RESUMO
Proactive policing, the strategic targeting of people or places to prevent crimes, is a well-studied tactic that is ubiquitous in modern law enforcement. A 2017 National Academies of Sciences report reviewed existing literature, entrenched in deterrence theory, and found evidence that proactive policing strategies can reduce crime. The existing literature, however, does not explore what the short and long-term effects of police contact are for young people who are subjected to high rates of contact with law enforcement as a result of proactive policing. Using four waves of longitudinal survey data from a sample of predominantly black and Latino boys in ninth and tenth grades, we find that adolescent boys who are stopped by police report more frequent engagement in delinquent behavior 6, 12, and 18 months later, independent of prior delinquency, a finding that is consistent with labeling and life course theories. We also find that psychological distress partially mediates this relationship, consistent with the often stated, but rarely measured, mechanism for adolescent criminality hypothesized by general strain theory. These findings advance the scientific understanding of crime and adolescent development while also raising policy questions about the efficacy of routine police stops of black and Latino youth. Police stops predict decrements in adolescents' psychological well-being and may unintentionally increase their engagement in criminal behavior.
Assuntos
Negro ou Afro-Americano , Hispânico ou Latino , Delinquência Juvenil , Polícia/psicologia , Estresse Psicológico , Adolescente , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Delinquência Juvenil/psicologia , Delinquência Juvenil/estatística & dados numéricos , Aplicação da Lei , Estudos Longitudinais , Masculino , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologiaRESUMO
Integrating smartphone applications into screening and identifying autism spectrum disorder (ASD) represents a promising and innovative frontier within healthcare. This forward-looking paper examines the current landscape of ASD screening apps, shedding light on their potential advantages and addressing and navigating significant challenges. One of the most compelling aspects of these apps lies in their potential to democratize access to ASD screening, effectively breaking down geographical barriers. By using the widespread availability of smartphones, these apps make it possible for individuals, caregivers, and healthcare providers to engage in early ASD screening from virtually anywhere. This accessibility is especially crucial in underserved areas or regions with limited access to specialized healthcare services. Moreover, these apps offer a degree of objectivity that traditional screening methods may need help to match. By relying on data-driven algorithms and machine learning, they can provide a more impartial assessment of a child's behavior, minimizing the potential for subjective bias. This objectivity, combined with the ability to monitor and assess a child's development over time, empowers caregivers with valuable insights into their child's progress. However, as with any technological advancement in healthcare, integrating smartphone apps for ASD screening is not without its share of ethical and privacy considerations. Ensuring informed consent is obtained, especially when collecting data from children, is complex and critical. Striking the right balance between collecting necessary data and protecting an individual's privacy requires careful thought and transparent communication. Additionally, the "digital divide" represents a challenge that needs to be acknowledged and addressed. Not all individuals and families have equal access to smartphones or the technological literacy required to use these apps effectively. This disparity in access must be considered when developing and implementing app-based screening solutions to prevent exacerbating existing healthcare inequalities. Nevertheless, the future of ASD screening apps holds significant promise. Advancements in technology, including integrating advanced sensors, wearables, augmented reality, and machine learning, can further enhance the accuracy and depth of screening. Interdisciplinary collaboration between researchers, developers, clinicians, and educators is crucial to ensure that these apps are effective, culturally sensitive, and user-friendly. Furthermore, integrating these apps into broader healthcare systems, including electronic health records and telehealth platforms, can streamline the screening process and enable a more seamless transition from screening to diagnosis and intervention.
