurie Comprehensive Cancer Center, 675 N. St. Clair St.Fl 21 Ste. 100, Chicago, IL, 60611, USA.
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Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement. Nucl Med Commun 2021; 41:540-549. [PMID: 32209829 DOI: 10.1097/mnm.0000000000001182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In patients with non-Hodgkin lymphoma (NHL), we investigated F FDG PET/computed tomography (CT) parameters, clinical findings, laboratory parameters, and bone marrow involvement (BMI) status for predictive methods in progression-free survival (PFS) and overall survival (OS), and whether F FDG PET/CT could take the place of bone marrow biopsy (BMB). METHODS The performance of F FDG PET/CT (BMPET) was evaluated. The prognostic value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), stage, international prognostic index (IPI) score, IPI risk, lactate dehydrogenase (LDH), B2 microglobulin, Ki67 proliferation index, and the presence of BMI was evaluated for OS and PFS. Kaplan-Meier curves were drawn for each designated cutoff value, and 5-year PFS and 7-year OS were evaluated using log-rank analysis. RESULTS The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BMPET and BMB to identify BMI were 69, 100, 86.1, 80, 100%, and 81.6, 100, 92.5, 89, 100%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of BMPET in patients with Ki67- proliferation index >25% were all 100%. BMPET, IPI risk, MTV, and LDH were found to be independent prognostic predictors for PFS, whereas BMPET, SUVmax, and MTV for OS. Five-year PFS analysis estimated as follows: BMPET (+) = 22%, BMPET (-) = 80%, LDH ≤ 437 (U/L) = 86%, LDH > 437 (U/L) = 51%, MTV ≤ 56 (cm) = 87%, MTV > 56 (cm) = 49%, low IPI risk = 87%, intermediate IPI risk = 69%, high IPI risk = 25%. Seven-year OS analysis was found as: SUVmax ≤ 17.6 = 80%, SUVmax > 17.6 = 48%, MTV ≤ 56 (cm) = 84.4%, MTV > 56 (cm) = 45.8%, BMPET (-) = 72.5%, BMPET (+) = 42%. CONCLUSION In the Ki-67 proliferation index > 25% group, F FDG PET/CT was able to differentiate BMI independently from NHL subgroups. We recommend using this method with large patient groups. MTV and BMPET were independent prognostic indicators for OS and PFS and may help to determine high-risk patients.
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Zhao Y, Shi F, Zhou Q, Li Y, Wu J, Wang R, Song Q. Prognostic significance of PD-L1 in advanced non-small cell lung carcinoma. Medicine (Baltimore) 2020; 99:e23172. [PMID: 33158004 PMCID: PMC7647545 DOI: 10.1097/md.0000000000023172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This study aimed to investigate the prognostic value of PD-L1 in Chinese patients with non-small cell lung carcinoma (NSCLC).In this retrospective study, 97 patients with NSCLC were consecutively recruited. The expression profiling of PD-1, PD-L1, p53 and Ki-67 was detected by immunohistochemistry. Median survival time was estimated by Kaplan-Meier survival curve with log-rank test. Risk factors were evaluated by Cox Proportional Hazards regression models.The median tumor size was larger (3.5 cm) among patients with positive PD-L1 expression, compared to those with negative expression (2.0 cm; P < .01). Compared to those with negative PD-L1 expression, patients with positive PD-L1 expression had significantly higher rates of nerve invasion (26.3% vs 5.0%; P < .01), blood vessel invasion (47.4% vs 20.0%; P < .01) and lymph node metastasis (64.9% vs 27.5%; P < .01), more advanced tumor stage (P < .01) and Ki-67 index (P < .01). PD-L1 expression status was not significantly associated with disease-free (DFS) or overall survival (OS). However, for patients with advanced disease, PD-L1 positive expression was related to worse outcome (HR: 4.13; 95% CI: 1.06-16.12).Positive PD-L1 expression is associated with more aggressive pathological features and poorer prognosis in advanced stage NSCLC.
