Cerebral Infectious Opportunistic Lesions in a Patient with Acute Myeloid Leukaemia: The Challenge of Diagnosis and Clinical Management

Central nervous system (CNS) lesions, especially invasive fungal diseases (IFDs), in immunocompromised patients pose a great challenge in diagnosis and treatment. We report the case of a 48-year-old man with acute myeloid leukaemia and probable pulmonary aspergillosis, who developed hyposthenia of the left upper limb, after achieving leukaemia remission and while on voriconazole. Magnetic resonance imaging (MRI) showed oedematous CNS lesions with a haemorrhagic component in the right hemisphere with lepto-meningitis. After 2 weeks of antibiotics and amphotericin-B, brain biopsy revealed chronic inflammation with abscess and necrosis, while cultures were negative. Clinical recovery was attained, he was discharged on isavuconazole and allogeneic transplant was postponed, introducing azacitidine as a maintenance therapy. After initial improvement, MRI worsened; brain biopsy was repeated, showing similar histology; and 16S metagenomics sequencing analysis was positive (Veilonella, Pseudomonas). Despite 1 month of meropenem, MRI did not improve. The computer tomography and PET scan excluded extra-cranial infectious-inflammatory sites, and auto-immune genesis (sarcoidosis, histiocytosis, CNS vasculitis) was deemed unlikely due to the histological findings and unilateral lesions. We hypothesised possible IFD with peri-lesion inflammation and methyl-prednisolone was successfully introduced. Steroid tapering is ongoing and isavuconazole discontinuation is planned with close follow-up. In conclusion, the management of CNS complications in immunocompromised patients needs an interdisciplinary approach.

BCL3 rearrangements in B-cell lymphoid neoplasms occur in two breakpoint clusters associated with different diseases

The t(14;19)(q32;q13) often juxtaposes BCL3 with immunoglobulin heavy chain (IGH) resulting in overexpression of the gene. In contrast to other oncogenic translocations, BCL3 rearrangement (BCL3-R) has been associated with a broad spectrum of lymphoid neoplasms. Here we report an integrative whole-genome sequence, transcriptomic, and DNA methylation analysis of 13 lymphoid neoplasms with BCL3-R. The resolution of the breakpoints at single base-pair revealed that they occur in two clusters at 5' (n=9) and 3' (n=4) regions of BCL3 associated with two different biological and clinical entities. Both breakpoints were mediated by aberrant class switch recombination of the IGH locus. However, the 5' breakpoints (upstream) juxtaposed BCL3 next to an IGH enhancer leading to overexpression of the gene whereas the 3' breakpoints (downstream) positioned BCL3 outside the influence of the IGH and were not associated with its expression. Upstream BCL3-R tumors had unmutated IGHV, trisomy 12, and mutated genes frequently seen in chronic lymphocytic leukemia (CLL) but had an atypical CLL morphology, immunophenotype, DNA methylome, and expression profile that differ from conventional CLL. In contrast, downstream BCL3-R neoplasms were atypical splenic or nodal marginal zone lymphomas (MZL) with mutated IGHV, complex karyotypes and mutated genes typical of MZL. Two of the latter four tumors transformed to a large B-cell lymphoma. We designed a novel fluorescence in situ hybridization assay that recognizes the two different breakpoints and validated these findings in 17 independent tumors. Overall, upstream or downstream breakpoints of BCL3-R are mainly associated with two subtypes of lymphoid neoplasms with different (epi)genomic, expression, and clinicopathological features resembling atypical CLL and MZL, respectively.

Efficacy and safety of cyclosporine A treatment in autoimmune cytopenias: the experience of two Italian reference centers

Background:

Immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA) show good responses to frontline steroids. About two-third of cases relapse and require second-line treatment, including rituximab, mainly effective in AIHA, and thrombopoietin-receptor agonists (TPO-RAs) in ITP, while the use of splenectomy progressively decreased due to concerns for infectious/thrombotic complications. For those failing second line, immunosuppressants may be considered.

Objectives:

The aim of this study was to evaluate the efficacy of cyclosporine treatment in patients with ITP and AIHA.

