THE ULTRASTRUCTURAL STUDY OF NON－HODGKIN＇S LYMPHOMA CELL，CHRONIC LYMPHOCYTIC AND HAIRY CELL LEUKEMIA

ＴＨＥＵＬＴＲＡＳＴＲＵＣＴＵＲＡＬＳＴＵＤＹＯＦＮＯＮ－ＨＯＤＧＫＩＮ＇ＳＬＹＭＰＨＯＭＡＣＥＬＬ，ＣＨＲＯＮＩＣＬＹＭＰＨＯＣＹＴＩＣＡＮＤＨＡＩＲＹＣＥＬＬＬＥＵＫＥＭＩＡＧｕｉＷｅｉ；归薇ＺｈａｎｇＱｉａｏｈｕａ；张巧花ＺｈｅｎｇＹｕｐｉｎｇ...     

THE EXPRESSION OF CATHEPSIN－D，C－erbB－2 AND EGFR IN BREAST CANCER AND ITS CORRELATION TO LYMPHATIC ME

ＴＨＥＥＸＰＲＥＳＳＩＯＮＯＦＣＡＴＨＥＰＳＩＮ－Ｄ，Ｃ－ｅｒｂＢ－２ＡＮＤＥＧＦＲＩＮ　ＢＲＥＡＳＴＣＡＮＣＥＲＡＮＤＩＴＳＣＯＲＲＥＬＡＴＩＯＮＴＯＬＹＭＰＨＡＴＩＣＭＥＴＡＳＴＡＳＩＳＸｕＬｉａｎｇｚｈｏｎｇ许良中；ＺｈｕＷｅｉｐｉｎｇ朱伟萍；...     

QUALITATIVE STUDY OF SIALOMUCINS CHANGES DURING N－METHYL－N－NITROSOUREA－INDUCED C OLONIC CARCINOGENESIS IN MICE

ＱＵＡＬＩＴＡＴＩＶＥＳＴＵＤＹＯＦＳＩＡＬＯＭＵＣＩＮＳＣＨＡＮＧＥＳＤＵＲＩＮＧＮ－ＭＥＴＨＹＬ－Ｎ－ＮＩＴＲＯＳＯＵＲＥＡ－ＩＮＤＵＣＥＤＣＯＬＯＮＩＣＣＡＲＣＩＮＯＧＥＮＥＳＩＳＩＮＭＩＣＥＷａｎｇＱｉａｎｇ王强；ＷａｎｇＹｕａｎｈｅ王元和；...     

AN ENZYMOCYTOCHEMICAL STUDY OF ALKALINE PHOSPHATASE ISOENZYMES IN GASTRIC CANCER－LIGHT AND ELECTRON

ＡＮＥＮＺＹＭＯＣＹＴＯＣＨＥＭＩＣＡＬＳＴＵＤＹＯＦＡＬＫＡＬＩＮＥＰＨＯＳＰＨＡＴＡＳＥＩＳＯＥＮＺＹＭＥＳＩＮＧＡＳＴＲＩＣＣＡＮＣＥＲ－ＬＩＧＨＴ　ＡＮＤＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＯＢＳＥＲＶＡＴＩＯＮＳＳｕＹｉｎｇｈａｏ苏英豪；...     

CLONING AND SEQUENCING OF IMMUNOGLOBULINVARIABLE－REGION GENE OF A MONOCLONALANTIBODY SPECIFIC FOR HUMANHEPATOCARCINOMA

ＣＬＯＮＩＮＧＡＮＤＳＥＱＵＥＮＣＩＮＧＯＦＩＭＭＵＮＯＧＬＯＢＵＬＩＮＶＡＲＩＡＢＬＥ－ＲＥＧＩＯＮＧＥＮＥＯＦＡＭＯＮＯＣＬＯＮＡＬＡＮＴＩＢＯＤＹＳＰＥＣＩＦＩＣＦＯＲＨＵＭＡＮＨＥＰＡＴＯＣＡＲＣＩＮＯＭＡＹａｎｇＰｉｎｇ杨萍；ＧａｏＬｅｉ高...     