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Affiliation(s)
- Yanjie Zhao
- Department of Medical Oncology
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Feng Shi
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University
| | - Quan Zhou
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yuchen Li
- Beijing Key Laboratory of Therapeutic Vaccines
| | | | | | - Qingkun Song
- Department of Clinical Epidemiology and Evidence-based Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Zohdy M, Abd El hafez A, Abd Allah MYY, Bessar H, Refat S. Ki67 and CD31 Differential Expression in Cutaneous T-Cell Lymphoma and Its Mimickers: Association with Clinicopathological Criteria and Disease Advancement. Clin Cosmet Investig Dermatol 2020; 13:431-442. [PMID: 32606882 PMCID: PMC7320895 DOI: 10.2147/ccid.s256269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/04/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cell proliferation and angiogenesis are important in progression of cancerous processes. Differentiating cutaneous T-cell lymphoma (CTCL) from its mimicking dermatoses and prognosticating it are challenging. AIM This study assesses cell proliferation and angiogenesis in different CTCL subtypes using immunohistochemistry (IHC) for Ki67 and CD31 to testify their usability in differentiating CTCL from mimicking dermatoses and discriminating CTCL subtypes from each other with correlation to clinicopathological parameters and disease advancement. PATIENTS AND METHODS IHC for Ki67 and CD31 were applied to skin biopsies from 81 patients divided into CTCL (n=59) and dermatoses (n=22) groups. Hot-spot analysis was used to score Ki67 and CD31 microvascular density (MVD) semiquantitatively. Statistical analysis was performed to compare Ki67 index and MVD between CTCL and dermatoses. CTCL subgroups were compared to each other. Ki67 index and CD31 were compared to age, gender, skin and nodal involvement, blood tumor burden and TNMB stage. RESULTS AND CONCLUSION There were significant differences in proliferation index and MVD between dermatoses and CTCL, and between dermatoses and all CTCL subtypes with exception of Ki67 in early mycosis fungoides (MF) and CD31 in patch lesions. Increased cell proliferation and MVD were significantly associated with older age, T3 and 4 skin involvement, significant nodes (N1-3), positive blood tumor burden (B1,2) in CTCL and TNMB stage of MF. Both markers differentiated significantly late from early MF, classic MF from its variants and non-MF CTCL from total MF, but not from late MF. In conclusion, Ki67 and CD31 expression in skin biopsies using IHC reproduces the role of proliferation and angiogenesis in the differential diagnosis and prognostication of CTCL being expressed at higher levels in aggressive than indolent CTCL. Therapeutic targeting of cell proliferation and angiogenesis may improve patient's outcome in CTCL. Usability of these markers into patient's stratification should be considered in further studies.
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Affiliation(s)
- Marwa Zohdy
- Department of Dermatology, Andrology and STDs, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Amal Abd El hafez
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Hagar Bessar
- Dermatology, Venerology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sherine Refat
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Li Q, Ma J, Li H, Xu W, Cao Z, Liu S, Chen L, Gao S, Yan T, Li D, Wang X, Yue Y, Zhao Z, Wang X, Yang H, Zhao H, Yu Y, Zhang Y, Fan F, Wang Y. Correlation Between Uptake of 18F-FDG During PET/CT and Ki-67 Expression in Patients Newly Diagnosed With Multiple Myeloma Having Extramedullary Involvement. Technol Cancer Res Treat 2019; 18:1533033819849067. [PMID: 31092140 PMCID: PMC6535751 DOI: 10.1177/1533033819849067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the relationship of prognosis of patients with multiple myeloma having extramedullary involvement (EMM) with the 18F- fluorodeoxyglucose(18F-FDG) maximum standardized uptake value and the expression of Ki-67 in biopsy samples. Sixty-five patients were newly diagnosed with multiple myeloma presenting with EMM at our hospital from January 2005 to January 2015. Of these 65 patients, 20 were enrolled in this study. Over the last decade, both the maximum standardized uptake value and Ki-67 expression in these extramedullary lesions significantly correlated with progression-free survival, respectively (P= .039, P =.009). After combining—the maximum standardized uptake value and the Ki-67 expression as an integral—there was a significant correlation between both the overall survival (P = .027) and progression-free survival (P= .014). Patients have poor outcomes when EMM is detected at presentation. Both the maximum standardized uptake value and Ki-67 expression could aid in accurately evaluating EMM patient prognosis.