Design:

In this retrospective study, we evaluated the efficacy and safety of cyclosporine A (CyA) in ITP (N = 29) and AIHA (N = 10) patients followed at two reference centers in Milan, Italy.

Methods:

Responses were classified as partial [Hb > 10 or at least 2 g/dl increase from baseline, platelets (PLT) > 30 × 10⁹/l with at least doubling from baseline] and complete (Hb > 12 g/dl or PLT > 100 × 10⁹/l) and evaluated at 3, 6, and 12 months. Treatment emergent adverse events were also registered.

Results:

The median time from diagnosis to CyA was 35 months (3–293), and patients had required a median of 4 (1–8) previous therapy lines. Median duration of CyA was 28 (2–140) months and responses were achieved in 86% of ITP and 50% of AIHA subjects. Responders could reduce or discontinue concomitant treatment and resolved PLT fluctuations on TPO-RA. CyA was generally well tolerated, and only two serious infectious complications in elderly patients on concomitant steroids suggesting caution in this patient population.

Conclusion:

CyA may be advisable in ITP, which is not well controlled under TPO-RA, and in AIHA failing rituximab, particularly if ineligible in clinical trial.

Odontogenic fibroma amyloid-variant: a typical case and brief considerations about mimickers

The World Health Organization's (WHO) updated classification of head and neck tumors (2017) defined odontogenic fibroma as a rare neoplasm. In this report, we describe an unusual, typical and rare variant of a central odontogenic fibroma with diffuse amyloid-like protein stromal deposition, and discuss the differential diagnosis with other entities. Radiographically, this lesion presented as a well-defined radiolucency of the mandible, partially cystic. Histologically, the lesion showed a unique confluence of odontogenic epithelial rests in a moderately cellular connective tissue. Immunohistochemical staining highlighted a mixture of benign epithelial and Langerhans cells within connective tissue with diffuse amyloid-like stromal deposition. The importance of recognizing this variant of odontogenic fibroma is due to its benign prognosis and clinical course.

CD34-Positive Blast Count and p53 Expression in Bone Marrow Biopsies of Patients with Low-Risk Myelodysplastic Syndromes: Potential Predictive Tools of Response to Erythropoietin Stimulating Agents

INTRODUCTION

The first-line therapy for patients with low-risk myelodysplastic syndromes (MDSs) commonly consists of erythropoietin stimulating agents (ESAs), with a response rate ranging from 34 to 62%. For nonresponder patients, outside clinical trials, blood transfusions are the most frequent therapeutic option, with detrimental effect on the quality of life and with risks of iron-overload. Since no studies have been yet conducted on this topic, we investigated the potential predictive role of bone marrow (BM) histological evaluation in patients treated with ESAs.

MATERIALS AND METHODS

We performed a morphological and immunohistochemical retrospective analysis of BM biopsies of 96 patients with low-risk MDSs subsequently treated with ESAs.

RESULTS

In our series, substantial morphological overlap was found between responder and nonresponder patients. On the contrary, patients with a percentage of CD34-positive blasts >3% or with p53 protein expression <1% responded with a significantly higher frequency to ESAs.

CONCLUSIONS

Our study reinforces the role of BM biopsy as diagnostic tool in MDSs, being also able to supply information related to response to ESAs and to its loss over time.

X-ray characterization of self-standing bent Si crystal plates for Large Hadron Collider beam extraction

Bent crystals can be used to deflect high-energy charged particles for beam extraction and/or beam collimation at accelerator facilities, thanks to the channelling phenomenon. In the present paper, two perfect silicon mono-crystals were bent using two different methods: sandblasting and the application of a carbon fibre composite. In particular, these samples were obtained for the realization of bent crystal prototypes to be used to steer the 7 TeV proton beam of the Large Hadron Collider in the context of the CRYSBEAM project. The two bending methods were selected since they allow a very homogeneous curvature of the crystals to be obtained, which is essential for high channelling efficiency. Moreover, the deformation obtained is self-standing, i.e. there is no need for any external device to keep the samples bent. Self-standing curvature can be useful because the presence of an external bender could be a severe limitation in the collider beam-pipe. The curvature of the samples was measured through high-energy X-ray diffraction at the ID11 beamline of the European Synchrotron Radiation Facility in Grenoble, France. Since the diffraction efficiencies obtained were in good agreement with theoretical expectations, it follows that the manufacturing techniques did not damage the samples, i.e. the crystallographic quality was preserved. Finally, the crystal quality of the sandblasted sample was investigated in detail at the synchrotron source at Karlsruhe Institute of Technology by X-ray white-beam topography. The measurements showed no diffusion of defects from the machined surfaces to the crystal bulk.