RESUMO
PURPOSE: A small supernumerary marker chromosome is often seen in patients with developmental disorders. Prior to array-based comparative genomic hybridization markers were rarely genotyped end to end. In this study, a valid genotype-to-phenotype correlation was possible because the supernumerary marker chromosomes were fully characterized by array-based comparative genomic hybridization in a genome-wide analysis. METHODS: Ten consecutive de novo small supernumerary marker chromosome cases were systematically genotyped using G-banding, C-banding, AgNOR staining, whole-genome array-based comparative genomic hybridization, and fluorescence in situ hybridization. RESULTS: Among 10 small supernumerary marker chromosome cases studied, 4 (40%) were not identified by array-based comparative genomic hybridization because of low-level mosaicism or because they lacked euchromatin. One case (10%) was a simple pericentromeric marker extending from 5p13.3 to 5q11.2. Five (50%) markers showed unexpected complexity. Two cases had markers that were derivative acrocentric (AgNOR+) chromosomes with the euchromatin from chromosomes 18p or 19p. Each of the other three cases with complex markers had unusual characteristics including a marker from noncontiguous segments of chromosome 19q, a highly complex rearrangement involving a chromosome 20 homolog as well as the small supernumerary marker chromosome, and a mosaic duplication of a proximal 8p marker. CONCLUSION: Small supernumerary marker chromosomes are frequently complex on the basis of our small sample. Whole-genome array-based comparative genomic hybridization characterization of the small supernumerary marker chromosome provided informed genetic counseling.
Assuntos
Aberrações Cromossômicas , Hibridização Genômica Comparativa , Marcadores Genéticos , Humanos , Hibridização in Situ Fluorescente , Cariotipagem , Mosaicismo , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Jumping translocations (JTs) are rare constitutional or acquired rearrangements involving a donor and several receiver chromosomes. They may be inherited or de novo. JTs can be found as a cultural artifact, in normal individuals or in pathological conditions. The clinical consequences range from spontaneous abortion, loss of fetus, chromosome syndrome, congenital abnormalities, and infertility to malignancy. Considering the breakpoints of JTs, they are localized predominantly in repeat regions such as pericentromeric, centromeric, subtelomeric, telomeric, and occasionally interstitial regions that may be in a low copy repeats (LCR) or in a telomere like sequence. Differences between the constitutional and acquired JTs donor breakpoints suggest an independent mechanism in their formation. In this review, a new JT involving a donor chromosome 18p10qter and recipients 17q25qter or 1q25qter found by CVS of a twin pregnancy is described. This case illustrates the diagnostic challenges posed by JTs.In this study, our knowledge on JTs is consolidated to improve identification, management, and counseling.
Assuntos
Amostra da Vilosidade Coriônica/métodos , Translocação Genética , Gêmeos/genética , Adulto , Desenvolvimento Embrionário , Feminino , Humanos , Hibridização in Situ Fluorescente , Sequências Repetitivas Dispersas/genética , Cariotipagem , GravidezRESUMO
Primary immunodeficiencies (PIDs) are a rare and heterogeneous group of inherited genetic disorders that are characterized by an absent or impaired immune system. In this report, we describe the use of next-generation sequencing to investigate a male infant with clinical and immunological manifestations suggestive of a PID. Whole-exome sequencing of the infant along with his parents revealed a novel nucleotide variant (cytosine to adenine substitution at nucleotide position 252) in the coding region of the interleukin 2 receptor subunit gamma (IL2RG) gene. The mother was found to be a carrier. These findings are consistent with a diagnosis of X-linked severe combined immunodeficiency and represent the first such reported mutation in an Indian family. This mutation leads to an asparagine to lysine substitution ( p.Asn84Lys ) located in the extracellular domain of IL2RG, which is predicted to be pathogenic. Our study demonstrates the power of next-generation sequencing in identifying potential causative mutations to enable accurate clinical diagnosis, prenatal screening, and carrier female detection in PID patients. We believe that this approach, which is not a current routine in clinical practice, will become a mainstream component of individualized medicine in the near future.
