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1.
Zhongguo Zhong Yao Za Zhi ; 46(16): 4061-4068, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34467715

RESUMO

Reverse prediction and molecular docking techniques were employed to evaluate the feasibility of reniformin A(RA) as an anti-tumor leading compound. Based on the reverse prediction, network pharmacology was used to construct a "disease-compound-target-pathway" network. Thirty-nine tumor-related targets of RA were predicted, which participated in the regulation of multiple cellular activities such as apoptosis, cell cycle, and tumor metastasis, and regulated estrogen signal transduction and inflammatory response. Discovery Studio 2020 was adopted for molecular docking and toxicity prediction(TOPKAT). As revealed by the results, the binding affinity of RA with the tumor-related targets ABL1, ESR1, SRC and BCL-XL was stronger than that of oridonin(OD), while its mutagenicity, rodent carcinogenesis, and oral LD_(50) in rats were all inferior to that of OD. Furthermore, in vitro experiments were performed to confirm the anti-tumor activity of RA, and the mechanism was preliminarily discussed. The results demonstrated that RA was superior to OD in cytotoxicity, inhibition of cell colony formation, and induction of apoptosis. RA, possessing potent anti-tumor activity, is expected to be a new anti-tumor leading compound.


Assuntos
Medicamentos de Ervas Chinesas , Neoplasias , Animais , Medicamentos de Ervas Chinesas/farmacologia , Chumbo , Simulação de Acoplamento Molecular , Neoplasias/tratamento farmacológico , Neoplasias/genética , Ratos , Transdução de Sinais
2.
Int J Lab Hematol ; 43(5): 1117-1122, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33847065

RESUMO

INTRODUCTION: Infantile leukemia encompasses a heterogeneous group which needs stratifying for treatment selection. METHODS: We collected 78 cases of infantile leukemia and retrospectively analyzed their clinicopathological data. RESULTS: Infantile leukemia featured a ratio of acute myeloid leukemia (AML) to B-lymphoblastic leukemia (B-ALL) of 1:2, with a better survival for AML than B-ALL (median survival 36 vs 24 months). When stratified by age, "early" infantile B-ALL (2-6 months) showed a high rate of KMT2A rearrangement (100%), similar to the rate seen in congenital B-ALL (1 month) (100%) and higher than seen in "late" infantile B-ALL (≥7 months) (68%). The three categories of infantile B-ALL exhibited an age-dependent increase in survival (median survival 8.5, 24, and >24 months, respectively). The age-dependent survival benefit remained after excluding the cases negative for KMT2A rearrangement. Conversely, infantile AML lacked an age-dependent pattern of survival. CONCLUSION: The clinical outcome of infantile leukemia depends on the type of leukemia. Given the age-dependent survival, infantile B-ALL can be divided into three subcategories.

3.
J Clin Pathol ; 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542108

RESUMO

AIMS: Myeloid neoplasms occur in the setting of chronic lymphocytic leukaemia (CLL)/CLL-like disease. The underlying pathogenesis has not been elucidated. METHODS: Retrospectively analysed 66 cases of myeloid neoplasms in patients with CLL/CLL-like disease. RESULTS: Of these, 33 patients (group 1) had received treatment for CLL/CLL-like disease, while the other 33 patients (group 2) had either concurrent diagnoses or untreated CLL/CLL-like disease before identifying myeloid neoplasms. The two categories had distinct features in clinical presentation, spectrum of myeloid neoplasm, morphology, cytogenetic profile and clinical outcome. Compared with group 2, group 1 demonstrated a younger age at the diagnosis of myeloid neoplasm (median, 65 vs 71 years), a higher fraction of myelodysplastic syndrome (64% vs 36%; OR: 3.1; p<0.05), a higher rate of adverse unbalanced cytogenetic abnormalities, including complex changes, -5/5q- and/or -7/7q- (83% vs 28%; OR: 13.1; p<0.001) and a shorter overall survival (median, 12 vs 44 months; p<0.05). CONCLUSIONS: Myeloid neoplasm in the setting of CLL/CLL-like disease can be divided into two categories, one with prior treatment for CLL/CLL-like disease and the other without. CLL-type treatment may accelerate myeloid leukaemogenesis. The risk is estimated to be 13-fold higher in patients with treatment than those without. The causative agent could be attributed to fludarabine in combination with alkylators, based on the latency of myeloid leukaemogenesis and the cytogenetic profile.