Clinical and molecular characteristics of lymphoplasmacytic lymphoma not associated with an IgM monoclonal protein: A multicentric study of the Rete Ematologica Lombarda (REL) network

Lymphoplasmacytic lymphoma (LPL) is usually associated with a serum IgM paraprotein, corresponding to Waldenström's Macroglobulinemia (WM). Cases presenting with IgG or IgA, or without a monoclonal protein are extremely rare. We analyzed clinical characteristics, frontline treatment, and the outcome of 45 patients with non-IgM LPL, and compared them with a control group of WM patients. The median age was similar, with significantly higher prevalence of females in non-IgM LPL, than in WM patients (60% vs 39%, P = .016). Patients with non-IgM LPL more frequently presented with lymphadenopathies (53% vs 15%, P < .001), splenomegaly (22% vs 8%, P = .015) or extranodal involvement (20% vs 8%, P = .05). In non-IgM LPL a serum monoclonal protein and bone marrow infiltration were less common than in WM patients (69% and 84% of cases respectively, P < .001 for both comparisons). The MYD88 (L265P) mutation was found in 8/19 patients using allele-specific polymerase chain reaction. A CXCR4 mutation was found in 4/17 cases using Sanger. In 16 patients we performed targeted next-generation sequencing of genes MYD88, CXCR4, ARID1-A, KMT2D, NOTCH2, TP53, PRDM1, CD79B, TRAF3, MYBBP1A, TNFAIP3. Seven patients (44%) had a MYD88 mutation (S219C in one), four (25%) a CXCR4 mutation, three (19%) a KMT2D mutation, one (6%) a TP53 mutation and one (6%) a TRAF3 mutation. With a median follow-up of 55.7 months, 36 non-IgM LPL patients (80%) were treated. Non-IgM LPL patients received more frequently anthracycline-containing regimens, as compared with WM patients, who mainly received alkylating-based therapies. Five-year overall survival (OS) was 84%, similar to that of WM patients.

Enhancement of the Inelastic Nuclear Interaction Rate in Crystals via Antichanneling

The interaction rate of a charged particle beam with the atomic nuclei of a target varies significantly if the target has a crystalline structure. In particular, under specific orientations of the target with respect to the incident beam, the probability of inelastic interaction with nuclei can be enhanced with respect to the unaligned case. This effect, which can be named antichanneling, can be advantageously used in the cases where the interaction between beam and target has to be maximized. Here we propose to use antichanneling to increase the radioisotope production yield via cyclotron. A dedicated set of experimental measurements was carried out at the INFN Legnaro Laboratories with the AN2000 and CN accelerators to prove the existence of the antichanneling effect. The variation of the interaction yield at hundreds of keV to MeV energies was observed by means of sapphire and indium phosphide crystals, achieving an enhancement of the interaction rate up to 73% and 25%, respectively. Such a result may pave the way to the development of a novel type of nozzle for the existing cyclotrons, which can exploit crystalline materials as targets for radioisotope production, especially to enhance the production rate for expensive prime materials with minor upgrades of the current instrumentation.

A double-hit High-grade B-cell lymphoma with three-way translocation t(3;8;14)(q27;q24;q32) involving BCL6, MYC, and IGH

We describe an High-grade B-cell lymphoma case, in which a complex translocation t(3;8;14) with effects on the genes BCL6, MYC, and IGH, was detected. This case could be the first double-hit lymphoma with a single chromosome rearrangement causing the double effect with three genes involved.

