Stratifying diffuse large B-cell lymphoma patients treated with chemoimmunotherapy: GCB/non-GCB by immunohistochemistry is still a robust and feasible marker.

Diffuse large B cell lymphoma (DLBCL) is a heterogeneous group of aggressive lymphomas that can be classified into three molecular subtypes by gene expression profiling (GEP): GCB, ABC and unclassified. Immunohistochemistry-based cell of origin (COO) classification, as a surrogate for GEP, using three available immunohistochemical algorithms was evaluated in TMA-arranged tissue samples from 297 patients with de novo DLBCL treated by chemoimmunotherapy (R-CHOP and R-CHOP-like regimens). Additionally, the prognostic impacts of MYC, BCL2, IRF4 and BCL6 abnormalities detected by FISH, the relationship between the immunohistochemical COO classification and the immunohistochemical expression of MYC, BCL2 and pSTAT3 proteins and clinical data were evaluated. In our series, non-GCB DLBCL patients had significantly worse progression-free survival (PFS) and overall survival (OS), as calculated using the Choi, Visco-Young and Hans algorithms, indicating that any of these algorithms would be appropriate for identifying patients who require alternative therapies to R-CHOP. Whilst MYC abnormalities had no impact on clinical outcome in the non-GCB subtype, those patients with isolated MYC rearrangements and a GCB-DLBCL phenotype had worse PFS and therefore might benefit from novel treatment approaches.

Morphological and immunohistochemical aspects of the biological seal in Klöckner's dental implants: study of 15 cases.

The morphological and immunohistochemical aspects of the peri-implanted pathological soft tissue of 21 Klöckner implants are assessed, corresponding to 15 patients and three gingival samples from three cadavers. For the collagen and vascular walls assessment, the Picro-Sirio technique is used with normal microscopy as well as with polarized light, evaluating the decrease of collagen fibers in relation to the grade of inflammation. In cases when there is a plasmocyte inflammatory prevalence, antibodies are used contrasted with Kappa and Lambda light chains, observing in all cases a polyclonal plasmocytosis (reactive). The Ag. Ki-67 is used to mark cell proliferation that shows a normal or enlarged activity that can reach the infiltrated cells of the lamina propria. Epitheliotropism or a lymphoepithelial lesion is analyzed in relation to the inflammation, observing the tendency to be larger in K-type implants with a completely-submerged technique. The lesion that is usually observed is the periimplanted mucositis of the chronic or mixed type. The regenerated epithelium has a slight thickness with congestive and dilated vessels. In one case (as anecdotal value), there is the presence of coilocytes compatible with infection by HPV (Human Papilloma Virus).

[Cutaneous vasculitis during primary myelofibrosis]. / Vasculitis cutánea en el curso de una mielofibrosis primaria.

A leukocytoclastic cutaneous vasculitis in the course of an idiopathic myelofibrosis is reported. The cutaneous lesions that might appear in this hematological disease are discussed, including cutaneous infections, myeloid metaplasia and cutaneous infiltration due to the myeloproliferative process. We point out the rarity of cutaneous vasculitis during the course of primary myelofibrosis.

[Initial clinicopathological manifestations of malignant lymphoproliferative processes in patients with human immunodeficiency virus seropositivity. Study of 40 cases]. / Características clinicopatológicas de presentación de los procesos linfoproliferativos malignos en pacientes seropositivos para el virus de la inmunodeficiencia humana. Estudio de 40 casos.

We analyzed the series of 40 malignant lymphoproliferative diseases (MLD) in HIV positive patients, diagnosed between 1986 and 1993 in a University Hospital in Spain. Median age was 32 years. 52% of the patients belonged to the intravenous drug users risk group, and 30% were homosexual. 26 patients were diagnosed of a non-Hodgkin's lymphoma (NHL), 8 of Hodgkin's disease (HD) and 6 of a primary central nervous system lymphoma (PCL). The 6 patients with a PCL (median CD4 of 20 cells/mm3, 80% antecedent AIDS criteria) and 13 NHL with histology of immunoblastic, large cell, plasmablastic, and high grade lymphoma non-otherwise specified (median CD4 of 291, 58% with AIDS criteria) tended to appear in patients with a deteriorated clinical and immunological status due to the underlying HIV infection. However, the 14 small non-cleaved cell NHLs appeared in patients without a previous AIDS-defining condition (93% of the cases, p = 0.065 compared with other NHL histologies). Finally, 8 patients with HD had a low CD4 cell count (median 103 cells/mm3, p = 0.049 compared with median CD4 in NHL patients) without other previous AIDS criteria. In conclusion, The presenting characteristics of HIV positive patients with MLD allows to define four subgroups of patients with a high clinicopathological correlation.

[Pulmonary hemorrhage and glomerulonephritis associated with essential mixed cryoglobulinemia]. / Hemorragia pulmonar y glomerulonefritis asociados a crioglobulinemia mixta esencial.

A 49-year-old male with essential mixed cryoglobulinemia IgM kappa-IgG of 4-years duration was treated with corticosteroids and immunosuppressive drugs during the repeated episodes. Finally, he developed a new episode with severe renal involvement and pulmonary hemorrhage without other associated etiological factors. The optical and immunofluorescent histological findings in lung and kidney are described. This is the second case of pulmonary hemorrhage and cryoglobulinemia associated with essential mixed cryoglobulinemia reported in the literature. A relation between essential mixed cryoglobulinemia and glomerulonephritis and pulmonary hemorrhage is suggested.