Kai Zhang

Geisinger Medical Center, Danville, Pennsylvania, United States

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Publications (4)7.91 Total impact

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    ABSTRACT: We describe a case of true histiocytic sarcoma (HS) with features of HS in clinical manifestation, histological presentation, and immunohistochemical panels. The flow cytometry studies were used for the diagnosis. The tumor presents in the small intestine with involvement of regional mesenteric lymph nodes of a 68-year-old female. Histological examination reveals that tumor cells are large and pleomorphic. They have vesicular chromatin and abundant eosinophilic cytoplasm. Immunohistochemical studies show the tumor cells to be positive for CD45 (LCA), CD45RO, CD4, CD68, and lysozyme; and negative for all other T-, B-, macrophage, follicular dendritic- and hematopoietic-cell markers. Proliferation rate is 5% by MIB stain. Flow cytometry studies reveal large atypical cells positive for CD4, CD14, and CD45. There are 29 cases of HS reported in the literature since 2001. All of these cases are summarized. The diagnostic methods and the possible prognostic factors are discussed. We believe that the correct diagnosis of HS is important for clinical treatment and prognostic prediction, although it is very rare.
    Pathology - Research and Practice 07/2008; 204(10):763-70. DOI:10.1016/j.prp.2008.03.009 · 1.40 Impact Factor
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    ABSTRACT: Follicular lymphoma is classified into grades (G)1, 2, and 3 based on the number of centroblasts in neoplastic follicles. However, the accuracy of manually counting these centroblasts is limited by certain cells (large centrocytes, follicular dendritic cells, and histiocytes) that could mimic centroblast morphology. The reproducibility of follicular lymphoma grading is dependent upon observer experience; therefore, significant variations occur. This study is to explore a more objective, reliable way of grading follicular lymphoma using a quantitative imaging system in conjunction with immunostains with antibodies to proliferation markers MIB-1 and S-phase kinase-associated protein 2 (SKP2). Fifty-eight follicular lymphomas (G1, n = 23; G2, n = 18; and G3, n = 17) were studied on formalin-fixed, paraffin-embedded sections. Positive nuclear staining of both Ki-67 and SKP2 was recorded using the quantitative Clarient ACIS II system (Aliso Viejo, CA, USA). Ten high-power fields (x400) from randomly selected neoplastic follicles were counted by a pathologist blinded to the previously assigned morphologic grade. The results show that the percentages of Ki-67+ and SKP2+ cells significantly differ among the different grades of follicular lymphoma. A higher grade of follicular lymphoma is associated with a higher percentage of Ki-67+ and SKP2+ cells. The overall SKP2+% cells are substantially lower than Ki-67+% cells in the same grade of follicular lymphoma. Statistical significance is observed in Ki-67+ cells between follicular lymphoma G1 and follicular lymphoma G3 and between G1 and G2. In contrast, statistical significance is noted in SKP2+% cells between follicular lymphoma G1 and follicular lymphoma G3 and between follicular lymphoma G2 and follicular lymphoma G3. The findings suggest that the SKP2 expression has better discrimination with grades of follicular lymphoma than Ki-67 expression. Compared with traditional methods, quantitation of SKP2 expression using a quantitative image analysis system might be a useful and objective approach in grading follicular lymphoma.
    Human Pathlogy 07/2007; 38(6):878-82. DOI:10.1016/j.humpath.2006.11.021 · 2.77 Impact Factor
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    Kai Zhang · Jeffrey W Prichard · Robert E Brown ·
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    ABSTRACT: Blastic NK cell lymphoma is a rare hematolymphoid neoplasm. This report illustrates an unusual presentation of this entity, namely as a primary leukemia, but without skin lesions.
    Annals of clinical and laboratory science 02/2006; 36(2):212-5. · 0.91 Impact Factor
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    ABSTRACT: We report a case of plasmablastic lymphoma presenting in cervical lymph nodes in an 82-year-old, human immunodeficiency virus-negative man. Cytologic and histologic examinations demonstrated a large cell lymphoma with plasmacytic differentiation. The tumor cells were positive for CD138, CD38, epithelial membrane antigen, CD30, and lysozyme, but lacked expression of leukocyte common antigen, T-cell, and B-cell markers. Abundant Epstein-Barr virus-encoded RNA transcripts were identified by in situ hybridization. A monoclonal rearrangement of kappa-light- chain gene was demonstrated. The cytologic, histologic, immunohistochemical, and molecular features of plasmablastic lymphoma are reviewed. The potential diagnostic pitfalls and differential diagnoses, especially in a fine-needle aspiration specimen, are addressed.
    Archives of pathology & laboratory medicine 06/2004; 128(5):581-4. DOI:10.1043/1543-2165(2004)128<581:PLOTCL>2.0.CO;2 · 2.84 Impact Factor