Bent crystals for efficient beam steering of multi TeV-particle beams

Charged particle beams can be manipulated by exploiting the channeling phenomenon in bent crystals. Two plate-like crystals, bent by mechanical holders, were manufactured and characterised for such purpose at the Sensor and Semiconductor Laboratory in Ferrara, Italy. An anticlastic curvature was obtained for these crystals, achieving a steering angle of the order of 1 mrad, which is about 20 times larger than the values currently achieved for the bent crystals used in the LHC for collimation experiments. Finally, a Geant4 simulation was performed to study the channeling efficiency for beam deflection with 400 GeV/c and 7 TeV/c proton beams. Such crystals represent technological progress in the development of bent crystals for highly energetic charged particle beams. Indeed, they are designed to impart an angular kick to a 7 TeV/c proton beam with unprecedented high efficiency. Therefore, this study demonstrates the possibility of realizing bent crystals suitable for beam extraction in high-energy hadron accelerators, such as LHC or at the future FCC. A further series of studies should be conducted to evaluate the channeling efficiency and the deflection angle of the realized crystals via a charged proton beam.

Strong Reduction of the Effective Radiation Length in an Axially Oriented Scintillator Crystal

We measured a considerable increase of the emitted radiation by 120  GeV/c electrons in an axially oriented lead tungstate scintillator crystal, if compared to the case in which the sample was not aligned with the beam direction. This enhancement resulted from the interaction of particles with the strong crystalline electromagnetic field. The data collected at the external lines of the CERN Super Proton Synchrotron were critically compared to Monte Carlo simulations based on the Baier-Katkov quasiclassical method, highlighting a reduction of the scintillator radiation length by a factor of 5 in the case of beam alignment with the [001] crystal axes. The observed effect opens the way to the realization of compact electromagnetic calorimeters or detectors based on oriented scintillator crystals in which the amount of material can be strongly reduced with respect to the state of the art. These devices could have relevant applications in fixed-target experiments, as well as in satellite-borne γ telescopes.

Study of inelastic nuclear interactions of 400 GeV/c protons in bent silicon crystals for beam steering purposes

Inelastic nuclear interaction probability of 400 GeV/c protons interacting with bent silicon crystals was investigated, in particular for both types of crystals installed at the CERN Large Hadron Collider for beam collimation purposes. In comparison to amorphous scattering interaction, in planar channeling this probability is ∼ 36 % for the quasi-mosaic type (planes (111)), and ∼ 27 % for the strip type (planes (110)). Moreover, the absolute inelastic nuclear interaction probability in the axial channeling orientation, along the ⟨ 110 ⟩ axis, was estimated for the first time, finding a value of 0.6 % for a crystal 2 mm long along the beam direction, with a bending angle of 55 μ rad. This value is more than two times lower with respect to the planar channeling orientation of the same crystal, and increases with the vertical angular misalignment. Finally, the correlation between the inelastic nuclear interaction probability in the planar channeling and the silicon crystal curvature is reported.

Electromagnetic dipole moments of charged baryons with bent crystals at the LHC

We propose a unique program of measurements of electric and magnetic dipole moments of charm, beauty and strange charged baryons at the LHC, based on the phenomenon of spin precession of channeled particles in bent crystals. Studies of crystal channeling and spin precession of positively- and negatively-charged particles are presented, along with feasibility studies and expected sensitivities for the proposed experiment using a layout based on the LHCb detector.

Observation of Quasichanneling Oscillations

We report on the first experimental observations of quasichanneling oscillations, recently seen in simulations and described theoretically. Although above-barrier particles penetrating a single crystal are generally seen as behaving almost as in an amorphous substance, distinct oscillation peaks nevertheless appear for particles in that category. The quasichanneling oscillations were observed at SLAC National Accelerator Laboratory by aiming 20.35 GeV positrons and electrons at a thin silicon crystal bent to a radius of R=0.15  m, exploiting the quasimosaic effect. For electrons, two relatively faint quasichanneling peaks were observed, while for positrons, seven quasichanneling peaks were clearly identified.