Assuntos
Sequenciamento de Nucleotídeos em Larga Escala/métodos , Subunidade gama Comum de Receptores de Interleucina/genética , Exoma/genética , Feminino , Predisposição Genética para Doença/genética , Humanos , Masculino , Mutação/genética , Doenças da Imunodeficiência Primária/genéticaRESUMO
Primary immunodeficiency (PID) refers to a group of heterogeneous genetic disorders with a weakened immune system. Mendelian susceptibility to mycobacterial disease (MSMD) is a subset of PID in which patients exhibit defects in intrinsic and innate immunity. It is a rare congenital disorder characterized by severe and recurrent infections caused by weakly virulent mycobacteria or other environmental mycobacteria. Any delay in definitive diagnosis poses a major concern due to the confounding nature of infections and immune deficiencies. Here, we report the clinical, immunological, and genetic characteristics of two siblings (infants) with recurrent infections. There was a history of death of two other siblings in the family after BCG vaccination. Whole exome sequencing of the two affected surviving infants along with their consanguineous parents identified a novel, homozygous single nucleotide splice acceptor site variant in intron 2 of the interferon gamma receptor 2 (IFNGR2) gene. Sanger sequencing of DNA obtained from blood and fibroblasts confirmed the variant. The patients underwent bone marrow transplantation from their father as a donor. RT-PCR and Sanger sequencing of the cDNA of patients from blood samples after transplantation showed the expression of both wild type and mutant transcript expression of IFNGR2. To assess partial or complete expression of IFNGR2 mutant transcripts, fibroblasts were cultured from skin biopsies. RT-PCR and Sanger sequencing of cDNA obtained from patient fibroblasts revealed complete expression of mutant allele and acquisition of a cryptic splice acceptor site in exon 3 that resulted in deletion of 9 nucleotides in exon 3. This led to an in-frame deletion of three amino acids p.(Thr70-Ser72) located in a fibronectin type III (FN3) domain in the extracellular region of IFNGR2. This illustrates individualized medicine enabled by next generation sequencing as identification of this mutation helped in the clinical diagnosis of MSMD in the infants as well as in choosing the most appropriate therapeutic option.
Assuntos
Predisposição Genética para Doença , Síndromes de Imunodeficiência/genética , Infecções por Mycobacterium/genética , Receptores de Interferon/genética , Humanos , Lactente , Masculino , Mutação , Sítios de Splice de RNARESUMO
CONTEXT: Inactivating germline mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene are linked to pituitary adenoma predisposition. Here, we present the youngest known patient with AIP-related pituitary adenoma. CASE DESCRIPTION: The patient presented at the age of 4 years with pituitary apoplexy and left ptosis with severe visual loss following a 1-year history of abdominal pain, headaches, and rapid growth. His IGF-1 level was 5× the upper limit of normal, and his random GH level was 1200 ng/mL. MRI showed a 43 × 24 × 35âmm adenoma with suprasellar extension invading the left cavernous sinus (Knosp grade 4). After transsphenoidal surgery, histology showed a grade 2A sparsely granulated somatotropinoma with negative O6-methylguanine-DNA methyltransferase and positive vascular endothelial growth factor staining. Genetic testing identified a heterozygous germline nonsense AIP mutation (p.Arg81Ter). Exome sequencing of the tumor revealed that it had lost the entire maternal chromosome-11, rendering it hemizygous for chromosome-11 and therefore lacking functional copies of AIP in the tumor. He was started on octreotide, but because the tumor rapidly regrew and IGF-1 levels were unchanged, temozolomide was initiated, and intensity-modulated radiotherapy was administered 5 months after surgery. Two months later, bevacizumab was added, resulting in excellent tumor response. Although these treatments stabilized tumor growth over 4 years, IGF-1 was normalized only after pegvisomant treatment, although access to this medication was intermittent. At 3.5 years of follow-up, gamma knife treatment was administered, and pegvisomant dose increase was indicated. CONCLUSION: Multimodal treatment with surgery, long-acting octreotide, radiotherapy, temozolomide, bevacizumab, and pegvisomant can control genetically driven, aggressive, childhood-onset somatotropinomas.