4.
Medicine (Baltimore) ; 100(6): e24699, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578605

RESUMO

RATIONALE: Pulmonary artery intimal sarcoma is a rare tumor with exceptionally high mortality and easily misdiagnosed as pulmonary thromboembolism pulmonary thromboembolism (PTE) due to the nonspecific clinical presentation and symptom. Misdiagnosis or untimely diagnosis makes the disease progress to an advanced stage and eventually leads to a poor prognosis. PATIENT CONCERNS: A 37-year-old Chinese female presented with chest tightness and dyspnea for 3 months. Echocardiography and chest computed tomography revealed an intraluminal obstruction of the pulmonary arteries. Tests of serum tumor makers showed slight elevation for carbohydrate antigen-125, and α-fetoprotein. PTE was suspected according to the radiological and laboratory findings. DIAGNOSIS: Microscopic findings of the presumed thrombus showed prominent myxoid and edematous background with atypical spindled cells and curvilinear vascularity. Immunohistochemical staining demonstrated that the atypical spindled cells were positive for vimentin but negative for CK, S100, SMA, desmin, CD68, STAT6, CD34, ß-catenin, ALK-p80, p53, and MDM2. According to the radiological and pathological findings, the diagnosis of fibrosarcoma of pulmonary artery was made. INTERVENTIONS: The patient underwent surgical resection and the mass was excised as completely as possible. OUTCOME: Follow-up information showed no evidence of recurrence or metastasis after 3 months postresection. LESSONS: Because of the low incidence rate, nonspecific clinical symptoms, and radiological findings, primary fibrosarcoma of the pulmonary artery is commonly misdiagnosed as PTE. Pathological examination is necessary to confirm the diagnosis.


Assuntos
Fibrossarcoma/diagnóstico , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Túnica Íntima/patologia , Adulto , Assistência ao Convalescente , Grupo com Ancestrais do Continente Asiático/etnologia , Antígeno Ca-125/metabolismo , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Ecocardiografia/métodos , Feminino , Fibrossarcoma/sangue , Fibrossarcoma/patologia , Fibrossarcoma/cirurgia , Humanos , Embolia Pulmonar/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Vimentina/metabolismo , alfa-Fetoproteínas/metabolismo
7.
Pathol Res Pract ; 215(12): 152704, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31699472

RESUMO

Hematolymphoid neoplasms, including lymphoma and myeloid neoplasms, can occur in patients with sickle cell disease (SCD) or equivalent hemoglobinopathy, but an underlying connection between the two conditions has yet to be fully determined. Herein, we report a unique case of sequential development of two separate hematolymphoid neoplasms, human herpes virus 8 (HHV8)-positive diffuse large B-cell lymphoma (DLBCL) and chronic myelomonocytic leukemia, in a 59 year-old African American female with hemoglobin SC disease. While etiology of immunodeficiency is unknown, the potential causes include hydroxyurea therapy, disease related immunomodulation, chronic inflammation, and relatively old age. The leukemia cells demonstrated profound trilineage dysplasia and harbored complex cytogenetic abnormalities with loss of chromosome 5q and 7q, which are often observed in therapy-related myeloid neoplasms. Besides the potential causes listed above, we propose that myeloid leukemia in this setting may result from genomic changes due to excessive hematopoietic replication triggered by a hemolysis-induced cytokine storm. While myeloid neoplasms in the setting of SCD seems to herald a dismal clinical outcome per the literature, the HHV8-positive DLBCL in our case was apparently indolent, opposing the current perception of its clinical outcome.


