Reed‐sternberg cells in breast FNA of a patient with left breast mass

Hodgkin's lymphoma is a potentially curable malignancy of the lymphatic system characterized by a variable number of scattered and large mononucleated and multinucleated tumor cells, the Hodgkin and Reed‐Sternberg cells residing in an abundant heterogeneous admixture of non‐neoplastic inflammatory cells. It represents approximately 30% of all lymphomas according to the World Health Organization (WHO). Patients with Hodgkin's lymphoma typically present with painless peripheral adenopathy, fever, night sweats, and weight loss. We report a rare case of Hodgkin's lymphoma presented as a breast mass in a 23‐year‐old woman diagnosed on fine needle aspiration (FNA). At presentation, she had no B symptoms, or palpable lymphadenopathy. Diagn. Cytopathol. 2010;38:663–668. © 2010 Wiley‐Liss, Inc.     

Impact of Cell of Origin on Outcomes After Autologous Hematopoietic Cell Transplant in Diffuse Large B-Cell Lymphoma

Germinal center B-cell-like diffuse large B cell lymphoma (GCB-DLBCL) at diagnosis is associated with superior long-term outcomes compared to non-GCB-DLBCL in patients treated with conventional chemo-immunotherapy. Whether cell of origin (COO) by Hans algorithm retains its prognostic significance in patients with (R/R) relapsed/refractory DLBCL undergoing autologous hematopoietic cell transplant (auto-HCT) is not well established. Three hundred and fifty-seven patients underwent auto-HCT between 2005 and 2018. The COO status was determined in 284 patients and these were included in the analysis. One hundred ninety-four patients had GCB-DLBCL while 90 had non-GCB-DLBCL. Median follow up was 1.7 (0-13) years. The GCB-DLBCL was associated with inferior 5-year overall survival at 44% (95%CI, 36-52) versus 64% (95%CI, 54-77) (P = .004) and a higher relapse incidence at 67% (95%CI, 58-74) versus 49% (95%CI, 35-60) (P = .01) in the non-GCB-DLBCL. The difference between GCB and non-GCB-DLBCL remained statistically significant in multivariate analysis. Additionally, response at the time of transplant was an independent prognostic factor. GCB-DLBCL was enriched in double-hit and triple hit phenotype based on available fluorescence in situ hybridization data. These results suggest an enrichment of high-risk genetic rearrangements in R/R GCB-DLBCL resulting in limited efficacy of auto-HCT.     

Absolute CD3+ CD158k+ lymphocyte count is reliable and more sensitive than cytomorphology to evaluate blood tumour burden in Sézary syndrome

Background CD158k/KIR3DL2 is a specific marker for Sézary cells which can be used to diagnose Sézary syndrome (SS) in erythrodermic patients with abnormal circulating T cells. Objectives To evaluate the suitability of CD158k/KIR3DL2 for detecting and evaluating blood tumour load during the follow up of patients with SS. Methods The absolute CD3+ CD158k+ lymphocyte count was compared with the absolute count of cytomorphological Sézary cells and was correlated with clinical flares in a cohort of patients with SS. Twenty‐five patients were included in the study and 48 blood samples were analysed. Results The absolute count of CD3+ CD158k+ cells strongly correlated with the absolute count of atypical circulating cells (r = 0·97, P < 10^?15). The CD3+ CD158k+ lymphocyte cell count was in eight cases more sensitive than cytomorphology for detecting atypical circulating cells especially for small‐sized tumour cells. The tumour burden evaluated by CD3+ CD158k+ immunostaining was significantly associated with clinical flare (P < 10^?4). Conclusions CD3+ CD158k+ phenotyping is a reliable and objective test to monitor the blood tumour burden in patients with SS under systemic therapy.     

论著p53基因突变与非霍奇金淋巴瘤病因学关系研究

目的:研究p53基因突变在非霍奇金淋巴瘤(NHL)发生发展中的作用。方法:在37例非霍奇金淋巴瘤组织中采用PCR-单链构象多态性分析法(PCR-SSCP)进行p53基因外显子5～8的突变检测。结果:p53基因总突变率为54.1%,惰性组、侵袭性组、高侵袭性组突变率分别为0.0%、58.1%、100.0%;T和NK细胞组和B细胞组突变率分别为37.5%、58.6%。结论:非霍奇金淋巴瘤中存在p53基因的突变,p53基因的突变在NHL的发展演变中可能起重要作用。     

脑原发淋巴瘤8例综合治疗分析

目的分析脑原发淋巴瘤的临床特点,探讨其治疗方式。方法8例脑原发淋巴瘤中7例行手术切除,1例行立体定向活检。8例均行放射治疗,1例接受γ刀治疗,7例6MV X线常规分割照射,全脑照射30～46 Gy,病灶区剂量40～56 Gy。6例接受了化疗,行CHOP方案4例,大剂量甲氨蝶呤(MTX)为主的化疗2例,鞘注MTX 3例。结果患者近期疗效好,全组生存时间为8～47个月,中位生存期19个月。1、3年生存率分别为75.0%和31.3%。加化疗未延长生存期,予MTX化疗者生存时间较长。结论脑原发淋巴瘤预后差,全脑放疗为主要治疗方式之一,放疗与MTX为主的化疗方案的综合治疗有可能提高疗效。