A definitive diagnosis of primary Hodgkin lymphoma on endoscopic biopsy material utilizing in-depth immunohistochemical analysis.
ABSTRACT The esophagus and stomach can be primary sites for Hodgkin lymphoma (HL). The pathognomonic feature of HL is the Reed-Sternberg cell. Because these cells can be rare in HL tumours, biopsies obtained via endoscopy are usually inadequate for establishing a definitive diagnosis. A case of a gastroesophageal junction primary HL is presented that was diagnosed on endoscopic biopsy material with the assistance of the immunohistochemical stains PAX5 and MUM1 which verified the presence of Reed-Sternberg cells. The patient was effectively treated for HL and avoided traditional laparotomy or thoracotomy procedures to obtain the diagnosis. This advanced immunohistochemical approach should be the standard in the diagnosis of primary gastrointestinal HL. An endoscopy-based approach should obviate more invasive, open biopsy procedures for establishing HL diagnosis.
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ABSTRACT: Insulin-like growth factor II mRNA-binding protein 3 (IMP3) is ubiquitously expressed in embryos, mediating organogenesis, RNA trafficking, and cell growth, and is generally down-regulated in adult tissue. However, IMP3 has recently been shown to be overexpressed in some malignant epithelial neoplasms and to be a useful diagnostic and/or prognostic biomarker for several carcinomas. To determine whether IMP3 might also be an accurate biomarker of Hodgkin lymphoma, we examined 81 Hodgkin lymphomas for immunoreactivity to IMP3 as compared to commonly used markers such as CD30, CD15, PAX5, and MUM1. Consequently, in 98.8% (80/81) of Hodgkin lymphomas, the malignant Hodgkin and Reed-Sternberg cells were selectively reactive for IMP3, with 72.8% (59/81) of the tumors showing strong, diffuse cytoplasmic staining. Positive staining of the Hodgkin lymphomas was also seen for CD30 (82.7%, 67/81), CD15 (65.4%, 53/81), PAX5 (84.0%, 68/81), and MUM1 85.2% (69/81), but significantly fewer cells showed strong staining intensity for CD30 (32.1%, 26/81), CD15 (17.3%, 14/81), PAX5 (12.3%, 10/81), and MUM1 (29.6%, 24/81). Furthermore, the IMP3 staining was selectively restricted to Hodgkin and Reed-Sternberg cells, with a clearly negative background, and complementary to CD30 staining. Our findings show that IMP3 may be a useful diagnostic marker of Hodgkin lymphoma, helping to improve diagnostic accuracy for this malignancy.Human pathology 07/2013; 44(10). DOI:10.1016/j.humpath.2013.04.011 · 2.81 Impact Factor
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ABSTRACT: Primary oesophageal lymphoma is a very rare entity, with few reported cases worldwide. It represents an unusual cause of dysphagia. Primary oesophageal lymphomas that are not associated with an immunocompromised state tend to affect elderly patients. We describe a case of primary oesophageal lymphoma in a 41-year-old immunocompetent male, who presented with history of dysphagia. In our case, there were no manifestations of the disease outside the oesophagus, which is very rare. He was treated with oeophagectomy followed by chemotherapy. KeywordsEsophagus–Computed tomography–ThoracotomyIndian Journal of Thoracic and Cardiovascular Surgery 01/2011; 27(1):53-55. DOI:10.1007/s12055-010-0069-x