THE EFFECT OF ACTIVE COMPONENTS OF LYCIUM BARBARUM AND GARLIC（LB－GO）ON THE SYNTHESIS OF DNA AND ULTRASTRUCTURE OF U_（14） CERV

ＴＨＥＥＦＦＥＣＴＯＦＡＣＴＩＶＥＣＯＭＰＯＮＥＮＴＳＯＦＬＹＣＩＵＭＢＡＲＢＡＲＵＭＡＮＤＧＡＲＬＩＣ（ＬＢ－ＧＯ）ＯＮＴＨＥＳＹＮＴＨＥＳＩＳＯＦＤＮＡＡＮＤＵＬＴＲＡＳＴＲＵＣＴＵＲＥＯＦＵ_（１４）ＣＥＲＶＩＸＣＡＮＣＥＲＣＥＬＬＳＩＮＭＩＣ?..     

A MICROCOMPUTER PROGRAM FOR CALCULATINGTHE CONFIDENCE INTERVALS OF SURVIVAL PROBABILITY IN MEDICAL FOLLOW－UP STUDIES

ＡＭＩＣＲＯＣＯＭＰＵＴＥＲＰＲＯＧＲＡＭＦＯＲＣＡＬＣＵＬＡＴＩＮＧＴＨＥＣＯＮＦＩＤＥＮＣＥＩＮＴＥＲＶＡＬＳＯＦＳＵＲＶＩＶＡＬＰＲＯＢＡＢＩＬＩＴＹＩＮＭＥＤＩＣＡＬＦＯＬＬＯＷ－ＵＰＳＴＵＤＩＥＳＸｉａｎｇｙｏｎｇｂｉｎｇ项永兵；Ｇａｏｙｕ...     

T－LYMPHOCYTE MEDIATED TUMOR CELL DESTRUCTIONIN VIVO ASSOCIATING WITH A SPECIFICFEATURE OF APOPTOSIS

Ｔ－ＬＹＭＰＨＯＣＹＴＥＭＥＤＩＡＴＥＤＴＵＭＯＲＣＥＬＬＤＥＳＴＲＵＣＴＩＯＮＩＮＶＩＶＯＡＳＳＯＣＩＡＴＩＮＧＷＩＴＨＡＳＰＥＣＩＦＩＣＦＥＡＴＵＲＥ　ＯＦ　ＡＰＯＰＴＯＳＩＳＹｕＤａ鱼达；ＹａｎｇＨｕａ杨骅；ＺｈｅｎｇＳｈｕ郑树；ＷａｎｇＸｉａ...     

RESEARCH ON SERUM LEVELS OF RETINOL，α－TOCOPHEROL β－CAROTENE，AND 12 ELEMENTS IN GASTRIC DYSPLASIA AND GASTRIC CANCER PATIENTS

ＲＥＳＥＡＲＣＨＯＮＳＥＲＵＭＬＥＶＥＬＳＯＦＲＥＴＩＮＯＬ，α－ＴＯＣＯＰＨＥＲＯＬβ－ＣＡＲＯＴＥＮＥ，ＡＮＤ１２ＥＬＥＭＥＮＴＳＩＮＧＡＳＴＲＩＣＤＹＳＰＬＡＳＩＡＡＮＤＧＡＳＴＲＩＣＣＡＮＣＥＲＰＡＴＩＥＮＴＳＣｈｅｎｇＷｕｆｅｎｇ；程五凤；...     

DETECTION OF OCCULT TUMOR CELLS IN RESECTED LYMPH NODES OF PATIENTS WITH STAGE I CARCINOMA AND ITS CLINICOPATHOLOGICAL SIGNIFICANCE

ＤＥＴＥＣＴＩＯＮＯＦＯＣＣＵＬＴＴＵＭＯＲＣＥＬＬＳＩＮＲＥＳＥＣＴＥＤＬＹＭＰＨＮＯＤＥＳＯＦＰＡＴＩＥＮＴＳＷＩＴＨＳＴＡＧＥＩＣＡＲＣＩＮＯＭＡＡＮＤＩＴＳＣＬＩＮＩＣＯＰＡＴＨＯＬＯＧＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＣｈｅｎＺｈａｏｌｕｎ...     

