A quantitative study of alpha-naphthyl acetate esterase-positive cells in non-Hodgkin's lymphomas and reactive lymph nodes.

The numbers of alpha-naphthyl acetate esterase (ANAE)-containing cells (other than T lymphocytes) in non-Hodgkin's lymphomas (NHL) and reactive lymph nodes have been counted, using the Reichert-Jung (Kontron) MOP-AMO3 user-controlled image analyzer. Twenty specimens of NHL and ten reactive nodes were examined. Cells were demonstrated by their content of acid alpha-naphthyl acetate esterase (ANAE) in fixed frozen sections. It was found that lymphomas of high-grade malignancy contained much larger numbers of ANAE-positive cells (10.8-20.5%) than those of low-grade malignancy (1.4-4.1%). The number of ANAE-positive cells (1.4-3.2%) in reactive lymph nodes was similar to that in low-grade NHL nodes.     

Papillary cystic tumours of the pancreas: An analysis by nuclear morphometry

Papillary cystic tumour (PCT) is a rare, low-grade malignant pancreatic neoplasm, in which the histological criteria for malignancy are still uncertain. We performed a histological examination of 3 metastasizing PCTs, while comparing them with 18 non-metastasizing PCTs, using a computed image analyser. The mean maximum nuclear diameter, the mean standard deviation (SD) of the nuclear diameter, the mean nuclear area and the nuclear-nonnuclear (N/NN) ratio obtained by the image analyser of the metastasizing PCTs (7.23 m, 2.21 m, 30.45 m², 36.41%) were all significantly larger than those of the non-metastasizing PCT (6.34 m, 1.59 m, 23.66 m², 23.74%;P<0.005,P< 0.005,P<0.005,P<0.001 respectively). However, there were no statistical differences in either the nuclear ellipsoidity or nuclear regularity. These results suggested that nuclear morphometry might be a useful parameter to define metastatic potential, in addition to histological variables such as venous invasion, nuclear grade and mitotic rate.     

A comparative study of nuclear form factor, area and diameter in non-Hodgkin's lymphomas and reactive lymph nodes.

The mean nuclear area, maximum nuclear diameter (Dmax) and form factor (FF) have been measured in 30 specimens of non-Hodgkin's lymphoma (NHL) and 10 reactive lymph nodes, using the Reichert-Jung (Kontron) MOP-AMO3 image analyzer. Nuclear area and Dmax were found to be greater in high-grade NHL than in low-grade lymphomas and reactive nodes. In addition, there was close correlation between nuclear area and Dmax, especially for low-grade NHL and reactive specimens. As a means of distinguishing between high- and low-grade lymphomas, however, the FF appears to be of little value.     

Image Analysis in Non-Hodgkin's Lymphoma

Abstract

Morphometry allows an objective method of assessing various cell features that are relevant in the subtyping of non Hodgkin's lymphoma (NHL). A wide variety of morphometric parameters that quantify features such as nuclear size and shape can be obtained with fully automated or interactive computerized image analysis. Most of these parameters rely on simple measures of area and perimeter, whereas others, especially those describing shape, use complicated mathematical formulas. Certain parameters have been found to be useful in specific situations; for example, the identification of cells of mycosis fungoides and Sézary syndrome is aided by the nuclear contor index. The application of morphometry in the subtyping of NHL is reviewed. Examples of cytologic preparations are given to illustrate theuse of nuclear size parameters to distinguish small, mixed, and large cell subtypes of follicular NHL. Large cell lymphoma and irnrnunoblastic sarcoma are categorized by nuclear area and shape, nucleolar area, and the standard deviation of nuclear-cytoplasmic ratio. Morphometric analysis is a useful method to subtype difficult cases of malignant lymphoma, particularly in identifying the controversial category of mixed cell lymphoma. (The J Histotechnol 15:263-276, 1992)     

非霍奇金淋巴瘤中的微血管密度及其临床病理意义

目的：探讨非霍奇金淋巴瘤(NHL)中的微血管密度(MVD)及其与NHL恶性程度、免疫学类型、预后的关系；方法：采用生物素标记的荆豆凝集素I(Bio-UEA-I)免疫组化ABC法对102例NHL的MVD进行原位观察和数量分析；结果：MVD随NHL恶性程度的增高而增高，高度恶性组和中度恶性组MVD显著高于低度恶性组MVD；T细胞性NHL中的MVD显著高于B细胞性NHL的MVD；短生存期组的MVD显著高于长生存期组的MVD；结论：NHL中的MVD可作为判断肿瘤恶性程度、免疫学类型及预后估计的有意义的指标，在临床病理中有实际应用价值。     