Assuntos
Adenoma/genética , Adenoma/terapia , Peptídeos e Proteínas de Sinalização Intracelular/genética , Neoplasias Hipofisárias/genética , Neoplasias Hipofisárias/terapia , Protocolos Antineoplásicos , Bevacizumab/uso terapêutico , Pré-Escolar , Terapia Combinada , Hormônio do Crescimento Humano/análogos & derivados , Hormônio do Crescimento Humano/uso terapêutico , Humanos , Masculino , Mutação , Octreotida/uso terapêutico , Hipófise/cirurgia , Radioterapia Adjuvante , Temozolomida/uso terapêuticoRESUMO
Robust diagnostics for many human genetic disorders are much needed in the pursuit of global personalized medicine. Next-generation sequencing now offers new promise for biomarker and diagnostic discovery, in developed as well as resource-limited countries. In this broader global health context, X-linked intellectual disability (XLID) is an inherited genetic disorder that is associated with a range of phenotypes impacting societies in both developed and developing countries. Although intellectual disability arises due to diverse causes, a substantial proportion is caused by genomic alterations. Studies have identified causal XLID genomic alterations in more than 100 protein-coding genes located on the X-chromosome. However, the causes for a substantial number of intellectual disability and associated phenotypes still remain unknown. Identification of causative genes and novel mutations will help in early diagnosis as well as genetic counseling of families. Advent of next-generation sequencing methods has accelerated the discovery of new genes involved in mental health disorders. In this study, we analyzed the exomes of three families from India with nonsyndromic XLID comprising seven affected individuals. The affected individuals had varying degrees of intellectual disability, microcephaly, and delayed motor and language milestones. We identified potential causal variants in three XLID genes, including PAK3 (V294M), CASK (complex structural variant), and MECP2 (P354T). Our findings reported in this study extend the spectrum of mutations and phenotypes associated with XLID, and calls for further studies of intellectual disability and mental health disorders with use of next-generation sequencing technologies.
Assuntos
Genes Ligados ao Cromossomo X , Doenças Genéticas Ligadas ao Cromossomo X/genética , Guanilato Quinases/genética , Deficiência Intelectual/genética , Proteína 2 de Ligação a Metil-CpG/genética , Microcefalia/genética , Quinases Ativadas por p21/genética , Adulto , Criança , Pré-Escolar , DNA/sangue , Exoma/genética , Feminino , Estudos de Associação Genética , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Índia , Deficiência Intelectual/diagnóstico , Masculino , Microcefalia/diagnóstico , Mutação , Linhagem , Fenótipo , Sequenciamento do ExomaRESUMO
A 53-year-old man diagnosed with chronic lymphocytic leukemia (CLL)-small lymphoma following splenectomy was found to have a t(8;14) with an apparent cryptic deletion of the MYC gene. This patient's spleen and bone marrow (BM) showed that 93% and approximately 70% of the viable cells, respectively, were lambda-monoclonal B-cells coexpressing CD5 with CD20, CD19, CD23, CD22, CD38, and low FMC-7. The smear showed a marked increase in small, mature lymphoid cells, with <2% prolymphocytes. The BM karyotype was 46,XY,t(8;14)(q24;q32),-18,+mar[3]/46,XY[27] and FISH analysis with an IGH/MYC green-red dual-fusion signal probe showed an atypical interphase result of one fusion, two green, and one red signal in 70% of the cells. The MYC dual red-green split-apart probe showed the expected t(8;14) pattern in 62% of the cells; however, sequential FISH on a t(8;14) GTG-metaphase showed the single fusion signal on derivative chromosome 8 and only a green signal on der(14) for the IGH/MYC dual-fusion probe and a green signal on der(14), red signal on der(8), and fusion signal on the normal chromosome 8 for the MYC split-apart probe. Thus, the apparently balanced t(8;14) had a cryptic deletion (approximately 1.6 Mb) between the red and the green regions flanking the MYC gene in the MYC split-apart probe, 128,585,631-130,226,339 bp from 8pter. The rarity of t(8;14) in CLL together with a cryptic deletion that probably includes the MYC gene in our CLL patient persuaded us to explore the clinicopathological role of MYC translocations by comparing disease progression in our patient and in other reported CLL cases.
