المؤلفون: Miranda, Roberto N.¹ roberto.miranda@mdanderson.org, Lin Lin¹, Talwalkar, Sameer S.¹, Manning, John T.¹, Medeiros, L. Jeffrey¹

المصدر: Archives of Pathology & Laboratory Medicine. Sep2009, Vol. 133 Issue 9, p1383-1390. 8p. 6 Color Photographs, 3 Charts.

مصطلحات موضوعية: *LYMPHOMAS, *ARTIFICIAL implants, *BREAST implants, *LYMPHOPROLIFERATIVE disorders, *RETICULOENDOTHELIAL granulomas, *ADENOLYMPHOMA

مستخلص: Context.—Lymphomas involving the breast are rare, and most cases are of B-cell lineage; T-cell neoplasms represent less than 10% of all breast lymphomas. Objective.—To define the clinicopathologic spectrum of anaplastic large cell lymphomas (ALCLs) involving the breast. Design.—Six cases of ALCL involving the breast were identified at a single institution during 21 years. The clinicopathologic and immunophenotypic features are presented, and the literature is reviewed. Results.—All patients were women, with a median age of 52 years. There were 4 anaplastic lymphoma kinase-negative (ALK-) ALCL cases; 3 of these neoplasms developed around breast implants. Two patients with ALK- ALCL had a history of cutaneous ALCL. There were 2 ALK+ ALCLs; both patients had stage IV disease. Histologically, all neoplasms were composed of large anaplastic cells that were uniformly CD30+ and expressed markers of T-cell lineage. Four patients with adequate follow-up are alive, with a mean of 4.1 years (range, 1.5-9 years) after diagnosis of the breast tumor. Included in this group are 2 patients with ALK- ALCL associated with breast implants who were alive 4 years and 9 years after diagnosis. Conclusions.—Including the 6 cases we describe, a total of 21 cases of ALCL involving the breast are reported. Fifteen cases, all ALK-, were associated with breast implants, suggesting a possible pathogenetic relationship, and associated with an excellent prognosis. Patients with cutaneous ALCL can subsequently develop ALK- ALCL involving the breast, and these tumors can be associated with breast implants. [ABSTRACT FROM AUTHOR]

المؤلفون: Miranda, Roberto N.¹ tmcmiranda@aol.com, Omurtag, Kenan¹, Castellani, William J.², De Las Casas, Luis E.³, Quintanilla, Norma M.⁴, Kaabipour, Emad⁵

المصدر: Archives of Pathology & Laboratory Medicine. Dec2006, Vol. 130 Issue 12, p1786-1791. 6p.

مصطلحات موضوعية: *FETAL death, *PLACENTA diseases, *FETAL development, *HEMATOPOIESIS, *FETAL membranes, *EMBRYOLOGY

مستخلص: Context.—Chorioamnionitis is the maternal and fetal response to an ascending intrauterine infection. The fetal response is manifested by funisitis and chorionic vasculitis, or as neutrophils within pulmonary spaces. Human hematopoiesis occurs in the liver primarily during the 6th to 22nd weeks of gestation. Objective.—To establish the relationship between the presence of an intrauterine infection and the degree of fetal hepatic myelopoiesis in second- and third-trimester fetuses. Design.—Liver and lungs from 49 fetal autopsies, 20 to 41 weeks of gestational age, and their associated placentas and membranes were analyzed for evidence of intrauterine infection and hepatic myelopoiesis. Hematoxylin-eosin- stained sections from fixed tissues were evaluated for the presence of amnionic fluid infection, defined by the presence of acute chorioamnionitis or funisitis. The degree of portal hematopoiesis, myelopoiesis and intra-alveolar neutrophils was assessed semiquantitatively with hematoxylineosin- stained sections and immunohistochemically with antimyeloperoxidase. The Kruskal-Wallis 1-way analysis of variance and the Wilcoxon-Mann-Whitney test were used to determine the significance of any observed difference. Results.—The degree of portal and lobular myelopoiesis was significantly greater with the presence of inflammation in both the membranes and umbilical cord, and correlated with the presence of intra-alveolar neutrophils (P < .001). A high correlation between the hematoxylin-eosin and immunohistochemistry assessment of myeloid cells was noted. Conclusions.—There is increased portal and lobular myelopoiesis in 20-week to 41-week gestational age fetal livers that is associated with intrauterine ascending infection. The presence of increased portal or lobular myelopoiesis suggests the presence of an active fetal response to an intrauterine ascending infection. [ABSTRACT FROM AUTHOR]