Immunoblastic lymphadenopathy, angioimmunoblastic lymphadenopathy, and IBL-like T-cell lymphoma. A spectrum of T-cell neoplasia

Thirty cases of immunologically determined and histologically diagnosed immunoblastic lymphadenopathy (IBL), angioimmunoblastic lymphadenopathy (AILD), and IBL-like T-cell lymphoma were clinicopathologically reviewed. Clinical manifestations and laboratory findings did not reveal significant differences in these three groups. IBL, AILD, and IBL-like T-cell lymphoma showed a spectrum of histologic changes, in which proliferation of pale cells was a critical diagnostic point for the histologic malignancy. Immunostaining for their subsets revealed that 3 of 21 cases showed T4+ phenotype and the remaining 19 cases showed T8+ phenotype. Three of seven immunohistochemically determined T8+ cases simultaneously expressed Leu7+ phenotype. The latter cells were consistent with large granular lymphocytes in one case, but no clinicopathological differences from the other T8+ cases were present. IBL and AILD were considered to be T-cell malignancies, which show a spectrum of histologic features from T-cell dysplasia to peripheral T-cell lymphoma (IBL-like T-cell lymphoma). Despite intensive chemotherapy, prognosis was poor in T8+ cases of which half of the patients died within 1 year. T4+ cases showed better prognosis, but a higher incidence of synchronous second primary cancers was recognized.     

Virus associated adult T-cell leukemia (ATL) in Japan: clinical, histological and immunological studies

Virus associated adult T-cell leukemia/lymphoma (ATLL), which includes both adult T-cell leukemia (ATL) and its non-leukemic counterpart (NLATL) was studied clinically, histologically, and immunologically. The disease usually occurred in the sixth decade in both sexes equally. The patients had a rapid clinical course with frequent leukemic changes, lymphadenopathy, hepatomegaly, and occasional skin rash. Bone marrow involvement with mild infiltration and hypercalcemia were more frequent in ATL than in NLATL. Histologically the disease was categorized as malignant lymphoma, diffuse pleomorphic type with cerebriform nuclear giant cells. The lymphoma was characterized by diffuse proliferation of tumor cells with irregular nuclear configurations, varying in size and shape, and the presence of giant cells with highly convoluted cerebriform nuclei. The giant cells seemed to be a diagnostic marker. Immunologically, the tumor cells usually possessed the surface antigens recognized by OKT 3, 4, Leu 8 and anti-Tac antibodies, indicating that they were lymphomas of helper/inducer peripheral T-cells with the receptor for interleukin 2, but they demonstrated no helper/inducer functions. The patients often died of opportunistic infections due to T-cell dysfunction caused by the disease itself and strong chemotherapy.     

Lymphoma type adult T-cell leukemia--a clinicopathologic study of HTLV related T-cell type malignant lymphoma

The clinical and pathological features of T-cell type malignant lymphoma related to human T-cell leukemia virus (HTLV) were investigated in eight patients presenting lymphadenopathy. Biopsy of lymph nodes showed an histology of diffuse non-Hodgkin's lymphoma. All patients were positive for anti-ATLA antibody and HTLV proviral DNA in the lymph node cells. Most patients showed pronounced hypercalcemia and high serum levels of lactic dehydrogenase. All patients died between 3 and 17 months (mean 8 months) after the onset of disease. HTLV-related malignant lymphoma should be added to the spectrum of ATL, being classified as a lymphoma type ATL.     

Indolent Lymphoproliferative T-Cell Disorders Associated With Gastrointestional Disease: Diagnostic Challenges and Outcomes

Lymphoproliferative diseases arise when the physiological mechanisms that control the proliferation of T and B lymphocytes are disrupted, resulting in an uncontrolled and autonomous increase in immune cells leading to lymphocytosis and lymphadenopathy, and often to the involvement of extranodal sites.The differential diagnosis of malignant T cell tumors involves other neoplasms and non–clonal T cell proliferations. Immunological markers are essential, as a first step, to distinguish between T-cell and non–T-cell disorders. It must be established based on the configuration of the genes of the TCR chain to rule out that the picture is not reactive to other underlying diseases. This clinical review and accompanying case reports highlight the diagnostic challenges associated with indolent lymphoproliferative T-cell disorders, which in many cases may represent the clinical manifestation of a single disease. Particularly we focus on gastrointestinal manifestations that could be expression either of lymphoproliferative disorder either of autoimmune disease either of both. The correct interpretation of the different clinical situations can help in the diagnostic and therapeutic process.     