Assuntos
Doença da Hemoglobina SC/complicações , Infecções por Herpesviridae/virologia , Herpesvirus Humano 8/patogenicidade , Leucemia Mielomonocítica Crônica/etiologia , Linfoma Difuso de Grandes Células B/etiologia , Antidrepanocíticos/efeitos adversos , Transformação Celular Neoplásica/genética , Progressão da Doença , Evolução Fatal , Feminino , Doença da Hemoglobina SC/diagnóstico , Doença da Hemoglobina SC/tratamento farmacológico , Doença da Hemoglobina SC/genética , Infecções por Herpesviridae/complicações , Infecções por Herpesviridae/diagnóstico , Humanos , Hidroxiureia/efeitos adversos , Leucemia Mielomonocítica Crônica/diagnóstico , Leucemia Mielomonocítica Crônica/genética , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/virologia , Pessoa de Meia-Idade , Fatores de Risco
8.
Am J Clin Pathol ; 152(6): 782-798, 2019 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-31365922

RESUMO

OBJECTIVES: Use of fine-needle aspiration/needle core biopsy (FNA/CNB) in evaluating hematolymphoid processes has been debated. We investigate its applicability in various clinicopathologic settings. METHODS: We retrospectively analyzed 152 cases of FNA/CNB. RESULTS: Of 152 FNA/CNBs, 124 (81.6%) resulted in diagnoses without excisional biopsies, while 28 required subsequent excisional biopsies. Of these, 43 FNA/CNBs performed for suspected lymphoma relapse demonstrated 95.4% diagnostic rate (41/43), which was significantly better than those without history of lymphoma (77/109, 71%; odds ratio [OR], 8.5; confidence interval, 1.9-37.4). Patients with immunodeficiency also showed a high rate of diagnosis by FNA/CNB (100%). When stratified by types of disease, diffuse large B-cell lymphoma/high-grade B-cell lymphoma demonstrated a higher success rate (92.7%) than small B-cell lymphoma (79.2%), though the difference was not statistically significant (OR, 3.3; P value = .07). A subsequent excisional biopsy was required in 28 cases, 23 of which resulted in diagnoses concordant with the FNA/CNB. Five cases showed diagnostic discordance, reflecting pitfalls of FNA/CNB in unusual cases with complex pathology. CONCLUSIONS: FNA/CNB is practical in evaluating most hematolymphoid lesions, with high efficacy in recurrent disease and some primary neoplasms with homogeneous/ aggressive histology, or characteristic immunophenotype.


Assuntos
Biópsia por Agulha/métodos , Neoplasias Hematológicas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
9.
Mod Pathol ; 32(12): 1712-1726, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31371806

RESUMO

Myeloid neoplasms occasionally occur in patients with sickle cell disease, and the underlying connection between the two diseases is unclear. Herein, we retrospectively analyzed four cases of sickle cell disease patients who developed myeloid neoplasm. Age at time of diagnosis ranged from 27 to 59 years with a median of 35.5 years. Two patients were treated with hydroxyurea and the other two with supportive care alone, with one out of the four patients receiving additional treatment with hematopoietic stem cell transplant. Three patients presented with leukocytosis, and the remaining patient presented with pancytopenia. Two patients were diagnosed with myelodysplastic syndrome/myeloproliferative neoplasm, one with myelodysplastic syndrome, and the other with acute myeloid leukemia. All four cases demonstrated certain degrees of myelodysplasia and complex cytogenetic abnormalities with - 7/7q- and/or - 5/5q- or with 11q23 (KMT2A) rearrangement. This cytogenetic profile resembles that seen in therapy-related myeloid neoplasm, suggesting that myeloid neoplasm in the setting of sickle cell disease may represent a subcategory of the disease distinct from de novo myeloid neoplasm in general. Extensive literature review further demonstrates this similarity in cytogenetic profile, as well as in other associated pathologic features. Potential etiology includes therapy for sickle cell disease, disease-related immunomodulation, or disease-related chronic inflammation. We hypothesize that constant hematopoietic hyperplasia, stimulated by a hemolysis-induced cytokine storm, may increase the chance of somatic mutations/cytogenetic aberrations, resulting in transformation of myeloid precursors. This group of myeloid neoplasms seems to herald a dismal clinical outcome, with median survival <1 year, although the exact pathogenesis and biology of the disease remain to be investigated by large cohorts in future studies.