المؤلفون: Gru, Alejandro A.¹ AAG4B@hscmail.mcc.virginia.edu, Lim, Megan S.², Dogan, Ahmet³, Horwitz, Steven M.⁴, Delabie, Jan⁵, Kai Fu⁶, Peker, Deniz⁷, Reddy, Vishnu V. B.⁸, Xu, Mina L.⁹, Vij, Kiran¹⁰, Slack, Graham W.¹¹, Miranda, Roberto N.¹², Jagadeesh, Deepa¹³, Lisano, Julie M.¹⁴, Hsi, Eric D.¹⁵, Torlakovic, Emina¹⁶

المصدر: Archives of Pathology & Laboratory Medicine. Jan2023, Vol. 147 Issue 1, p79-86. 8p. 1 Color Photograph, 2 Charts.

مصطلحات موضوعية: *CONSENSUS (Social sciences), *IMMUNOHISTOCHEMISTRY, *ANAPLASTIC large-cell lymphoma, *DECISION making, *DIAGNOSIS, *PANEL analysis, *LITERATURE reviews

مستخلص: * Context.--Although CD30 testing is an established tool in the diagnostic workup of lymphomas, it is also emerging as a predictive biomarker that informs treatment. The current definition of CD30 positivity by immunohistochemistry is descriptive and based on reactivity in lymphomas that are defined by their universal strong expression of CD30, rather than any established threshold. Challenges include inconsistencies with preanalytic variables, tissue processing, pathologist readout, and with the pathologist and oncologist interpretation of reported results. Objective.--To develop and propose general best practice recommendations for reporting CD30 expression by immunohistochemistry in lymphoma biopsies to harmonize practices across institutions and facilitate assessment of its significance in clinical decision-making. Design.--Following literature review and group discussion, the panel of 14 academic hematopathologists and 2 clinical/academic hematologists/oncologists divided into 3 working groups. Each working group was tasked with assessing CD30 testing by immunohistochemistry, CD30 expression readout, or CD30 expression interpretation. Results.--Panel recommendations were reviewed and discussed. An online survey was conducted to confirm the consensus recommendations. Conclusions.--CD30 immunohistochemistry is required for all patients in whom classic Hodgkin lymphoma and any lymphoma within the spectrum of peripheral T-cell lymphoma are differential diagnostic considerations. The panel reinforced and summarized that immunohistochemistry is the preferred methodology and any degree of CD30 expression should be reported. For diagnostic purposes, the interpretation of CD30 expression should follow published guidelines. To inform therapeutic decisions, report estimated percent positive expression in tumor cells (or total cells where applicable) and record descriptively if nontumor cells are positive. [ABSTRACT FROM AUTHOR]

المؤلفون: Dim, Daniel C.¹, Cooley, Linda D.², Miranda, Roberto N.¹ tmcmiranda@aol.com

المصدر: Archives of Pathology & Laboratory Medicine. Jan2007, Vol. 131 Issue 1, p152-156. 5p. 5 Color Photographs, 1 Black and White Photograph, 2 Charts.

مصطلحات موضوعية: *SARCOMA, *RENAL cell carcinoma, *MELANOMA, *NEURAL crest, *MAGNETIC resonance imaging, *IMMUNOHISTOCHEMISTRY, *METASTASIS

مستخلص: Clear cell sarcoma of tendons and aponeuroses, also referred to as malignant melanoma of soft parts, is a rare malignancy derived from neural crest cells. It usually presents in the distal lower extremities of young adults, frequently attached to tendons or aponeuroses. It behaves like a high-grade soft tissue sarcoma and is associated with poor overall survival. Magnetic resonance imaging studies of the lesion reveal T1 hypointensity, T2 hyperintensity, and gadolinium uptake. Grossly, the tumor is usually circumscribed with a histologic pattern of uniform polygonal to fusiform cells with clear to pale eosinophilic cytoplasm divided into variably sized clusters by fibrous septa. Immunohistochemical studies in most cases show that the neoplastic cells are positive with HMB-45 and react with antibody against S100 protein. Most cases show a reciprocal cytogenetic translocation t(12;22)(q13;q12) that creates a unique chimeric fusion EWSR1/ATF1 gene transcript. Metastasis occurs mainly to regional lymph nodes and lungs. Poor prognostic indicators include a tumor size equal to or more than 5 cm, presence of metastasis, and necrosis. The mainstay of treatment is wide excision of the tumor. The use of sentinel lymph node biopsy may become an important procedure in detecting occult regional metastasis and guiding the extent of surgery. The beneficial effects of adjuvant chemotherapy and radiotherapy have not been fully evaluated. This article provides a short overview of the current knowledge of clear cell sarcoma of tendons and aponeuroses. [ABSTRACT FROM AUTHOR]