Assuntos
Linfoma de Burkitt/genética , Deleção Cromossômica , Cromossomos Humanos Par 14/genética , Cromossomos Humanos Par 8/genética , Leucemia Linfocítica Crônica de Células B/genética , Translocação Genética , Genes myc/fisiologia , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Hibridização in Situ Fluorescente , Leucemia Linfocítica Crônica de Células B/complicações , Masculino , Pessoa de Meia-Idade , EsplenectomiaRESUMO
PURPOSE: This study aims to describe the phenotype and genotype of two Indian families affected with X-linked choroideremia (CHM). MATERIALS AND METHODS: In these two families, the affected individuals and unaffected family members underwent a comprehensive ophthalmic examination including an optical coherence tomography (OCT) and electroretinogram. Blood samples were collected from the families for genetic analysis. Next generation sequencing (NGS) was done using a panel of 184 genes, which covered previously associated genes with retinal dystrophies. Sequencing data were analyzed for the CHM, RPGR, and RP2 genes that have been implicated in CHM and X-linked retinitis pigmentosa (XLRP), respectively. The identified variants were confirmed by Sanger sequencing in available individuals and unrelated controls. RESULTS: In two unrelated male patients, NGS analysis revealed a previously reported 3'-splice site change c.820-1G>C in the CHM gene in the first family and hemizygous mutation c.653G>C (p.Ser218X) in the second family. The asymptomatic family members were carriers for these mutations. Spectral domain-OCT showed loss of outer retina, preservation of the inner retina, and choroidal thinning in the affected males and retinal pigment epithelial changes in the asymptomatic carriers. The identified mutations were not present in 100 controls of Indian origin. There were no potential mutations found in XLRP-associated (RPGR and RP2) genes. CONCLUSION: This report describes the genotype and phenotype findings in patients with CHM from India. The identified genetic mutation leads to lack of Rab escort protein-1 (REP-1) or affects the production of a REP-1 protein that is likely to cause retinal abnormalities in patients.
Assuntos
Coroideremia/genética , Proteínas do Olho/genética , Testes Genéticos/métodos , Mutação , Adulto , Coroideremia/diagnóstico , Coroideremia/metabolismo , Análise Mutacional de DNA , Eletrorretinografia , Proteínas do Olho/metabolismo , Feminino , Angiofluoresceinografia , Fundo de Olho , Genótipo , Humanos , Índia , Masculino , Linhagem , FenótipoRESUMO
BACKGROUND: Autism is a behavioral disorder with impaired social interaction, communication, and repetitive and stereotypic behaviors. About 5-10 % of individuals with autism have 'secondary' autism in which an environmental agent, chromosome abnormality, or single gene disorder can be identified. Ninety percent have idiopathic autism and a major gene has not yet been identified. We have assessed the incidence of chromosome abnormalities and Fragile X syndrome in a population of autistic patients referred to our laboratory. METHODS: Data was analyzed from 433 patients with autistic traits tested using chromosome analysis and/or fluorescence in situ hybridization (FISH) and/or molecular testing for fragile X syndrome by Southern and PCR methods. RESULTS: The median age was 4 years. Sex ratio was 4.5 males to 1 female [354:79]. A chromosome (cs) abnormality was found in 14/421 [3.33 %] cases. The aberrations were: 4/14 [28%] supernumerary markers; 4/14 [28%] deletions; 1/14 [7%] duplication; 3/14 [21%] inversions; 2/14 [14%] translocations. FISH was performed on 23 cases for reasons other than to characterize a previously identified cytogenetic abnormality. All 23 cases were negative. Fragile-X testing by Southern blots and PCR analysis found 7/316 [2.2 %] with an abnormal result. The mutations detected were: a full mutation (fM) and abnormal methylation in 3 [43 %], mosaic mutations with partial methylation of variable clinical significance in 3 [43%] and a permutation carrier [14%]. The frequency of chromosome and fragile-X abnormalities appears to be within the range in reported surveys (cs 4.8-1.7%, FRAX 2-4%). Limitations of our retrospective study include paucity of behavioral diagnostic information, and a specific clinical criterion for testing. CONCLUSIONS: Twenty-eight percent of chromosome abnormalities detected in our study were subtle; therefore a high resolution cytogenetic study with a scrutiny of 15q11.2q13, 2q37 and Xp23.3 region should be standard practice when the indication is autism. The higher incidence of mosaic fragile-X mutations with partial methylation compared to FRAXA positive population [50% vs 15-40%] suggests that faint bands and variations in the Southern band pattern may occur in autistic patients.
