Bone marrow-restricted aberrant myeloperoxidase expression in B-acute lymphoblastic leukemia: A diagnostic dilemma and mimicry of mixed phenotype acute leukemia.

Myeloperoxidase (MPO) is the most specific marker of the myeloid lineage, essential for diagnosing acute myeloid leukemia and mixed phenotype acute leukemia with myeloid components. In this regard, we present a unique case of B-acute lymphoblastic leukemia (B-ALL) with isolated MPO expression in bone marrow blasts detected by flow cytometry and immunohistochemistry, while peripheral blood blasts were negative for MPO expression. In this report, our discussion encompasses diagnostic pitfalls from a laboratory testing perspective in similar cases and includes a literature review. Furthermore, we emphasize the necessity of conducting a comprehensive analysis for the accurate diagnosis of MPO-positive B-ALL cases.

From the archives of MD Anderson Cancer Center Castleman disease involving the thymus gland: Case report and literature review.

Castleman disease is a nodal based disease and very rarely involves the thymus gland. We report a 52-year-old man who was found incidentally to have a single thymic mass by computerized tomography scan. Thymectomy was performed, and the gross specimen showed a well-circumscribed, multi-loculated cystic mass. Histologic examination showed thymus involved by Castleman disease, hyaline-vascular variant. The lesion was characterized by lymphoid follicles with wide mantle zones, variably lymphocyte-depleted germinal centers with sclerotic radial blood vessels, and prominent interfollicular/stromal changes including numerous endothelial venules with sclerotic walls and hyaline sclerosis, scattered and frequent dysplastic follicular dendritic cells and foci of dystrophic calcification. Immunohistochemical analysis showed that the follicle mantle zones were composed of numerous B-cells positive for CD20, PAX5, and IgD. Antibodies specific for CD21 and CD23 highlighted prominent follicular dendritic cell networks within follicles. There was no evidence of human herpes virus 8. We searched the literature and could identify only 10 additional cases of thymic CD. Previously reported cases included 8 unicentric and 2 multicentric, classified pathologically as plasma cell variant (n = 4), hyaline vascular variant (n = 3), and mixed (n = 3). Thymectomy, as was done in the currently reported case, most often leads to the diagnosis of Castleman disease and was a mainstay of treatment in other reported cases.

High-Grade B-Cell Lymphoma With Malignant Effusions as the Initial Presentation.

OBJECTIVES: Malignant effusion is usually caused by metastatic carcinoma. Malignant lymphoma is often not included as a top differential diagnosis of malignant effusion. Here, we describe 3 cases of young female patients with no significant past medical history who presented with fluid overload and were diagnosed with high-grade B-cell lymphoma (HGBL). METHODS: We conducted histopathologic examination and immunophenotypic and cytogenetic analyses on three cases using immunohistochemistry, flow cytometry, fluorescence in situ hybridization (FISH), and karyotyping. We also included patients' clinical and radiological findings in our case reports. RESULTS: Histologic examination of the effusion samples showed numerous intermediate to large lymphoma cells with irregular nuclear contours and fine chromatin. The lymphoma cells were positive for CD10, CD20, BCL2, BCL6, and PAX5 and negative for CD34, cyclin D1, HHV-8, and TdT. In situ hybridization for Epstein-Barr virus (EBV)-encoded small RNAs was negative. The proliferation index by Ki-67 stain was more than 80%. Flow cytometry showed CD10-positive B cells with monotypic immunoglobulin light chain expression. Fluorescence in situ hybridization analysis demonstrated MYC, BCL2, or BCL6 rearrangements. These 3 patients were diagnosed as having HGBL with double-/triple-hit rearrangements. Despite receiving aggressive chemotherapy, all 3 patients had a dismal clinical course, with 2 patients dying less than 2 years after initial diagnosis. CONCLUSIONS: High-grade B-cell lymphoma should be considered in the differential diagnoses of malignant effusions. Flow cytometric and FISH analyses of the body fluid specimens are essential to reach an accurate and timely diagnosis.

Formation of the oxidized flavor compounds at different heat treatment and changes in the oxidation stability of milk.

The oxidized flavor could affect the sensory acceptability of consumers. In this study, the oxidized flavor compound (OFC) in different heated milk was analyzed using the solid phase microextraction-gas chromatography-mass spectrometry (SPME-GC-MS). The concentration of OFC increased with increasing the intensity of heat treatment. The concentrations of heptanal, nonanal, 2-heptanone, and 2-nonanone in the heated milk samples were in the range of 1.88-5.51, 1.03-3.26, 6.89-88.04, and 1.46-12.78 µg/kg, respectively. The correlation coefficients between the OFC and the heat intensity were above 0.86. It was found that the intensity of heat treatment (below 80°C for 10 min) could not cause the significant changes in the distribution of fat globules. The contents of partial proteins in milk fat globule membrane gradually destructed with increasing the intensity of heat treatment. The DPPH˙ scavenging activity reduced by 23.15%, and the peroxide value (POV) increased by 37.23% as raw milk was heated at 90°C for 20 min. Values of thiobarbituric acid reactive substances (TBARS) had a tendency to increase as the heated time was operated for 20 min (p < 0.05). It indicated the heat treatment could change the oxidative environment of milk and influence the distribution of milk fat and the formation of oxidized flavor compounds.

Effect of fluoridated milk on caries in primary teeth: 21-month results.

OBJECTIVES: Use of fluoridated milk has been shown to be a safe and effective method to prevent caries in permanent teeth in children. However, studies on its effectiveness on caries prevention in the primary teeth are scarce. The purpose of the present study was to evaluate the effect of milk fluoridation on caries development in young Chinese children. METHODS: This was a community-based demonstration study carried out in Beijing, China. All children in three selected kindergartens were invited to participate. Each participant consumed 200 ml of fluoridated milk (concentration 2.5 mg F- per litre) per day from Monday to Friday in the kindergarten, and was given two packs of fluoridated milk (250 ml) for consumption at home on Saturday and Sunday every week. Children from a similar background, but without access to fluoridated milk, attending two other kindergartens, were used as the control. RESULTS: There were 534 children (mean age 54 +/- 4 months) and 305 children (mean age 53 +/- 4 months) in the test and control groups, respectively, at baseline. After 21 months, 417 and 247 children in the test and control groups, respectively, remained in the study. There was no statistically significant difference in the baseline mean dmft scores between the two groups (3.2 vs. 3.5, P = 0.312). After 21 months, the mean net caries increment was 0.4 dmft for the test group and 1.3 dmft for the control group (t-test, P < 0.001). CONCLUSION: The consumption of fluoridated milk by the kindergarten children in Beijing was an effective measure in preventing caries in the primary teeth.