Orientational Coherent Effects of High-Energy Particles in a LiNbO3 Crystal

A bent lithium niobate strip was exposed to a 400-GeV/c proton beam at the external lines of CERN Super Proton Synchrotron to probe its capabilities versus coherent interactions of the particles with the crystal such as channeling and volume reflection. Lithium niobate (LiNbO3) exhibits an interplanar electric field comparable to that of Silicon (Si) and remarkable piezoelectric properties, which could be exploited for the realization of piezo-actuated devices for the control of high-energy particle beams. In contrast to Si and germanium (Ge), LiNbO3 shows an intriguing effect; in spite of a low channeling efficiency (3%), the volume reflection maintains a high deflection efficiency (83%). Such discrepancy was ascribed to the high concentration (10(4) per cm2) of dislocations in our sample, which was obtained from a commercial wafer. Indeed, it has been theoretically shown that a channeling efficiency comparable with that of Si or Ge would be attained with a crystal at low defect concentration (less than ten per cm2). To better understand the role of dislocations on volume reflection, we have worked out computer simulation via dynecharm++ Monte Carlo code to study the effect of dislocations on volume reflection. The results of the simulations agree with experimental records, demonstrating that volume reflection is more robust than channeling in the presence of dislocations.

The experimental setup of the Interaction in Crystals for Emission of RADiation collaboration at Mainzer Mikrotron: Design, commissioning, and tests

Silicon/germanium flat/bent crystals are thin devices able to efficiently deflect charged particle GeV-energy beams up to a few hundreds of μrad; moreover, high intensity photons can be efficiently produced in the so-called Multi-Volume Reflection (MVR) and Multiple Volume Reflections in One Crystal (MVROC) conditions. In the last years, the research interest in this field has moved to the dynamic studies of light negative leptons in the low energy range: the possibility to deflect negative particles and to produce high intensity γ sources via the coherent interactions with crystals in the sub-GeV energy range has been proved by the ICE-RAD (Interaction in Crystals for Emission of RADiation) Collaboration at the MAinzer MIkrotron (MAMI, Germany). This paper describes the setup used by the ICE-RAD experiment for the crystals characterization (both in terms of deflection and radiation emission properties): a high precision goniometer is used to align the crystals with the incoming beam, while a silicon based profilometer and an inorganic scintillator reconstruct, respectively, the particle position and the photon spectra after the samples. The crystals manufacturing process and their characterization, the silicon profilometer commissioning at the CERN PS T9 beamline, and the commissioning of the whole setup installed at MAMI are presented.

Observation of deflection of a beam of multi-GeV electrons by a thin crystal

We report on an experiment performing channeling and volume reflection of a high-energy electron beam using a quasimosaic, bent silicon (111) crystal at the End Station A Test Beam at SLAC. The experiment uses beams of 3.35 and 6.3 GeV. In the channeling orientation, deflections of the beam of 400 μrad for both energies with about 22% efficiency are observed, while in the volume-reflection orientation, deflection of the beam by 120 μrad at 3.35 GeV and by 80 μrad at 6.3 GeV is observed with 86%-95% efficiency. Quantitative measurements of the channeling efficiency, surface transmission, and dechanneling length are taken. These are the first quantitative measurements of channeling and volume reflection using a primary beam of multi-GeV electrons.

Steering of a sub-GeV electron beam through planar channeling enhanced by rechanneling

We report the observation of efficient steering of a 855 MeV electron beam at MAMI (MAinzer MIkrotron) facilities by means of planar channeling and volume reflection in a bent silicon crystal. A 30.5  μm thick plate of (211) oriented Si was bent to cause quasimosaic deformation of the (111) crystallographic planes, which were used for coherent interaction with the electron beam. The experimental results are analogous to those recorded some years ago at energy higher than 100 GeV, which is the only comparable study to date. Monte Carlo simulations demonstrated that rechanneling plays a considerable role in a particle's dynamics and hinders the spoiling of channeled particles. These results allow a better understanding of the dynamics of electrons subject to coherent interactions in a bent silicon crystal in the sub-GeV energy range, which is relevant for realization of innovative x-ray sources based on channeling in periodically bent crystals.