Assuntos
Transtorno Autístico/epidemiologia , Transtorno Autístico/genética , Aberrações Cromossômicas/estatística & dados numéricos , Análise Citogenética/métodos , Síndrome do Cromossomo X Frágil/genética , Pré-Escolar , Feminino , Proteína do X Frágil da Deficiência Intelectual , Humanos , Masculino , Epidemiologia Molecular/métodos , Mutação/genética , Proteínas do Tecido Nervoso/genética , Proteínas de Ligação a RNA/genéticaRESUMO
A recurring translocation (X;20)(q13;q13) was found in four women ranging in age from 57 to 77 years. They had myelodysplasia, myelodysplasia with thrombocytopenia and pancytopenia, transforming to myelofibrosis, and myelodysplasia with sideroblastic anemia, respectively. The t(X;20) was the sole abnormality in three cases; one case also had a der(1;7)(q10;p10). Added to three previously reported cases, our four cases bring the total to seven; thus, t(X;20)(q13;q13) is a nonrandom translocation associated with myeloid disorders. Previous FISH studies showed that the breakpoint on the X is proximal to XIST. In one of our cases, the breakpoint on the X was shown to be proximal to Xq12, by FISH using a probe for the androgen receptor gene locus.
Assuntos
Cromossomos Humanos Par 20 , Cromossomos Humanos X , Síndromes Mielodisplásicas/genética , Translocação Genética , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Pancitopenia/genética , Mielofibrose Primária/genéticaRESUMO
An experimental study tests if people's hostility after experiencing rejection is partly explained by the degree to which they had initially suppressed their own feelings and beliefs to please the source of rejection. This hypothesis emerges from the literatures on women's self-silencing and that on rejection-sensitivity, which has documented that rejection-sensitive women show strong responses to rejection, but are also likely to self-silence to please their partners. An online dating paradigm examined if this self-silencing drives post-rejection hostility among women. Participants were given the opportunity to read about a potential dating partner before meeting that person, and were randomly assigned to one of 3 experimental conditions that resulted in rejection from the potential date or from another dater. Self-silencing was captured as the suppression of tastes and opinions that clashed with those of the prospective partner. Self-silencing moderated the effect of rejection on hostility: Self-silencing to the prospective partner was associated with greater post-rejection hostility among women, but not men. Self-silencing to someone other than the rejecter was not predictive of hostility. Women's dispositional rejection-sensitivity predicted greater hostility after rejection, and self-silencing mediated this association. Efforts to secure acceptance through accommodation may help explain the paradoxical tendency of some people to show strong rejection-induced hostility toward those whose acceptance they have sought.
RESUMO
Societies and social scientists have long held the belief that exclusion induces ingratiation and conformity, an idea in contradiction to robust empirical evidence linking rejection with hostility and aggression. The classic literatures on ingratiation and conformity help resolve this contradiction by identifying circumstances under which rejection may trigger efforts to ingratiate. Jointly, findings from these literatures suggest that when people are given an opportunity to impress their rejecters, ingratiation is likely after rejection experiences that are harsh and that occur in important situations that threaten the individual's self-definition. Four studies tested the hypothesis that people high in rejection sensitivity and therefore dispositionally concerned about rejection will utilize opportunities to ingratiate after harsh rejection in situations that are self-defining. In 3 studies of situations that are particularly self-defining for men, rejection predicted ingratiation among men (but not women) who were high in rejection sensitivity. In a 4th study, harsh rejection in a situation particularly self-defining for women predicted ingratiation among highly rejection-sensitive women (but not men). These findings help identify the specific circumstances under which people are willing to act in socially desirable ways toward those who have rejected them harshly.
