[Application of digital pathology tools. An unusual case of non-Hodgkin lymphoma]. / Anwendung von Verfahren der digitalen Pathologie. Fallbeispiel eines ungewöhnlichen Non-Hodgkin-Lymphoms.
Pathologe
; 33 Suppl 2: 200-4, 2012 Nov.
Article
en De
| MEDLINE
| ID: mdl-23011022
ABSTRACT
Currently, lymphoma diagnosis is based on a combination of morphology, immunophenotyping, and molecular testing. Using the example of an unusual case of malignant non-Hodgkin lymphoma, we show that improved visualization using digital pathology contributes to the convergence of these complementary diagnostic modalities. A 45-year-old woman presented with skin rash and cervical lymphadenopathy. Histological workup of an excised lymph node showed loss of normal architecture with diffuse infiltration and increased mitotic activity. Immunohistochemistry for CD3/CD5 showed atypical arrangement and infiltration of a T-cell population that dominated over regionally dense, MUM1-positive plasmacellular infiltrates. Expanded CD21/CD23-positive meshworks of follicular dendritic cells were present within and between regressed follicles and the T-cell infiltrate; staining for CD56 and cyclin-D1 was negative. Quantification of Ki-67 staining within the T-, B- and plasmacellular compartments was achieved by digital image conversion, overlay and subsequent quantification algorithms that revealed proliferation within more than 60% of T-cells, over 50% of plasma cells and only 20% of B-cells. Clonality analysis by PCR revealed monoclonal rearrangement for both T-cell receptor gamma chains and immunoglobulin heavy chains. Taken together, we present an unusual combination of an angioimmunoblastic T-cell lymphoma (AITL) and simultaneous plasmacellular lymphoma. This report demonstrates how application of modern tools of digital pathology can visually integrate unusual morphological and molecular findings.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Plasmacitoma
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Aumento de la Imagen
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Inmunofenotipificación
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Linfoma Cutáneo de Células T
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Linfadenopatía Inmunoblástica
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Ganglios Linfáticos
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Neoplasias Primarias Múltiples
Tipo de estudio:
Diagnostic_studies
Idioma:
De
Revista:
Pathologe
Año:
2012
Tipo del documento:
Article