Design and validation of an analyser to measure sulphur hexafluoride gas during respiration

The study presents the results of the development of an analyser to measure sulphur hexafluoride (SF₆) gas in breathing circuits, for application is studies of lung function. The analyser consists of an in-line breathing circuit measurement transducer and a compact unit for signal treatment. The detector unit of the analyser consists of a near-infrared light source, a bandpass filter and a pyro-electrical detector. When incremental steps of SF₆ gas between 0 and 2% were presented to the analyser, the maximum deviation from the theoretical calibration curve was calculated to be 0.01% SF₆. The step response of the analyser (10–90%) was 250 ms. The sensitivity of the analyser to ambient temperature was 0.01% SF₆ °C⁻¹ in the range between 0 and 2% SF₆. It is concluded that the analyser presented is accurate, and has a sufficient response speed to be used in clinical measurement settings. Furthermore, the analyser is resistant to changes in temperature, gas flow, orientation and movement, which are likely to occur in clinical measurement settings.     

Quantitative analysis of non-Hodgkin's lymphoma.

A preliminary attempt has been made to characterise a small series of non-Hodgkin''s lymphomas (NHL) by morphometric means using the Quantimet 720 Kontron MOP/AMO3 image analysis systems. In most cases it was found that the distribution of nuclear area and correlation between mean nuclear area and frequency per unit field, corresponded closely with tumour classification determined by light microscopy. These results suggest that it may be possible to devise an objective and reproducible grading system for NHL using quantitative morphometric techniques.     

Quantitative study of the immunoglobulin-containing cells in trephine samples of bone marrow

Immunoglobulin (Ig) was demonstrated in paraffin sections of 12 trephine bone marrow biopsies by means of the unlabelled antibody peroxidase-antiperoxidase (PAP) method. The Ig-containing cells, which were counted with the Reichert-Jung (Kontron) MOP-AMO₃ user-controlled image-analyser, were found to constitute approximately 4·2% of all the nucleated cells in the marrow, a figure significantly higher than those reported by previous workers.     

Evolutionary somatic cell changes in cervical tumour progression quantitatively evaluated with morphological, histochemical and kinetic parameters.

The somatic cell changes which characterise malignancy evolution in human cervical preneoplastic and neoplastic lesions have been assessed on histological sections by means of a computerised image analyser. Many features have been simultaneously measured on each cell of the lesions studied, and the following results have been obtained: Some features, mainly kinetic, show continuously increasing values which express changes correlated to the increasing malignancy; other features, especially related to nuclear atypia, cellular heterogeneity and the degree of aneuploidy, have values dropping at the level of early stromal infiltration, which can be morphometrically characterised as composed of relatively homogeneous phenotypes; these features seem to express the degree of genetic instability and relate to the evolutionary somatic cell changes; tumour progression evolves through sequential discontinuous steps, each of them characterised by specific phenotypical features of the neoplastic cell population; the neoplastic cells in the foci of early stromal infiltration and vascular invasion, phenotypically more homogeneous than the parent cell populations of carcinoma in situ and infiltrating carcinoma, seem to possess a greater genetic stability.     

Histologic transformation in extranodal non-Hodgkin's lymphoma

Histologic transformation in the course of non-Hodgkin's lymphoma (NHL) has been reported to occur in 18 to 30% of the cases. Less favorable prognosis in cases with initial low grade malignancy followed by emergence of high grade malignancy has been previously described. In the previous literature, the histologic transformation has been examined mostly in nodal NHL. In the present study, histologic transformation in the course was investigated on 20 cases with early extranodal NHL. All these 20 cases were diffuse lymphomas, and were composed of 7 cases with low grade malignancy and 13 cases with high grade malignancy. Histologic transformation was not observed in any of these cases. These findings indicate that the frequency of histologic transformation is much lower in extranodal NHL than in nodal NHL. The prognostic significance of these findings is also discussed.     

