[show abstract][hide abstract] ABSTRACT: Myelolipoma is a lesion arising in the adrenal glands or in various extra-adrenal sites. Only one human case developing in the spleen has been published in the literature. We report two such exceptional cases discovered in two women aged 65 and 67 years, presenting with splenomegaly. Both spleens showed a round mass constituted by red pulp containing nests of extra-medullar haematopoiesis and adipose tissue resembling bone marrow tissue. In addition, Emh developed in the surrounding red pulp. Erythroblasts and granulocytic cells at different stages of normal maturation and a few megakaryocytes were observed, without blasts. We consider the relationship with extra-adrenal myelolipoma and the differential diagnosis with non neoplastic and neoplastic Emh.
Revue Francophone des Laboratoires 01/2013; 2013(448):71–75.
[show abstract][hide abstract] ABSTRACT: The distribution of non-Hodgkin lymphoma (NHL) subtypes differs around the world but a systematic study of Latin America has not been done. Therefore, we evaluated the relative frequencies of NHL subtypes in Central and South America (CSA). Five expert hematopathologists classified consecutive cases of NHL from five CSA countries using the WHO classification and compared them to 400 cases from North America (NA). Among the 1028 CSA cases, the proportions of B- and T-cell NHL and the sex distribution were similar to NA. However, the median age of B-cell NHL in CSA (59 years) was significantly lower than in NA (66 years; p<0.0001). The distribution of high-grade (52.9%) and low-grade (47.1%) mature B-cell NHL in CSA was also significantly different from NA (37.5% and 62.5%; p<0.0001). Diffuse large B-cell lymphoma was more common in CSA (40%) than in NA (29.2%; p<0.0001), whereas the frequency of follicular lymphoma was similar in Argentina (34.1%) and NA (33.8%), and higher than the rest of CSA (17%; p<0.001). Extranodal NK/T-cell NHL was also more common in CSA (p<0.0001). Our study provides new objective evidence that the distribution of NHL subtypes varies significantly by geographic region and should prompt epidemiological studies to explain these differences.
[show abstract][hide abstract] ABSTRACT: The distribution of subtypes of non-Hodgkin lymphoma (NHL) in Latin America is not well known. This Chilean study included 207 consecutive cases of NHL diagnosed at five cancer centers in the capital, Santiago, and one center in Viña del Mar. All cases were reviewed and classified independently by five expert hematopathologists according to the 2001 World Health Organization classification of NHL. A consensus diagnosis of NHL was reached in 195 of the 207 cases (94%). B-cell lymphomas constituted 88% of NHL, and diffuse large B-cell lymphoma (DLBCL, 38.5%) and follicular lymphoma (25.1%) were the most common subtypes. There was a high frequency of marginal zone B-cell lymphoma (10.3%), as well as of extranodal natural killer (NK)/T-cell lymphoma, nasal type (2.6%) and adult T-cell leukemia/lymphoma (0.5%). Extranodal presentation was seen in 74 of the 195 cases (38%) and the most common extranodal presentation was in the stomach (37.6%). The most common gastric lymphoma was DLBCL (54.5%) followed by mucosa-associated lymphoid tissue (MALT) lymphoma (41%). Overall, the frequency of NHL subtypes in Chile is between that reported in Western and Eastern countries, which is probably a reflection of the admixture of ethnicities as well as the environment and socioeconomic status of its population.
[show abstract][hide abstract] ABSTRACT: Lymphomas may involve the breast either primary or secondary and in both conditions, the same types of lymphomas are observed. Unilateral localisation is the most frequent. The occurrence in males is exceptional. The majority of lymphomas are of B-cell type. NK/T cell lymphomas remain very rare in the western countries. The most frequent type is represented by diffuse large B-cell lymphoma, which present, when primary, a peculiar type of relapse in the central nervous system. Among small B-cell lymphomas, which occur less frequently, follicular lymphoma and marginal zone lymphoma, MALT type predominate. A very few number of the last type may be associated with amyloidosis. During the last decade, a peculiar type of primary breast lymphoma, presenting as a large anaplastic T-cell lymphoma, ALK negative, has been described, developing in direct contact with a silicon implant, surrounded by chronic inflammatory reaction and often accumulation of liquid called ‘seroma’.