Broad and intense radiation accompanying multiple volume reflection of ultrarelativistic electrons in a bent crystal

The radiation emitted by 120  GeV/c electrons traversing a single bent crystal under multiple volume reflection orientation is investigated. Multiple volume reflection in one crystal occurs as a charged particle impacts on a bent crystal at several axial channeling angles with respect to a crystal axis. The resulting energy-loss spectrum of electrons was very intense over the full energy range up to the nominal energy of the beam. As compared to the radiation emission by an individual volume reflection, the energy-loss spectrum is more intense and peaks at an energy 3 times greater. Experimental results are compared to a theoretical approach based on the direct integration of the quasiclassical Baier and Katkov formula. In this way, it is possible to determine the mean number of photons emitted by each electron and, thus, to extract the single-photon spectrum, which is broad and intense. The soft part of the radiation spectrum is due to the contribution of coherent interaction between electrons and several reflecting planes intersecting the same crystal axis, whereas the hard part is mainly connected to coherent bremsstrahlung induced by correlated scattering of electrons by atomic strings (string of strings scattering and radiation). The radiation generation by multiple volume reflection takes place over a broad angular range of the incident beam with respect to coherent bremsstrahlung and channeling radiation in straight crystals. Therefore, this type of radiation can be exploited for applications, such as beam dump and collimation devices for future linear colliders.

Coherent effects of high-energy particles in a graded Si(1-x)Ge(x) crystal

A graded Si(1-x)Ge(x) crystal has been manufactured for operation with high-energy protons to excite coherent interactions of the particles with the crystal such as channeling and volume reflection. The crystal had the shape of a parallelepiped though its (111) atomic planes were curved at a radius of 25.6 m because of the graded Ge content. The crystal was exposed to a 400  GeV/c proton beam at the external lines of CERN Super Proton Synchrotron to probe its capability to steer high-energy particles. Measured deflection efficiency was 62.0% under planar channeling and 96.0% under volume reflection. Such values are critically compared to their counterparts for a standard bent Si crystal under peer conditions. A Monte Carlo simulation of the dynamics of channeled and volume reflected particles in a graded crystal including the effect of Ge impurities and of lattice dislocations has been carried out. We found that the effect of crystal imperfections spoiled the efficiency of channeling while it negligibly affected the performance of volume reflection. We finally propose the usage of the graded crystal as a primary scatterer to aid halo collimation for the new generation of hadronic machines. As a unique feature, a properly cut graded crystal circumvents the problem of the miscut angle, which is currently a severe limitation for implementation of crystal-assisted collimation.

A case of compound mutations in the MYBPC3 gene associated with biventricular hypertrophy and neonatal death

Hypertrophic cardiomyopathy (HCM) is a familial, genetically determined, primary cardiomyopathy caused by mutations in genes coding for proteins of the sarcomere, or, less frequently, genes involved in storage diseases. In pediatric settings, pure HCM has an estimated incidence of 4.7 per million children. The disease is often sub-clinical and goes unrecognized mainly because most patients with HCM have only mild symptoms, if any. However, sudden cardiac death, the most dramatic clinical occurrence and the primary concern for patients and physicians alike, may be the first manifestation of the disease. We describe a case of compound heterozygosity in the MYBPC3 gene (p.Glu258Lys and IVS25-1G>A) associated with biventricular hypertrophy, atrial enlargement and subsequent neonatal death 33 days postpartum. Other studies have reported compound and/or double heterozygosis in the same or different sarcomeric genes during childhood and adulthood, and neonatal presentations have also been described. Our observations show that the combination of a missense (p.Glu258Lys) and a splice-site mutation (IVS25-1G>A) profoundly affects the clinical course. In families in which parental mutations are known, preimplantation (where ethically and legally feasible) or prenatal genetic screening should be adopted because: (1) neonatal HCM in genetic heterozygosity is potentially lethal and (2) heart disease is the most common developmental malformation and the leading cause of neonatal mortality and morbidity.

Congenital aggressive variant of Langerhans cells histiocytosis with CD56+/E-Cadherin- phenotype

In children < 2 years of age, cutaneous involvement is the most frequent presentation of Langerhans cell histiocytosis (LCH). Cutaneous LCH can be localized or associated with dissemination and organ dysfunction. The clinical course is variable, ranging from spontaneous regression to a fatal outcome. We describe a female newborn presenting with congenital cutaneous lesions who rapidly developed pulmonary infiltrates and multiple osteolytic lesions. Skin biopsy showed a dermal infiltrate of medium to large cells morphologically and phenotypically consistent with LCH. The clinical course was rapidly fatal in spite of chemotherapy. No strict correlation between morphology and prognosis has been documented in LCH, but, in our case, distinct morphological and immunohistochemical features (CD56 expression and no E-Cadherin expression) may have contributed to an aggressive clinical course.