计算机图像处理系统用于血管平滑肌细胞形态定量分析

采用计算机图像分析法，定量测定家兔培养主动脉血管平滑肌细胞的形态学参数及其与ＤＮＡ合成指标的相关关系，并在此基础上，从细胞形态学角度探讨了中药制剂川芎嗪对ＶＳＭＣ增殖的影响，以评价计算机图像分析技术在细胞学研究中的作用，建立一种研究ＶＳＭＣ增殖水平的新方法。     

An ultrastructural morphometric study of follicular center lymphocytes: III. The control of lymphocyte nuclear size in reactive hyperplasia and non-Hodgkin's lymphoma

Since lymphocyte nuclear size and shape play such a key role in the classification of non-Hodgkin's lymphoma (NHL), the mechanisms and nuclear compartments responsible for the control of nuclear size are of fundamental importance to pathologists. To assess the role of condensed chromatin and the interchromatinic region of the nucleus in determining the size of this organelle, morphometric image analysis of total nuclear area and the area occupied by these two compartments was performed on electron micrographs of nuclear profiles from lymphocytes in lymph node biopsies of four cases of reactive lymphoid hyperplasia and ten examples of NHL. Using bivariate linear regression analysis, it was clear that, whether in normal mantle zone and follicular center lymphocytes or in the neoplastic lymphocytes of various NHLs, there is an extremely high correlation (R = 0.96) between the size of the interchromatinic region and the area of nuclear profiles. In contrast, there is a poorer correlation (R = 0.63) between the area occupied by condensed chromatin and nuclear area. The results demonstrate for the first time that even in NHL, where some nuclear features clearly vary from the normal counterpart, the control of nuclear size continues to be largely dependent on a particular subcompartment of the nucleus, the interchromatinic region. How this fact influences the categorization of subtypes of NHL for therapeutic and prognostic purposes will be an essential avenue for further investigation.     

Relation between clinical parameters and histologic findings in patients with non-Hodgkin's lymphoma

Clinical and morphological findings of lymph nodes in 150 consecutive untreated non-Hodgkin lymphoma (NHL) patients were retrospectively studied. One hundred and fifteen (77%) patients had B-NHL and 35 (23%) T-NHL, 96 (64%) patients had NHL low grade malignancy and 54 (36%) NHL of high grade malignancy according to the Kiel classification. Lymph nodes exceeding 2 cm in diameter (p less than 0.05), hepatomegaly (p less than 0.05), splenomegaly (p less than 0.05), and the duration of lymphadenopathy for more than 6 months preceding diagnosis (p less than 0.01) were significantly more common in low than high grade malignancy of NHL patients. Febrile episodes at the diagnosis were significantly more common in high than in low grade malignancy of NHL patients (p greater than 0.05). Lymph nodes exceeding 2 cm in diameter (p less than 0.05) in B-NHL, and lymph nodes above the diaphragm (p less than 0.05) and skin infiltration (p less than 0.001) were more common in T-NHL than in B-NHL patients. At the diagnosis low grade NHL patients have significantly more often splenomegaly, hepatomegaly, large palpable lymph nodes, and long lasting lymphadenopathy before diagnosis. High grade malignancy NHL patients have more often general symptoms, B-NHL patients have more often large palpable lymph nodes, T-NHL patients have more often skin infiltration and lymph nodes above the diaphragm. Precise clinical characterization of patients in addition to pathohistological diagnosis are very important in this highly variable disease.     

Application of computerized image analyzing system in morphometric study of vascular smooth muscle cells]

The authors used image analyser to measure several morphometric parameters of cultured aorta vascular smooth muscle cell (VSMC) and assess the relationships between these morphometric parameters and 3H-TdR incorporations. On this basis, the authors also explored the effect of Ligustrazine, a traditional Chinese medicine, on VSMC morphology in order to evaluate the role of computerized image analysing system in the study of VSMC proliferation. The results showed that (1) there were significant correlations between VSMC cellular area, nuclear area and 3H-TdR incorporations in control group; (2) Ligustrazine significantly decreased VSMC cellular area, nuclear area and nuclear perimeter, and a significant correlation was also noted between cellular area and 3H-TdR incorporation in Ligustrazine group. These suggest that computerized image analysing system is a rapid, accurate and reliable method to study the morphology and proliferation of VSMC.     

An exploratory survey of money boys and HIV transmission risk in Jilin Province,PR China

Background

In the HAART era, the incidence of HIV-associated non-Hodgkin lymphoma (NHL) is decreasing. We describe cases of NHL among patients with multi-class antiretroviral resistance diagnosed rapidly after initiating newer-class antiretrovirals, and examine the immunologic and virologic factors associated with potential IRIS-mediated NHL.

Methods

During December 2006 to January 2008, eligible HIV-infected patients from two affiliated clinics accessed Expanded Access Program antiretrovirals of raltegravir, etravirine, and/or maraviroc with optimized background. A NHL case was defined as a pathologically-confirmed tissue diagnosis in a patient without prior NHL developing symptoms after starting newer-class antiretrovirals. Mean change in CD4 and log₁₀ VL in NHL cases compared to controls was analyzed at week 12, a time point at which values were collected among all cases.