Plasmacytoid monocyte proliferation associated with myeloproliferative disorders.

Plasmacytoid T-cell (PTC) lymphoma is a rare clinicopathologic entity characterized by generalized lymphadenopathy in association with a myeloproliferative disorder. Hepatosplenomegaly and weight loss frequently are present. Nodal T-zone expansion by mononuclear cells with ultrastructural and immunohistochemical features typical of PTC is diagnostic. All of the five previously reported cases of PTC lymphoma coincided with or heralded the onset of a clinically aggressive myeloid leukemia. This strong association and recent immunohistochemical findings in reactive or neoplastic PTC favored a monocyte/macrophage derivation of these cells, and it has been suggested that they be renamed plasmacytoid monocytes (PM). Two additional cases of PTC lymphoma were studied at the institutions of the authors, and the findings supported the concept that PTC belong to the monocytic lineage. The disease presentation was generalized lymphadenopathy with constitutional symptoms. One patient also had hepatosplenomegaly and bilateral renal enlargement concomitantly with myelofibrosis with myeloid metaplasia that progressed within months to acute myelogenous leukemia. Similar rapid evolution of acute monoblastic leukemia occurred in the other patient. Tumor cells within subtotally effaced lymph nodes had positive findings for CD45, CD4, CD7, and LN2 and negative findings for CD3, CD8, and beta F1. Occasional cells had positive findings for CD2. One case demonstrated CD5, HLA-DR, CD71, and CD43 (Leu-22)-positive cells. The myeloid/monocyte-associated antigens CD14 and CD68 were identified in both. The tumor cells lacked the B-cell markers LN1, CD20 (L26), CD19, and CD22 and did not rearrange immunoglobulin heavy chain genes and T-cell receptor beta, gamma, and delta chain genes. The term plasmacytoid T-zone lymphoma or PM proliferation is more appropriate for this rare disease. The close association of the PM proliferation with a myeloproliferative disorder indicates that the two entities are related.     

Detection of clonal Epstein-Barr virus in malignant proliferation of peripheral blood CD3+ CD8+ T cells.

Epstein Barr virus (EBV) DNA was detected in a monoclonal proliferation of T cells in a three-year-old girl who presented with a history of fever, hepatosplenomegaly, and generalised lymphadenopathy. The disease ran a rapid, fulminant course and the patient died 11 days after presentation. Examination of the blood showed a lymphocytosis of 50 x 10(9)/l with all the cells showing the morphology of large granular lymphocytes. These cells were CD2+3+8+25+. Cytogenetic studies showed the presence of a 6q- clone. Southern blotting and hybridisation with a constant region probe for the T-cell receptor (TCR) beta chain gene showed clonal rearrangement of the TCR beta gene. Hybridisation of the Southern blot to the EBV XhoI probe revealed a clonal pattern of episomal EBV DNA. Our results establish the association between clonal EBV infection to a malignant proliferation of peripheral blood CD8+ T cells.     

Peripheral T-cell lymphoma. A clinical, histologic, and immunologic study of five cases

The authors describe five white patients with peripheral T-cell lymphoma. Four patients were older than 65 years. All cases presented with a short clinical course and advanced stage at the time of diagnosis. Clinical manifestations included asthenia, weight loss, peripheral and abdominal lymphadenopathy. One case showed tonsillar involvement and subcutaneous lymph node enlargement; hepatomegaly was present in four cases, two of them with splenomegaly. Only one case presented peripheral lymphocytosis and antibodies to human T-leukemia virus. Although three cases were classified as diffuse mixed lymphomas and two as poorly differentiated lymphocytic lymphomas, there were some common characteristics: diffuse infiltration by different proportions of small lymphoid cells and large immunoblasts, some of them multinucleated and similar to Reed-Sternberg cells; accumulation of histiocytes, plasmacytosis, eosinophilia, venular proliferation and compartmentalization were also found. Bone marrow infiltration was observed in two patients. Results of monoclonal markers showed four cases to be OKT4+ and the other OKT8+. The morphologic and immunologic characteristics of these patients were typical and similar to those reported from other geographical areas.     