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Affiliation(s)
- Qian Li
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,2 Tianjin Key Laboratory of Radiation Medicine and Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, China.,They are co-first authors and have contributed equally to this article
| | - Jing Ma
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.,They are co-first authors and have contributed equally to this article
| | - Han Li
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Wengui Xu
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Zeng Cao
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Su Liu
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Lin Chen
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Shuang Gao
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Tinghui Yan
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Dongying Li
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Xue Wang
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yuanfang Yue
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Zhigang Zhao
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Xiaofang Wang
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Hongliang Yang
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Haifeng Zhao
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yong Yu
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yizhuo Zhang
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Feiyue Fan
- 3 Institute of Laboratory Animal Sciences, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yafei Wang
- 1 Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer. Tianjin's Clinical Research Center for Cancer. Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
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Wang JD, Katz SG, Morgan EA, Yang DT, Pan X, Xu ML. Proapoptotic protein BIM as a novel prognostic marker in mantle cell lymphoma. Hum Pathol 2019; 93:54-64. [PMID: 31425695 PMCID: PMC7038910 DOI: 10.1016/j.humpath.2019.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/31/2019] [Accepted: 08/07/2019] [Indexed: 12/20/2022]
Abstract
Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma. Numerous studies have demonstrated many genetic aberrations in MCL in addition to the characteristic t(11:14), including frequent biallelic deletions of Bim, a proapoptotic member of the BCL-2 family. In mice, Bim deletion coupled with cyclin D1 overexpression generates pathologic and molecular features of human MCL. Since the regulation of apoptosis is crucial in MCL pathogenesis, we hypothesize that BIM expression may be associated with tumor cell survival. Clinical data and tissue from 100 nodal MCL cases between 1988 and 2009 were collected from three large academic medical centers. The average patient age of our MCL cohort was 65.5 years old (range, 42-97) with a 2:1 male to female ratio. Immunohistochemistry was performed with a validated anti-BIM antibody. Patients were separated into low and high BIM-expressing categories with a cutoff of 80%. As expected for a proapoptotic tumor suppressor, patients with high BIM expression were less likely to have progressive disease and more likely to have a complete response (P = .022). In addition, high BIM-expressing MCL tumors revealed a trend toward increased overall survival with this trend persisting in sub-analysis of Ann Arbor stages III and IV. No correlation between BIM expression, Ki-67 index, and MIPI score was observed, suggesting a role for BIM as a novel independent prognostic factor. While BIM is only one member of a complex family of apoptosis-regulating proteins, these findings may yield clinically relevant information for the prognosis and therapeutic susceptibility of MCL.
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Affiliation(s)
- Jeff D Wang
- Department of Pathology, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510.
| | - Samuel G Katz
- Department of Pathology, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510.
| | - Elizabeth A Morgan
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
| | - David T Yang
- Department of Pathology, University of Wisconsin Medical Center, Madison, WI 53705-2281.
| | - Xueliang Pan
- Department of Biomedical Informatics, Ohio State University, Columbus, OH 43210.
| | - Mina L Xu
- Department of Pathology, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510.