Assuntos
Anemia Falciforme/complicações , Leucemia Mieloide Aguda/complicações , Síndromes Mielodisplásicas/complicações , Adulto , Aberrações Cromossômicas , Feminino , Humanos , Leucemia Mieloide Aguda/genética , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/genética , Estudos Retrospectivos
10.
Pathol Res Pract ; 215(8): 152400, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30944066

RESUMO

Sickle cell disease (SCD) is a hereditary blood disorder that often has multiple comorbidities. Patients occasionally develop malignant neoplasms, but the risk of lymphoma in SCD is currently unknown. Here, we report a unique case of subcutaneous panniculitis-like T-cell lymphoma (SPTCL) in a 25-year-old male patient with SCD. The patient suffered from episodes of sickling crisis since his initial SCD diagnosis and had been treated with supportive care. Hydroxyurea was added at the age of 23 years old. Two years later, he presented with right cheek swelling, and the biopsy showed a lymphohistiocytic infiltrate within adipose tissue resembling lobular panniculitis. Immunohistochemistry demonstrated CD8/ß-F1-positive T-cells around the fat vacuoles, with a high proliferative index. The histopathologic features suggested a diagnosis of SPTCL. A subsequent TCRß gene rearrangement analysis detected a clonal amplicon, confirming the diagnosis. Because of the lack of systemic symptoms, the patient received conservative therapy with prednisone and responded well with resolution of his right cheek swelling within one month. To the best of our knowledge, this is the first reported case of SPTCL associated with SCD. The proposed lymphomagenesis in the setting of SCD is also discussed.


Assuntos
Anemia Falciforme/diagnóstico , Anemia Falciforme/patologia , Linfoma de Células T/patologia , Paniculite/patologia , Adulto , Biópsia/métodos , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica/métodos , Linfoma de Células T/diagnóstico , Masculino , Paniculite/diagnóstico
12.
Medicine (Baltimore) ; 98(11): e14883, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30882698

RESUMO

RATIONALE: Signet-ring cell is a rare morphological finding in bone marrow, which usually indicates metastatic carcinoma from either the gastrointestinal tract or a primary hematolymphoid neoplasm. Here, we present a very unusual case of lobular breast carcinoma with metastasis to the bone marrow. PATIENT CONCERNS: A 67-year-old female with estrogen receptor (ER)-positive lobular breast carcinoma was staged as T3N3M0, and treated with modified radical mastectomy followed by chemotherapy and radiotherapy. One year after treatment, she was noted to have moderate thrombocytopenia on complete blood count with the remainder of the parameters within normal limits. Radiographic examination revealed no evidence of recurrent disease. DIAGNOSIS: Bone marrow biopsy was performed to exclude therapy-related myelodysplastic syndrome (MDS), which demonstrated hypercellularity with "hyperplastic" hematopoiesis. Upon closer inspection, a few signet-ring cells were identified which morphologically resembled histiocytes. These formed an interstitial infiltrate among the predominantly hematopoietic elements, and could have been easily overlooked. Immunohistochemistry demonstrated that these signet-ring cells were positive for pancytokeratin as well as ER which confirmed metastatic lobular breast carcinoma. On retrospective review of the aspirate smear, rare signet-ring cells were identified. INTERVENTIONS: The patient was treated with additional chemotherapy. OUTCOMES: The patient eventually succumbed to overt dissemination after 14 months. LESSONS: Due to the relative discohesiveness of lobular breast carcinoma, the cells frequently assume single-cell infiltration in bone marrow. This attribute, along with small cell size, bland cytologic features and paucity of tissue response, contributes to its escaping from identification on hematoxylin-eosin (H&E) sections. In this case, the signet-ring cells were hidden in apparently hyperplastic hematopoiesis. Careful inspection raised the possibility of occult metastasis which was readily detected and confirmed with immunohistochemistry.


Assuntos
Neoplasias da Mama/complicações , Carcinoma de Células em Anel de Sinete/etiologia , Idoso , Biópsia/métodos , Medula Óssea/anormalidades , Medula Óssea/patologia , Medula Óssea/fisiopatologia , Neoplasias da Mama/patologia , Tratamento Farmacológico/métodos , Feminino , Humanos , Mastectomia/métodos , Radioterapia/métodos
13.
Leuk Lymphoma ; 60(4): 1006-1013, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30188223

RESUMO

Acute lymphoblastic leukemia (ALL) in infants <1-year-old is biologically different from ALL in older children. Although KMT2A rearrangement is the predominant genetic signature in infantile B-ALL, disease course is heterogenous, behaving more aggressively in younger infants. We investigated clinicopathological differences throughout the first year to understand the transition to pediatric B-ALL. In a multi-institutional review involving four medical institutions, 54 cases of infantile B-ALL were identified. Patients were divided into congenital and non-congenital groups with multiple age subgroups. Male predominance was seen in congenital cases compared to female in non-congenital cases. There were decreasing trends of hyperleukocytosis, central nervous system involvement, KMT2A rearrangements, lineage switch, and mortality, versus increasing trends of CD10 expression and non-KMT2A abnormalities. Statistically significant differences emerged at 3 and 9 months, the latter was not previously described. Poor-prognostic risk factors decreased with age, the last trimester of infantile B-ALL essentially merging with pediatric B-ALL.