Results

Five cases occurred among 78 patients (mean incidence = 64.1/1000 patient-years). All cases received raltegravir and one received etravirine. Median symptom onset from newer-class antiretroviral initiation was 5 weeks. At baseline, the median CD4 and VL for NHL cases (n = 5) versus controls (n = 73) were 44 vs.117 cells/mm3 (p = 0.09) and 5.2 vs. 4.2 log₁₀ (p = 0.06), respectively. The mean increase in CD4 at week 12 in NHL cases compared to controls was 13 (n = 5) vs. 74 (n = 50)(p = 0.284). Mean VL log₁₀ reduction in NHL cases versus controls at week 12 was 2.79 (n = 5) vs. 1.94 (n = 50)(p = 0.045).

Conclusions

An unexpectedly high rate of NHL was detected among treatment-experienced patients achieving a high level of virologic response with newer-class antiretrovirals. We observed trends toward lower baseline CD4 and higher baseline VL in NHL cases, with a significantly greater decline in VL among cases by 12 weeks. HIV-related NHL can occur in the setting of immune reconstitution. Potential immunologic, virologic, and newer-class antiretroviral-specific factors associated with rapid development of NHL warrants further investigation.     

鼻咽未分化癌与非何杰金淋巴瘤的显微图像分析

本文在HE染色及免疫组织化学反应的基础上将诊断鼻咽未分化癌者16例及淋巴瘤15例作显微图像分析,结果两组病例所测得的瘤细胞核面积,核周长,形状因子,核球径(sphere diameter)及核球容积(sphere volume)差异均高度显著,P<0.001,由此可见图像分析不失为病理诊断的一个有力辅助手段,值得进一步研究。     

A potential treatment option for elderly non-Hodgkin lymphoma patients with multiple comorbidities: Two case reports and literature review

Non-Hodgkin lymphoma (NHL) is a heterogeneous lymphoproliferative malignancy. More than half of the NHL cases occur in patients over 65 years of age. As elderly patients have a poor performance status and multiple comorbidities, the use of standard chemotherapy is often limited, leading to poor clinical outcomes and an increasing need for an alternate therapeutic modalities.A 73-year-old man was diagnosed with extranodal NK/T-cell lymphoma concurrently combined with recurrent gastric adenocarcinoma and metastatic prostate cancer. A 79-year-old woman was diagnosed with T-cell and B-cell dual-phenotype NHL on the right chest wall showing tumor thrombosis and multiple enlarged lymph nodes under chronic emphysema with extensive pleural calcification. Both elderly patients had multiple comorbidities and pathologically confirmed non-Hodgkin lymphoma. Both patients achieved tumor responses following anticancer treatment with Korean medicine (KM), suggesting that the extracts of Angelica gigas Nakai and Geopungtang are potential options for treating NHL in elderly patients with multiple comorbidities.Considering the clinical outcomes of KM treatment in the two elderly patients with NHL and multiple comorbidities, this study generates a research hypothesis for future prospective clinical studies in patients with NHL who are ineligible for conventional anticancer therapy.     