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Foshat M, Stewart J, Khoury JD, Staerkel GA, Caraway NP. Accuracy of diagnosing mantle cell lymphoma and identifying its variants on fine‐needle aspiration biopsy. Cancer Cytopathol 2018; 127:44-51. [DOI: 10.1002/cncy.22077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 09/13/2018] [Accepted: 10/04/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Michelle Foshat
- Department of Anatomic Pathology The University of Texas MD Anderson Cancer Center Houston Texas
| | - John Stewart
- Department of Anatomic Pathology The University of Texas MD Anderson Cancer Center Houston Texas
| | - Joseph D. Khoury
- Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston Texas
| | - Gregg A. Staerkel
- Department of Anatomic Pathology The University of Texas MD Anderson Cancer Center Houston Texas
| | - Nancy P. Caraway
- Department of Anatomic Pathology The University of Texas MD Anderson Cancer Center Houston Texas
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Doroudinia A, Bakhshayesh Karam M, Ranjbar M, Nikmanesh A, Mehrian P. Mantle cell lymphoma presenting as bilateral adrenal huge masses. BMJ Case Rep 2018; 2018:bcr-2017-223247. [PMID: 29666081 DOI: 10.1136/bcr-2017-223247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a middle-aged woman complaining of weakness, lethargy and weight loss for 6 months. Positron emission tomography (PET)/CT scan revealed huge bilateral adrenal masses with intense 18F-fluorodeoxyglucose avidity. Biopsy and immunohistochemical staining were compatible with mantle cell lymphoma (MCL). The patient received six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) followed by four cycles of intrathechal methotrexate chemotherapy. Bone marrow aspiration biopsy was performed for initial staging and also before bone marrow transplantation. Follow-up PET/CT scan after completion of chemotherapy and before bone marrow transplantation demonstrated complete metabolic response with no evidence of abnormal metabolic activity in either adrenal gland or bone marrow. MCL has an aggressive nature and is usually considered incurable; however, there have been a few reports indicating favourable treatment response when MCL is rarely arising from the adrenal glands. Dramatic response of a primary adrenal MCL to R-CHOP is documented in this case.
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Affiliation(s)
- Abtin Doroudinia
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Bakhshayesh Karam
- Pediatric Respiratory Diseases Research Center (PRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Ranjbar
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Nikmanesh
- Digestive Disease Research Center (DDRC), Digestive Disease Research Institute (DDRI), Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Mehrian
- Telemedicine Research Center (TRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), University of Medical Sciences, Tehran, Iran
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The degree of overlap between the follicular dendritic cell meshwork and tumor cells in mantle cell lymphoma is associated with prognosis. Pathol Res Pract 2018. [PMID: 29525403 DOI: 10.1016/j.prp.2018.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study concerning mantle cell lymphoma (MCL) investigated retrospectively an association between patient prognosis and the percentage of the total number of lymphoma cells found in the follicular dendritic cell (FDC) meshwork, that is, the degree of overlap of lymphoma cells. Two hundred and nine MCL patients were apportioned to grades I-III, in which the CD21-positive FDC meshwork covered ≤50%, 51%-89%, and ≥90% of the tumor area, respectively. Significant differences among the grades (all, P < 0.01) were found in the following: duration of disease (from onset of clinical manifestation to diagnosis); clinical staging; extranodal involvement (non-lymphoid organs); histological subtype; and Ki-67 proliferation index (PI). After removing the aggressive variants, the overall survival rates of grade I (n = 92) and II (n = 57) patients were similar. The overall survival rates of grade III (n = 46) patients differed from that of grade I + II patients (P < 0.01). The grades negatively correlated with the Ki-67 PI value (r = -0.234, P = 0.001). At each grade the OSR of patients with Ki-67 PI ≤30% was similar to that of patients with Ki-67 >30%. In the Ki-67 PI ≤30% group, the OSRs of the patients differed significantly among the grades. In the Ki-67 >30% group the OSRs of the grades were similar. The results of multivariate Cox regression analysis showed that the degree of overlap, age and Ki-67 PI was the independent prognostic factors of the OSRs of MCL patients. Our data suggests that MCL patients in whom there was a high degree of overlap between the FDC meshwork and tumor area have a better clinical prognosis. The degree of overlap correlates well with the Ki-67 PI, which can be used to predict the prognosis of patients.
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