Assuntos
Biomarcadores Tumorais , Estudos de Associação Genética , Predisposição Genética para Doença , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Transformação Celular Neoplásica/genética , Aberrações Cromossômicas , Feminino , Citometria de Fluxo , Histocitoquímica , Humanos , Lactente , Cariotipagem , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Prognóstico , Resultado do Tratamento
14.
J Exp Clin Cancer Res ; 37(1): 315, 2018 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-30547821

RESUMO

BACKGROUND: Disabled-2 (Dab2) is known as a tumor suppressor as well as a Wnt pathway inhibitor. We previously reported that Dab2 was down-regulated due to gene promoter hypermethylation in lung cancer. Here, we aim to study if X-ray irradiation can induce de-methylation of the Dab2 gene and subsequently up-regulate its expression, and also to attempt to suppress the malignant biological behavior of and enhance the radiosensitivity in lung cancer cells with hypermethylation of the Dab2 gene. METHODS: Immunostaining was performed to investigate the relationship between Dab2 expression and lung cancer clinicopathological characteristics. Bisulfite sequencing PCR (BSP) was used to evaluate the methylation status of lung cancer cells with or without X-ray treatment. Real-time PCR and western Blot were performed to investigate the expression of Dab2, Wnt pathway factors, DNMTs and methyl CpG binding protein 2 (MeCP2). Colony Formation, matrigel invasion and xenograft experiment were performed to evaluate the malignant biological behavior of lung cancer cells with irradiation. RESULTS: The result of immunostaining of Dab2 in lung cancer tissues showed that decreased Dab2 expression was positively correlated with poor differentiation, lymph node metastasis, advanced TNM stage and poor prognosis. X-ray treatment significantly up-regulated Dab2 expression and inhibited Wnt factors in LK2 cells (with hypermethylation of the Dab2 gene promoter, P < 0.05), but not in SPC-A-1 cells (with hypomethylation of the Dab2 gene promoter); however, the effect could be reversed by Dab2 or Axin knockdown (P < 0.05). Decreased expression of DNMT1, DNMT3b and MeCP2 could be detected in both LK2 and SPC-A-1 cells compared to non-irradiated cells (P < 0.05). Both in vitro studies and in vivo xenograft tumor growth demonstrated that X-ray could significantly inhibit the proliferation and invasion of LK2 but not SPC-A-1 cells (P < 0.05). CONCLUSION: In general, X-ray-induced up-regulation of Dab2 and inhibition of the Wnt pathway may be mediated by de-methylation of a hypermethylated Dab2 gene promoter. X-ray treatment significantly inhibits proliferation and invasion of lung cancer cells with hypermethylation of the Dab2 gene promoter, but is less effective in lung cancer cells with hypomethylation of the Dab2 gene promoter. These results indicate that the methylation status of the Dab2 gene promoter might be a potential predictor of the radiosensitivity of lung cancer cells.


Assuntos
Proteínas Adaptadoras de Transporte Vesicular/metabolismo , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/radioterapia , Regiões Promotoras Genéticas/efeitos dos fármacos , Tolerância a Radiação/efeitos dos fármacos , Via de Sinalização Wnt/efeitos dos fármacos , Terapia por Raios X/métodos , Proteínas Adaptadoras de Transdução de Sinal , Animais , Proteínas Reguladoras de Apoptose , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Linhagem Celular Tumoral , Feminino , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Camundongos , Camundongos Nus , Pessoa de Meia-Idade , Transfecção
15.
Medicine (Baltimore) ; 97(38): e12482, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30235749