Only limited surgery should be done in all type of lymphomas. The treatment is based on chemotherapy and immunotherapy, with central nervous system prophylaxis in cases of primary diffuse large B-cell lymphoma.
Revue Francophone des Laboratoires 01/2012; 2012(438):79–84.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to report the relative frequencies of non-Hodgkin lymphoma (NHL) subtypes in Guatemala. A panel of five hematopathologists reviewed 226 consecutive biopsies and classified them according to the 2001 World Health Organization (WHO) classification. The 83 cases of diffuse large B-cell lymphoma (DLBCL) were further subclassified into germinal center B-cell-like (GCB) and non-GCB subtypes. Of the 226 cases, 194 (86%) were confirmed as NHL, including 169 (87%) B-cell and 25 (13%) T- or natural killer (NK)-cell NHL. The most common subtype was DLBCL (44.3%), and the most frequent subtype among T- and NK-cell NHL was extranodal NK/T-cell lymphoma, nasal type (7.8% of all NHL). A comparison of the frequencies of NHL subtypes between Guatemala and other parts of the world showed that Guatemala is most similar to the Middle East and Asia. However, there is no significant difference in the frequency of the DLBCL subtypes compared to North America and Europe.
[show abstract][hide abstract] ABSTRACT: Diffuse large B-cell Lymphoma (DLBCL) constitutes the most frequent type of adult lymphoma. However, this lymphoma is heterogeneous, clinically, morphologically, phenotypically and molecularly. Among this heterogeneity, few clinicopathological entities are recognized by the 2008 WHO Classification and should be recognized by the pathologist taking into account the whole clinical, biological and pathological parameters. Once these entities being eliminated, the pathologist is facing the group DLBCL “NOS” (Not Otherwise specified”). Inside this large group, also heterogeneous, the pathologist should recognize the immunohistochemical and even better the molecular subtype. Even if today, there is no direct clinical application, some targeted therapies are used in phase I, II trials toward some recognized molecular subgroups. Immunohistochemistry, FISH, quantitative PCR, DNA sequencing performed from paraffin embedded tissue will allow in the near future to better recognize these subgroups and the oncogenic pathways for each case.
Revue Francophone des Laboratoires 01/2011; 2011(428):57-64.
[show abstract][hide abstract] ABSTRACT: The diagnosis of myelodysplastic syndromes (MDS) is mostly based on clinical information, cytology, biology (particularly cytogenetics). However, bone marrow biopsy (BMB) brings useful information for the diagnosis and for the assessment of prognosis, in various entities. For ex. BMB allows to recognize hypoplastic type of MDS and MDS with fibrosis. BMB is particularly useful in the appreciation of the presence of blast cells and their quantification, allowing the diagnosis of refractory anaemia with excess of blasts and the identification of transformation in acute myeloid leukaemia, particularly in MDS with hypoplasia and MDS with fibrosis. BMB plays also an important role in differential diagnosis with diverse benign or malignant hemopathies.
Revue Francophone des Laboratoires 01/2011; 2011(428):65-72.
[show abstract][hide abstract] ABSTRACT: Fifty-five consecutive cases of Hodgkin’s lymphoma (HL), collected between 1996 and 1998 from Cairo, Egypt, were histologically subtyped, phenotyped, and then studied for the presence of Epstein–Barr virus (EBV). We used immunohistochemical stains for EBV latent membrane protein 1 (LMP-1) and in situ hybridization stains for EBV-encoded small RNA (EBER-1) transcripts. Forty-five cases (82%) had classic HL (cHL), and ten cases (18%) had nodular lymphocyte predominant HL (NLPHL), with each group expressing its typical phenotype. LMP-1 stains were positive in 63% and 0% of cHL and NLPHL cases, respectively. EBER-positive Reed–Sternberg cells and variants were also present in 62% and 0% of each group, respectively. The cHL cases showed variable EBER positivity: nodular sclerosis, 58%; mixed cellularity, 100%; lymphocyte depletion, 100%; and unclassifiable, 67%. Our findings are similar to those from other developing countries and point towards a pathogenic role of EBV in cHL.