Ki-1-positive large cell lymphomas, a heterogenous group of neoplasms. Morphologic, immunophenotypic, genotypic, and clinical features of 24 cases.

Clinical and pathologic features of 24 patients with large cell lymphomas that expressed the activation antigen Ki-1 are described. Phenotypic and/or genotypic studies characterized these neoplasms as T-cell (16 cases), B-cell (six cases), or null cell (two cases) type. Males predominantly were affected. Age of patients ranged from 19 to 73 years, with a bimodal distribution, with peaks in the third and seventh decades. Lymphadenopathy was present in nearly all patients. Extranodal involvement, including skin, soft tissue, bone, central nervous system, lung, or small intestine was observed in a total of 54% of the patients, either at presentation or during the course of disease. "Prototypic" features of large cell anaplastic lymphomas were observed for eight T-cell lymphomas, with morphologic heterogeneity noted for the remainder. Eight patients, all with T-cell neoplasms (only one with prototypic morphology), have died of lymphoma (median survival, 5 months). An antecedent history of a lymphoproliferative disorder (mycosis fungoides, B-cell lymphoma, immunoblastic lymphadenopathy) was apparent in seven patients. An 8-year history of Crohn's disease occurred in one patient with a T-cell lymphoma involving small intestine. Phenotypically, loss of one or more markers was typically noted for T-cell neoplasms. Leukocyte common antigen was detected in all cases, although partial loss of immunoreactivity was noticed in some cases. Nearly all cases evaluated for Ia antigen or alpha-1-antichymotrysin were reactive. Eleven of 16 T-cell, two of six B-cell, and two null cell lymphomas expressed epithelial membrane antigen. Ki-1-positive large cell lymphomas are characterized by clinical, morphologic, and immunophenotypic heterogeneity.     

Myelodysplastic Syndrome Associated with Immunoblastic Lymphadenopathy-like T-Cell Lymphoma: Simultaneous Clinical Improvement with Chemotherapy

A 75-year-old woman presented with anemia, lymphadenopathy,hepatomegaly and lingual tumor, but no constitutional symptoms.The laboratory data showed pancytopenia and polyclonal hypergammaglobulinemia.A bone marrow aspirate represented an apparent myelodysplasticsyndrome (MDS) feature, specifically, refractory anemia withexcess of blasts. A lymph-node biopsy revealed the disappearanceof normal architecture, small arborizing blood vessels, largelymphoid cells with prominent cytoplasm (so-called pale cells)and a clonal proliferation of T-lymphocytes. The patient wasdiagnosed as having MDS associatd with immunoblastic lymphadenopathy(IBL)-like T-cell lymphoma. She was subsequently treated withcyclophosphamide, adriamycin, vincristine and prednisolone forlymphoma which successfully induced a remission of not onlythe T-cell lymphoma but also the MDS. The case suggested thatMDS might be a paraneoplastic complication of IBL-like T-celllymphoma.     

侵袭性NK细胞白血病九例

 目的　提高对侵袭性NK细胞白血病（ANKL）的认识。方法　回顾分析2004年3月至2007年3月期间收治的9例ANKL患者的临床资料。结果　ANKL患者多有全身症状、肝脾大、淋巴结肿大、肝功能异常、贫血、中性粒细胞减少、血小板减少。大部分骨髓侵犯为轻、中度。肿瘤细胞免疫表型sCD-3、CD+56,可同时表达CD2、CD7、CD8、CD11b。3例患者有细胞遗传学异常,但未发现重现性染色体异常,TCR基因重排均为胚系构型。ANKL病程进展迅速,易发生多器官衰竭,中位生存时间9周。获得和未获得完全缓解（CR）患者生存时间分别为50周和3周。结论　ANKL为来源于成熟NK细胞的恶性肿瘤,具有独特的临床特征和免疫表型。病程呈侵袭性,对化疗不敏感,大部分患者短期内死亡。获得CR患者生存期明显延长,但难免复发,治愈率没有提高。