Immunopathology of non-Hodgkin lymphomas

Summary The immunopathological features of (1) lymphocytic non-Hodgkin lymphomas (NHL), (2) follicular centre cell tumours and (3) large-cell NHL are described with particular emphasis on in situ evaluation of cryostat sections using monoclonal antibodies. The immunological phenotypes of tumour cells and the pattern of reactive cellular infiltrates with characteristic differences for the various subtypes are summarized.Immunological membrane features of the following lymphocytic NHL of B lymphocyte origin are discussed in detail: B-CLL (most common phenotype of the lymphoma cells: VIB-C5, To-15, Ia, Leu-1), lymphoplasmocytoid NHL (To-15, Ia), B-prolymphocytic leukaemia (VIB-C5, To15, Ia, Leu (±), FMC-7(±)) and hairy-cell leukaemia (HCL: To-15, Ia, FMC-7). NHL of T-lymphocytes detailed in respect of mycosis fungoides and Sézary syndrome (OKT-3, OKT-4, OKT-11), to subtypes of T-CLL with particular emphasis on the azurophilic type, to T-zone NHL, and to adult T-cell leukaemia/lymphoma (OKT-3, OKT-4, OKT-11, anti-tac), all of them with the usual immunological phenotype of T-helper (T_H) lymphocytes. NHL with a predominance of T-suppressor (T_S) lymphocytes include the immunoblastic lymphadenopathy like T-cell lymphoma (OKT-3, OKT-8, OKT-11) and some lymphoepitheloid (Lennert) lymphomas.Immunological features of follicular centre cell tumours are discussed with emphasis on similarities and differences with the normal germinal centre. Tumour cells usually show the following membrane phenotype: centroblastic/centrocytic (cb/cc: To-15, VIL-A1, Ia; meshwork of non-neoplastic R4/23+, To-5+DRC), centrocytic (VIB-C5, To-15, Leu-1, Ia; R4/23 and To-5 meshwork), centroblastic (cb, To-5, To-15, Ia, VIL-Al±). Large-cell NHL include the last entity (cb), immunoblastic (B-ib, T-ib) and lymphoblastic (lb) NHL and are discussed in respect to B-ib (Ia, To-15±, VIL-Al±), T-lb (WT-1, OKT-6±, OKT-11±), pre-B-lb (VIB-C5, Ia, TdT, VIL-Al±) and Burkitt-type NHL (VIB-C5, VIL-A1, Ia, sIg).Reactive cellular infiltrates may account for a large fraction of the cellular content of NHL (e.g. the mean T_H and T_S content amount to about 40% of that seen in normal lymph nodes). In comparison to other NHL B-CLL and cb/cc showed the highest, HCL the lowest number of T_H. T_S exhibited less typical alterations. With the HNK 1 antibody as marker of putative natural killer (NK cells) high numbers of positive cells were found in cb/cc (and in some CLL and other NHL), sparse infiltrates in lb NHL. The highest number of cells with the phenotype of macrophages were usually found in ib NHL. We conclude that immunological typing of tumour cells as well as of reactive cellular infiltrates is of major interest not only in the evaluation of tumour cell characteristics but also with respect to the microenvironment of lymphomas and the host response.Abbreviations NHL Non-Hodgkin lymphomas - CLL chronic lymphocytic leukaemia - PLL prolymphocytic leukaemia - HC hairy cells - ATLL adult T-cell leukaemia/lymphoma - LCL large-cell lymphomas - lb lymphoblastic - RBC red blood cells - sIg surface immunoglobulins - cIg cytoplasmic immunoglobulins - ADCC antibody-dependent cellular cytotoxicity - cALLA common acute lymphoblastic leukaemia antigen - EBNA Epstein-Barr-virus-determined nuclear antigen - T_H helper/inducer T cells - T_S cytotoxic/suppressor T cells - NK cells natural killer cells - HTLV human T-cell leukaemia/lymphoma virus     

Exfoliative respiratory cytology in the diagnosis of leukemias and lymphomas in the lung

Leukemias and lymphomas involving the lung were diagnosed by means of exfoliative cytology in 31 specimens from 20 patients. Initial diagnostic categorizations included 29 specimens “positive for malignancy,” including two thought to represent “carcinoma vs. lymphoma,” and two considered suspicious for lymphoma. Previous diagnoses of lymphoma (13 patients) and acute myelogenous leukemia (AML) (2 patients) were available. In 5 additional patients, exfoliative respiratory cytology yielded the first diagnosis of hematopoietic malignancy. Cytologic diagnosis included nine large-cell and six small-cell non-Hodgkin's lymphomas (NHL), three Hodgkin's lymphomas (HD), and two AML. Key cytologic features included markedly pleomorphic and monomorphic cell populations in HD and NHL, respectively, as well as lack of tumor cell cohesion and necrosis in all cases. Cytologically, acute leukemia may be difficult to differentiate from large-cell NHL, and small-cell NHL from reactive/benign small lymphocytes. Blood, scant cellularity, crush artifacts, and apparent molding may affect diagnostic accuracy. Immunocytochemistry in cell block sections of sputa and washings is useful in the diagnostic workup in selected cases. Although involvement of the respiratory system by leukemias and lymphomas is uncommon and not always preceded by a history of malignancy, cytologic diagnosis is usually prompt, reliable, and accurate. Diagn Cytopathol 1996;14:108–113. © 1996 Wiley-Liss, Inc.     

Quantitative analysis of the retrograde reaction of motoneurons with an image analyser

Summary The neuronal profiles of cell bodies in the facial nerve nucleus of adult rats were measured after partial peripheral nerve transsection. An image analyser was used for automatic recognition and morphometry. Based on classification of the neuronal profiles described in a previous paper, a morphometrical study was performed in order to analyse structural aspects of the retrograde reaction in quantitative terms. Beside the quantification of classical features of retrograde reaction (chromatolysis; nuclear eccentricity; increased basophilia; perikaryal, nuclear and nucleolar swelling), several reactive changes so far not recognized (karyoplasmic basophilia and granulation) were detected. These changes were interpreted as morphological correlates of regeneration in retrogradely reacting cells.