RESUMO

RATIONALE: Primary central nervous system lymphoma (PCNSL) is a rare form of non-Hodgkin lymphoma with a dismal outcome. Most patients relapse in intracranial sites and <5% of patients relapse in extracranial sites. Here, we present the first case of PCNSL with an adrenal relapse. PATIENT CONCERNS: A 72-year-old woman, first presented 7 years ago with complaints of headache and dizziness. DIAGNOSES: Enhanced magnetic resonance imaging revealed the mass within the splenium of the corpus callosum. On histological examination, there was a diffuse growth pattern of neoplastic cells in the brain biopsy. Immunohistochemistry and flow cytometric analysis demonstrated that the neoplastic cells were of B-cell lineage. INTERVENTIONS: The patient underwent methotrexate-based chemotherapy and whole-brain radiotherapy after the initial diagnosis of primary central nervous system-large B-cell lymphoma (CNS-DLBCL). OUTCOMES: After 4 years of clinical remission, the patient was diagnosed with endometrial cancer. Interestingly, a radiological study following the treatment of endometrial cancer demonstrated a right adrenal mass, which was suspicious for malignancy. Morphologic examination and immunohistochemistry studies confirmed the diagnosis of diffuse large B-cell lymphoma. A fluorescent in situ hybridization panel for lymphoma showed rearrangement of Immunoglobulin heavy chain (IGH) and B-cell lymphoma 6 (BCL6), respectively, suggesting fusion of BCL6/IGH. Immunoglobulin kappa analysis demonstrated a common origin for the brain and adrenal lesions, which led to the final diagnosis of an adrenal relapse of CNS-DLBCL. LESSONS: PCNSL is a highly infiltrative neoplasm, particularly at relapse. To the best of our knowledge, this is the first case of CNS-DLBCL with adrenal relapse. Considering the poor outcome of CNS-DLBCL, molecular genetic studies should be done to identify a common origin for the primary and secondary lesion.


Assuntos
Neoplasias das Glândulas Suprarrenais/secundário , Neoplasias do Sistema Nervoso Central/patologia , Linfoma Difuso de Grandes Células B/patologia , Recidiva Local de Neoplasia/patologia , Idoso , Feminino , Humanos
16.
Pathol Res Pract ; 214(10): 1738-1744, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30025593

RESUMO

Aberrant expression of CD3 on diffuse large B-cell lymphoma (DLBCL) is rare, and its mechanism and biological significance are currently unclear. Herein we report a case of Epstein-Barr virus-negative, CD3-positive DLBCL in a 53 year-old male, who had a remote history of renal transplantation. After standard chemotherapy, the patient was in clinical remission. He relapsed three years later, but at this time with apparent loss of CD3 expression. PCR-based IGK gene rearrangement studies demonstrated clonal amplicons with an identical nucleotide size between the primary and secondary DLBCL, confirming the clonal relationship despite their phenotypic differences. To our knowledge, this is the first case of CD3-positive DLBCL that demonstrated a loss of aberrant CD3 on relapse. The chronologic change in phenotype seen in this case suggests that the source of the patient's lymphoma relapse may arise from either a quiescent subclone without CD3 expression, or from an upstream neoplastic precursor cell.


Assuntos
Linfoma Difuso de Grandes Células B/imunologia , Linfoma Difuso de Grandes Células B/patologia , Recidiva Local de Neoplasia/imunologia , Recidiva Local de Neoplasia/patologia , Complexo CD3/biossíntese , Complexo CD3/imunologia , Humanos , Hospedeiro Imunocomprometido/imunologia , Imunofenotipagem , Transplante de Rim , Masculino , Pessoa de Meia-Idade
17.
Am J Clin Pathol ; 150(3): 246-258, 2018 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-29992292

RESUMO

OBJECTIVES: Therapy-related chronic myeloid leukemia (CML) has been reported, but its clinical presentation and pathologic features have not yet been well characterized. METHODS: Twenty-one cases of CML following treatment for primary diseases were collected and retrospectively analyzed. RESULTS: The clinical presentation, pathologic features, and cytogenetic profile were similar to de novo CML. In particular, those with an isolated Philadelphia chromosome constituted 88.9% of our cases, and additional aberrations characteristic of therapy-related acute myeloid leukemia/myelodysplastic syndrome (AML/MDS) were not identified in this study. The patients responded to imatinib/derivatives and survived with limited follow-up. CONCLUSIONS: Therapy-related CML has a clinical presentation, pathologic features, and cytogenetic profile akin to de novo CML. Absence of additional significant aberrations seems to suggest a pathogenesis different from therapy-related AML/MDS. Therapy-related CML exhibits a robust therapeutic response to imatinib/derivatives and favorable clinical outcomes similar to de novo CML.

