{"title":"Epstein-Barr virus-negative classical Hodgkin's lymphoma in a patient with T-cell prolymphocytic leukemia treated with fludarabine.","authors":"Takahiro Tsuji, Hiroshi Yamasaki, Nobuyuki Arima, Daisuke Niino, Koichi Ohshima, Hiroyuki Tsuda","doi":"10.3960/jslrt.52.71","DOIUrl":"https://doi.org/10.3960/jslrt.52.71","url":null,"abstract":"","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"71-5"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30697009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rheumatoid lymphadenopathy with abundant IgG4(+) plasma cells : a case mimicking IgG4-related disease.","authors":"Naoko Asano, Yasuharu Sato","doi":"10.3960/jslrt.52.57","DOIUrl":"https://doi.org/10.3960/jslrt.52.57","url":null,"abstract":"<p><p>Immunoglobulin (Ig) G4-related disease is a recently confirmed clinical entity with several unique clinicopathological features. Here we report a case of rheumatoid lymphadenopathy mimicking IgG4-related disease. The patient was a 63-year-old woman who had been treated for rheumatoid arthritis (RA) for six years. The patient noted cervical lymphadenopathy. Upon radiological examination, systemic lymphadenopathy was detected, and enlarged right brachial lymph node biopsy was performed. Histologically, the lymph node showed marked follicular hyperplasia and interfollicular plasmacytosis without eosinophil infiltration. Although the histological findings were compatible with rheumatoid lymphadenopathy, numerous plasma cells were IgG4(+) (IgG4(+)/IgG(+) plasma cell ratio > 50%). However, laboratory findings revealed elevation of C-reactive protein level, polyclonal hyper-γ-globulinemia, anemia, and hypoalbuminemia. These findings were compatible with hyper-interleukin (IL)-6 syndrome, namely, RA. It is known that hyper-IL-6 syndromes, such as multicentric Castleman's disease, RA, and other autoimmune diseases, fulfill the histological diagnostic criteria for IgG4-related disease. Therefore, hyper-IL-6 syndromes and IgG4-related disease cannot be differentially diagnosed by immunohistochemical staining alone. In conclusion, rheumatoid lymphadenopathy sometimes occurs with abundant IgG4(+) plasma cells, which is required for the differential diagnosis of IgG4-related disease.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"57-61"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3960/jslrt.52.57","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30697006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Granulomatous lymphadenitis.","authors":"Shigeyuki Asano","doi":"10.3960/jslrt.52.1","DOIUrl":"https://doi.org/10.3960/jslrt.52.1","url":null,"abstract":"<p><p>In this review, representative types of granulomatous lymphadenitis (GLA) are described. GLA can be classified as noninfectious GLA and infectious GLA. Noninfectious GLA includes sarcoidosis and sarcoid-like reaction. The cause of sarcoidosis remains unknown, but it has good prognosis. Sarcoid-like reaction, which is considered to be a biological defense mechanism, is observed in regional lymph nodes with many underlying diseases. Infectious GLA can be classified as suppurative lymphadenitis (LA) and nonsuppurative LA. Suppurative LA generally shows follicular hyperplasia and sinus histiocytosis in the early phase. In tularemia and cat scratch disease, monocytoid B lymphocytes (MBLs) with T cells and macrophages contribute to the formation of granuloma. However, none of the epithelioid cell granulomas of Yersinia LA contains MBLs like in cat scratch disease. In addition, almost all have a central abscess in granulomas induced by Gram-negative bacteria. In terms of the lymph nodes, tularemia and cat scratch disease are apt to affect the axillary and cervical regions while Yersinia LA affects the mesenteric lymph node. Nonsuppurative LA includes tuberculosis and BCG-histiocytosis. These are induced by delayed allergic reaction of M. tuberculosis. Tuberculosis LA mainly appears in the cervical lymph node. Organisms are histologically detected by Ziehl-Neelsen staining in the necrotic area. Toxoplasmosis is also a nonsuppurative protozoan infection (Toxoplasma gondii). In toxoplasma LA, MBLs can also be seen, but round and organized, well-formed granulomas are not found in this disease. Furthermore, necrosis is not induced and there are no accompanying neutrophils, eosinophils and fibrosis. GLA described above is associated with characteristic histological findings. An accurate pathological diagnosis using the above findings can lead to precise treatment.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"1-16"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3960/jslrt.52.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30698661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K Girardi, A Paviglianiti, M Cirillo, A Bianchi, G Gherardi, O Annibali, E Cerchiara, F Marchesi, V Tomarchio, C Miglio, Mc Tirindelli, A Onetti Muda, G Avvisati