Space and time-resolved gene expression experiments on cultured mammalian cells by a single-cell electroporation microarray

Single-cell experiments represent the next frontier for biochemical and gene expression research. Although bulk-scale methods averaging populations of cells have been traditionally used to investigate cellular behavior, they mask individual cell features and can lead to misleading or insufficient biological results. We report on a single-cell electroporation microarray enabling the transfection of pre-selected individual cells at different sites within the same culture (space-resolved), at arbitrarily chosen time points and even sequentially to the same cells (time-resolved). Delivery of impermeant molecules by single-cell electroporation was first proven to be finely tunable by acting on the electroporation protocol and then optimized for transfection of nucleic acids into Chinese Hamster Ovary (CHO-K1) cells. We focused on DNA oligonucleotides (ODNs), short interfering RNAs (siRNAs), and DNA plasmid vectors, thus providing a versatile and easy-to-use platform for time-resolved gene expression experiments in single mammalian cells.

B-cell posttransplant lymphoproliferative disorders in heart and/or lungs recipients: clinical and molecular-histogenetic study of 17 cases from a single institution

BACKGROUND

Posttransplantation lymphoproliferative disorders (PTLDs) are heterogeneous lymphoid proliferations representing a major complication of solid organ transplant. This study details the clinicopathological and molecular features of 17 B-cell PTLDs observed in a single center series of 988 heart and/or lung transplant recipients.

METHODS

Cases were classified according to World Health Organization lymphoma classification and tested for Epstein-Barr Virus (EBV), clonality, histogenetic phenotypic (CD10, Bcl-6, MUM1, CD138), and genotypic (immunoglobulin and BCL-6 genes somatic hypermutation) markers.

RESULTS

This series of 17 PTLDs included: two B-cell monoclonal polymorphic PTLDs and 15 B-cell monomorphic PTLDs (13 diffuse large B-cell lymphomas [DLBCL] and 2 Burkitt lymphomas [BL]). EBV was detected in 9/17 cases. A monoclonal immunoglobulin variable (IGV) genes rearrangement was documented in 17/17 cases; IGV somatic hypermutation was found in 88% of cases, indicating a prevalent origin from germinal center (GC)-experienced B cells. Using immunophenotypic markers, three histogenetic profiles were identified: a) CD10/bcl-6/MUM1/CD138, mimicking GC B-cells; b) CD10-/bcl-6+/MUM1+/CD138-, reminiscent of B-cells at the latest phases of GC reaction; and c) CD10-/bcl-6-/MUM1+/CD138+/-, consistent with preterminally differentiated B-cells.

CONCLUSIONS

Correlation between morphology, histogenesis, and EBV status demonstrated a high degree of homogeneity in the two GC-related groups, mostly including EBV-negative cases with BL and DLBCL-centroblastic features; the third group, consisting of post GC EBV-positive cases, was histologically less homogeneous, as it included polymorphic PTLDs and DLBCL with immunoblastic and anaplastic features. The EBV-negative cases with GC histogenetic phenotype showed a slightly better outcome; however, such less aggressive prognostic trend was not confirmed by statistical analysis.

A fully electronic sensor for the measurement of cDNA hybridization kinetics

Ion sensitive field effect transistors (ISFET) are candidates for a new generation of fully electrical DNA sensors. To this purpose, we have modified ISFET sensors by adsorbing on their Si(3)N(4) surface poly-L-lysine and single (as well as double) stranded DNA. Once coupled to an accurate model of the oppositely charged layers adsorbed on the surface, the proposed sensor allows quantitatively evaluating the adsorbed molecules densities, as well as estimating DNA hybridization kinetics.

[Fenestration of the extracranial tract of the vertebral artery: angiographic demonstration of 3 cases]

The authors describe 3 cases of the extracranial Vertebral artery fenestration. This anomaly is a rare case seen in autopsy and angiographically, and in literature too the cases described are few and prevalently by Japanese authors. This anomaly is important because frequently is associated with others congenital intra and extracranial vascular abnormalities.