19.
Medicine (Baltimore) ; 97(26): e11271, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29953002

RESUMO

RATIONALE: Primary central nervous system histiocytic sarcoma (PCNSHS) is a rare lymphohematopoietic tumor with a histiocytic cell origin. To our knowledge, only 28 cases have been published in English and 2 cases in Chinese. PATIENT CONCERNS: A 49-year-old Asian female presented to the hospital with a 2 month history of hypomnesia, odynophagia, and gait disorder. Physical examination demonstrated decreased lower extremity muscle strength. The patient denied a history of malignancy. DIAGNOSES: Radiology demonstrated a lesion in parietal lobe with uniformenhancement. Histologic analysis showed pleomorphic tumor cells with a loose arrangement, effacing the normal brain tissue. The tumor cells exhibited abundant eosinophilic cytoplasm, highly atypical nuclei and predominant nucleoli. Immunohistochemistry revealed positive immunoreactivity for CD45, lysozyme, CD68, and CD163, and negative for pan-cytokeratin (CK), epithelial membrane antigen (EMA), glial fibrillary acidic protein (GFAP), CD3, CD20, CD1a, CD79a, CD138, oligodendrocyte transcription factor (olig2), CD15, melan-A, CD30, CD21, CD35, Human Melanoma Black-45 (HMB45), and anaplastic lymphoma kinase-1 (ALK-1). The diagnosis of PCNSHS was rendered. INTERVENTIONS: The patient underwent complete surgical resection and adjuvant radiotherapy. OUTCOMES: Follow-up information shows the patient died 8 months following the initial diagnosis. LESSONS: PCNSHS is extremely rare with an aggressive clinical course. Immunohistiochemistry is necessary to make this diagnosis and to exclude other primary intracranial and lymphohematopoietic tumors. Further research is required to improve the outcome of patients with PCNSHS.


Assuntos
Neoplasias do Sistema Nervoso Central/diagnóstico , Sarcoma Histiocítico/diagnóstico , Antígenos CD/imunologia , Neoplasias do Sistema Nervoso Central/imunologia , Neoplasias do Sistema Nervoso Central/terapia , Feminino , Sarcoma Histiocítico/imunologia , Sarcoma Histiocítico/terapia , Humanos , Pessoa de Meia-Idade
20.
Medicine (Baltimore) ; 97(12): e0181, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29561433

RESUMO

RATIONALE: Primary testicular natural killer (NK)/T-cell lymphoma is an extremely rare and highly aggressive lymphoid malignancy. At present, only 20 cases have been reported. PATIENT CONCERNS: A 32-year-old Chinese man complained of discomfort and swelling of his right testicle for 3 months. Physical examination revealed a 10 × 10 × 9.5 cm mass on the right side of the scrotum area. DIAGNOSES: Pathologic evaluation showed effacement of normal testicular parenchymal architecture by small-to-medium-sized lymphoid cells with irregular nuclear profiles, and immunohistochemical studies positively expressed CD2, CD56, cytoplasmic CD3, granzyme B, perforin, and TIA-1. Therefore, the patient was diagnosed with primary testicular NK/T-cell lymphoma. INTERVENTIONS: The patient underwent CHOP (cyclophosphamide (CTX), pirarubicin (THP-ADM), vincristine (VCR), and prednisolone (PDN)) chemotherapy. OUTCOMES: The patient relapsed 5 months after his initial presentation and died after an infection and gastrointestinal bleed. LESSONS: Clinicopathological assessment of this rare case highlights the clinical and pathological features required to diagnose testicular NK/T-cell lymphoma. In addition, it highlights the dismal survival of these patients. We hope it may serve as a reference aiding prompt clinical diagnosis, which can hopefully improve the survival and quality of life of these patients.


Assuntos
Linfoma de Células T/diagnóstico por imagem , Linfoma de Células T/patologia , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/patologia , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica , Diagnóstico Diferencial , Evolução Fatal , Humanos , Linfoma de Células T/tratamento farmacológico , Linfoma de Células T/cirurgia , Masculino , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/cirurgia
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