[show abstract][hide abstract] ABSTRACT: Lymphoid clonality detection using PCR is becoming crucial in rare cases of lymphoid lesions difficult to interprete at the histo- and immunohistopathogical level. European Concerted Action “BIOMED-2” developed highly efficient PCR protocols as well as standardized methods and reagents involving 47 european Laboratories. However, it is important that these test results are interpreted with the full knowledge of the limits of these techniques. Therefore, close cooperation between clinician, pathologist, haematologist and molecularist are important to optimize the diagnostic and to further adapt the treatment.
Revue Francophone des Laboratoires 01/2010; 2010(418):47-50.
[show abstract][hide abstract] ABSTRACT: PCR has been shown previously to be the most sensitive technique to detect a clonal population in marrow aspirates (MAs), and the clinical standard for evaluation of bone marrow lymphoma involvement today is bone marrow trephine biopsy (BMTB). The goal of this study was to compare morphological evaluation of B cell neoplasm in BMTB (histology and immunohistochemistry) and PCR analysis in MA, with both specimens obtained at the same time, in patients with a known molecular marker of the disease.
This was a retrospective evaluation of 98 consecutive BMTB specimens from 60 patients with a known B-cell neoplasm and a previous PCR marker of the disease (BCL2 and/or IGH).
Considering the IGH PCR cases alone, a B cell clone was detected in 85% and 39% of the morphology (M) positive and negative groups, respectively. Five M(+), IGH(-) cases were found, including two cases of follicular lymphoma (FL), one case of diffuse large B cell lymphoma, and two cases of mantle cell lymphoma. The FLs had about 20% and 50% of BMTB involvement each. All other cases had minimal lymphoma localisation. The two FLs were also BCL2-MBR(+). Use of BCL2-MBR detected all M(+) cases and 66% of M(-) cases whenever it was an initial marker of disease.
IGH PCR alone is not good enough for BMTB assessment, especially in FL. On the other hand, the PCR study for BCL2 is more sensitive than morphology, without any false negative results in this series, suggesting that BCL2-MBR PCR on MA can be used as an alternative and more sensitive examination for disease evaluation, providing that there is careful analysis of data, adequate knowledge of PCR pitfalls and absence of other haematological disorders.
Journal of clinical pathology 05/2009; 62(4):357-60. · 2.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: 3 cases of hairy cell leukaemia were studied with ultrastructural immunocytochemical methods using an anti human Ig HRPO-Fab fragment. Ig were detected on the cell surface, in the perinuclear cisterna and endoplasmic reticulum of hairy cells. Evidence of Ig in these sites demonstrates a B-lymphoid differentiation of the leukaemic cells.
European Journal Of Haematology 04/2009; 31(5):501 - 506. · 2.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: A 23-year-old patient with Gaucher's disease and IgG kappa monoclonal gammopathy is described. The decrease of the serum immunoglobulin level after splenectomy and the immunoflourescence study of the spleen indicate a predominant splenic location of the secreting plasma cells.
European Journal Of Haematology 04/2009; 28(1):54 - 58. · 2.55 Impact Factor
[show abstract][hide abstract] ABSTRACT: Histopathological study of bone marrow biopsy (BMB) in chronic myelomonocytic leukemia (CMML) is often difficult and might benefit from an immunohistochemical approach. We immunostained 15 cases of CMML, focusing at two new antibodies staining for CD14 and CD16 on paraffin-embedded tissues. CD68 (KP1), CD68 (PG-M1), and CD163 were not differentially expressed between CMML and chronic myelogenous leukemia (CML). In CMML BMB, we found a significant increase in the number of CD14+ monocytes. This increase was made of dispersed cells in the interstitium, often exhibiting bilobated nuclei, and being difficult to differentiate from neutrophils. There was no expansion of CD16+ monocyte-like cells. However, we found a significant decrease in the number of granulocytes expressing CD16, MPO, and CD15 in CMML compared to CML and control BMB, probably related to dysgranulopoiesis. Indeed, BMB immunohistochemistry can be helpful in CMML by identifying both the monocyte expansion with CD14 and the dysgranulopoiesis with CD16.
Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 03/2009; 454(4):411-9. · 2.68 Impact Factor