Assuntos
Rejeição em Psicologia , Conformidade Social , Comportamento , Feminino , Doações , Processos Grupais , Hostilidade , Humanos , Masculino , Motivação , Grupo Associado , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
This study assessed the efficacy of FISH for detecting 1p/19q deletion in gliomas on 77 paraffin-embedded tissue samples, of which 42 cases (55%) were positive for 1p/19q codeletion; 7 of the 42 had a previous history of glioma. In one case, analysis failed. The remaining 34 cases were negative; of these, three had a previous history of glioma and one had the reverse 1q/19p deletion. A majority of the 10 recurrent gliomas had progressed, and 70% had a 1p/19q deletion. The signal pattern in a majority of 1p/19q codeletion cases was a single red marker signal and two green reference signals (1R2G) for both probe sets. One case had a different signal pattern for chromosomes 1 and 19 (1R2G and 2R4G), as seen in polysomy cells. Three cases had two target and four control signals (2R4G), as seen in tetraploid cells. Eleven had complex signal patterns seen in diploid and polyploid cells (1R2G/Assuntos
Neoplasias Encefálicas/genética
, Deleção Cromossômica
, Cromossomos Humanos Par 19
, Cromossomos Humanos Par 1
, Glioma/genética
, Hibridização in Situ Fluorescente/métodos
, Adulto
, Idoso
, Biomarcadores Tumorais/genética
, Neoplasias Encefálicas/diagnóstico
, Estudos de Coortes
, Feminino
, Glioma/diagnóstico
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Prognóstico
RESUMO
A validation of fluorescence in situ hybridization (FISH) assays for paraffin-embedded tissues (PET) is required before clinical use. Although the FISH probe validation process for hematologic disorders has been described during recent years, none of these descriptions, to our knowledge, address the validation process for paraffin-embedded tissues in detail. We describe an applicable preclinical validation process. The following five-step validation is outlined: (1) pathologist's review of slide; (2) probe validation on metaphases to assess sensitivity and specificity; (3) a pilot study using FISH probes on PET; (4) analytical validation using normal and abnormal PET samples to establish a normal reference range or cutoff; and (5) application of the cutoffs to test samples. Although the procedure focuses on dual-color, dual-fusion FISH assays, the same steps could be used for any type of probe. We have described a preclinical validation for probes on paraffin-embedded tissue.
Assuntos
Corantes Fluorescentes , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/patologia , Hibridização in Situ Fluorescente/métodos , Inclusão em Parafina , Corantes Fluorescentes/farmacologia , Doenças Hematológicas/genética , Humanos , Cariotipagem , Metáfase , Projetos Piloto , Sensibilidade e EspecificidadeRESUMO
MYC gene rearrangements are observed as a genetic change in the blastoid variant of mantle cell lymphoma (MCL). We present two patients, one had 30% atypical lymphocytes with Burkitt-like morphology in the peripheral blood and the other had 30% blasts in the bone marrow. Both had a CCND1/IGH and an MYC rearrangement by cytogenetics and FISH. The immunophenotype was CD5+[one was a weak positive], CD10+, CD20+, CCND1+, >90% Ki-67 proliferation fraction and CD23 negative. The diagnosis was blastic MCL with Burkitt features. These cases, along with the reported cases, distinguish an aggressive category of a blastic MCL with a poor prognosis that probably requires Burkitt therapy.
Assuntos
Linfoma de Célula do Manto/genética , Translocação Genética , Idoso , Idoso de 80 Anos ou mais , Linfoma de Burkitt/genética , Cromossomos Humanos Par 11 , Cromossomos Humanos Par 14 , Cromossomos Humanos Par 8 , Rearranjo Gênico , Humanos , Hibridização in Situ Fluorescente , MasculinoRESUMO
BACKGROUND: Precursor B-cell lymphoblastic lymphoma (B-LBL) is an uncommon high-grade neoplasm of immature B cells. In contrast to the more common lymphoblastic lymphoma of T-cell lineage, B-LBL can be an extranodal disease, with a propensity to involve skin and bone. Most reported cases of B-LBL in the skin, a rarity in adults, are manifestations of existing systemic disease. OBSERVATIONS: We report 2 unusual cases of primary cutaneous B-LBL in adults. Fluorescence in situ hybridization studies, not previously reported in primary cutaneous B-LBL to our knowledge, demonstrated rearrangement of the MLL gene in one patient and possible hyperdiploidy in the other, both reported in precursor acute lymphoblastic leukemia. CONCLUSIONS: Review of the literature identified 13 reported cases of B-LBL occurring primarily in the skin, in addition to our 2 cases. Precursor B-cell lymphoblastic lymphoma is more common in children and in young adults, with a tropism for the head and neck region. Histologically, B-LBL must be differentiated from other high-grade lymphoid tumors and small "blue round cell" tumors. Because of the common absence of mature B-cell markers in immunohistochemical studies and the frequent expression of CD99, B-LBL may present a diagnostic challenge. Although there is a suggestion in a limited number of patients that abbreviated therapy may provide long-term disease control, the risk of relapse remains significant, particularly if a patient's condition is misdiagnosed and the patient is treated as having mature B-cell lymphoma. In the absence of prospective studies for this population, patients with B-LBL are treated currently with intensive acute lymphoblastic leukemia regimens.