{"title":"Tuberculous meningoencephalitis in a patient with hairy cell leukemia in complete remission.","authors":"K Girardi, A Paviglianiti, M Cirillo, A Bianchi, G Gherardi, O Annibali, E Cerchiara, F Marchesi, V Tomarchio, C Miglio, Mc Tirindelli, A Onetti Muda, G Avvisati","doi":"10.3960/jslrt.52.31","DOIUrl":"https://doi.org/10.3960/jslrt.52.31","url":null,"abstract":"<p><p>Tuberculous meningoencephalitis is a rare disease associated with high morbidity and mortality. We report a patient with hairy cell leukemia in complete remission who, after a single cycle of chemotherapy with cladribine, presented fever and neurological deficits. Laboratory diagnosis of tuberculous meningoencephalitis was made by polymerase chain reaction testing for Mycobacterium tuberculosis in cerebrospinal fluid. Despite the prompt institution of antitubercular-therapy, patient's general condition did not improve and he died. Mycobacterial infection should be considered in patients with intra-cranial lesions, affected by hematological malignancies and persistent immunosuppression.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"31-4"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3960/jslrt.52.31","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30697003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Orbital MALT lymphoma, abdominal hodgkin lymphoma, and systemic diffuse large B-cell lymphoma develop sequentially in one patient.","authors":"Toshihiko Matsuo, Kouichi Ichimura, Katsuji Shinagawa","doi":"10.3960/jslrt.52.41","DOIUrl":"https://doi.org/10.3960/jslrt.52.41","url":null,"abstract":"<p><p>In February 2002, a 42-year-old woman developed ocular adnexal extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), MALT lymphoma, in the bilateral orbits involving lacrimal glands. She underwent 30 Gy external beam irradiation to the orbital lesions on both sides. She was well until November 2008 when she developed abdominal lymphadenopathy and transabdominal excisional biopsy showed mixed cellularity classical Hodgkin lymphoma at stage II. She underwent standard combination chemotherapy. In July 2010, she developed systemic lymphadenopathy and was diagnosed with diffuse large B-cell lymphoma (DLBCL) by cervical lymph node biopsy. She underwent rituximab monotherapy and finally allogeneic hematopoietic stem cell transplantation in October 2010, but died of renal failure in February 2011. Amplification by polymerase chain reaction of the immunoglobulin heavy chain gene gave rise to dominant discrete fragments of the same size between the orbital lesion with MALT lymphoma in 2002 and the cervical lymph node lesion with DLBCL in 2010. The sequential development of MALT lymphoma, Hodgkin lymphoma, and DLBCL in the long-term course of this patient suggests the common origin of the neoplastic cells, changing their pathological faces in response to irradiation and combination chemotherapy.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"41-9"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3960/jslrt.52.41","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30697005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction of progression from refractory cytopenia with unilineage dysplasia by analysis of bone marrow blast cell composition.","authors":"Satoko Oka, Kazuo Muroi, Shin-Ichiro Fujiwara, Iekuni Oh, Tomohiro Matsuyama, Ken Ohmine, Takahiro Suzuki, Katsutoshi Ozaki, Masaki Mori, Tadashi Nagai, Keiya Ozawa, Toshiaki Hanafusa","doi":"10.3960/jslrt.52.63","DOIUrl":"https://doi.org/10.3960/jslrt.52.63","url":null,"abstract":"<p><p>A retrospective analysis of 71 patients newly diagnosed with refractory cytopenia with unilineage dysplasia (RCUD) revealed that 12 developed refractory anemia with an excess of blasts or acute myeloblastic leukemia. Before the diagnosis of RCUD was made, phenotypes of cells in the bone marrow (BM) blast region were analyzed using flow cytometry. Patients with RCUD were divided into two groups ; those with no progression (Group A) and those with disease progression later on (Group B). The cell composition in the BM blast region differed significantly between the groups : Group A showed higher percentages of B lymphoid cells but lower percentages of myeloid cells. A cut-off value of 20 for the CD33/CD10 ratio in the BM blast region clearly separated Group A from Group B. These results suggest that cell composition in the BM blast region evaluated by flow cytometry may indicate the progression of RCUD.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"63-6"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30697007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blastic plasmacytoid dendritic cell neoplasm : report of two cases.","authors":"Kanako Tsunoda, Takashi Satoh, Kiyomi Akasaka, Yuichi Ishikawa, Yoji Ishida, Tomoyuki Masuda, Toshihide Akasaka","doi":"10.3960/jslrt.52.23","DOIUrl":"https://doi.org/10.3960/jslrt.52.23","url":null,"abstract":"<p><p>Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a clinically aggressive tumor derived from the precursor of plasmacytoid dendritic cells. We describe two cases of BPDCN. In case 1, the patient presented with multiple erythema on the trunk and arms. Histopathology of a skin biopsy specimen and immunohistochemistry demonstrated that the tumor cells were small to medium-sized with a blastoid morphology and positive for CD4, CD56, CD123 and T-cell leukemia-1 (TCL-1). In case 2, the patient presented with a solitary skin nodule and rapidly developed involvement of the bone marrow and peripheral blood. Although immunohistochemistry of the infiltrating tumor cells demonstrated positivity for CD4, CD56, CD123 and TCL-1, the cells were large with a distinct nucleolus, and different from those of typical BPDCN. The atypical morphological features of BPDCN may be diagnostically problematic, and should therefore be recognized correctly.</p>","PeriodicalId":520662,"journal":{"name":"Journal of clinical and experimental hematopathology : JCEH","volume":" ","pages":"23-9"},"PeriodicalIF":1.5,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3960/jslrt.52.23","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30698662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}