المؤلفون: Jabbar, Kausar J.¹, Medeiros, Jeffrey¹ ljmedeiros@mdanderson.org, Wang, Sa A.¹, Miranda, Roberto N.¹, Johnson, Malisha R.¹, Verstovsek, Srdan¹, Jorgensen, Jeffrey L.¹

المصدر: Archives of Pathology & Laboratory Medicine. Sep2014, Vol. 138 Issue 9, p1210-1214. 5p.

مصطلحات موضوعية: *MAST cell disease, *ANTIGENS, *BONE marrow, *FLOW cytometry, *IMMUNOHISTOCHEMISTRY, *IMMUNOPHENOTYPING, *LONGITUDINAL method, *MAST cells, *DESCRIPTIVE statistics, *DIAGNOSIS

مستخلص: Context.—Mast cells of systemic mastocytosis (SM) have aberrant immunophenotypes that are useful for their detection by flow cytometry immunophenotyping. Objectives.—To assess the usefulness of CD2, CD25, and other antigens for establishing the diagnosis of SM in bone marrow using flow cytometry immunophenotyping. Design.—We studied 50 bone marrow aspirates of patients with SM using flow cytometry immunophenotyping. The bone marrow aspirates were stained with antibodies specific for CD2, CD25, CD35, CD59, CD63, and CD69. For the detection of CD2 and CD25, antibodies conjugated with phycoerythrin (PE) or fluorescein isothiocyanate (FITC) were compared. CD45-PerCP and CD117-APC were used for gating. Data were acquired on FACS Calibur cytometers and analyzed using CellQuest software. Results.—CD2 and CD25 were positive in 41 of 50 (82%) and 45 of 50 (90%) SM cases, respectively. For CD2, the PE-conjugated antibody yielded better sensitivity than the FITC–conjugated antibody (31 of 40 [78%] versus 28 of 40 [70%]). For CD25, PE-conjugated and FITC-conjugated antibodies showed similar detection sensitivity, although the intensity of expression was brighter with CD25-PE. Compared with immunohistochemistry, flow cytometry immunophenotyping was superior for detecting CD2 (14 of 23 [61%] versus 9 of 23 [39%]). Other antigens frequently overexpressed in SM were CD35 (43 of 50 [86%]), CD59 (46 of 50 [92%]), CD63 (43 of 49 [88%]), and CD69 (39 of 48 [81%]). Conclusions.—Flow cytometry immunophenotyping is a rapid and sensitive technique for characterizing mast cells in bone marrow aspirate specimens. The use of PE-conjugated antibodies for CD2 and CD25 improves the detection rate (CD2) or facilitates analysis (CD25); therefore, PE-conjugated antibodies are suggested. Antibodies reactive with CD35, CD59, CD63, and CD69 are also helpful in detecting SM in bone marrow. [ABSTRACT FROM AUTHOR]

المؤلفون: Challagundla, Pramoda¹, Jorgensen, Jeffrey L.¹, Kanagal-Shamanna, Rashmi¹, Gurevich, Inga², Pierson, Diane M.³, Ferrajoli, Alessandra⁴, Reyes, Steven R.¹, Medeiros, L. Jeffrey¹, Miranda, Roberto N.¹ Roberto.miranda@mdanderson.org

المصدر: Archives of Pathology & Laboratory Medicine. Jul2014, Vol. 138 Issue 7, p903-909. 7p.

مصطلحات موضوعية: *CHRONIC lymphocytic leukemia diagnosis, *B cell lymphoma, *CHRONIC lymphocytic leukemia, *CYTOGENETICS, *DIFFERENTIAL diagnosis, *FLOW cytometry, *IMMUNOPHENOTYPING, *KARYOTYPES, *LONGITUDINAL method, *PROBABILITY theory, *STATISTICAL hypothesis testing, *T-test (Statistics), *TUMOR antigens, *FLUORESCENCE in situ hybridization, *DATA analysis software, *GENETICS, *DIAGNOSIS

مستخلص: Context.—The value of assessing CD5 expression in the differential diagnosis of small B-cell neoplasms is well established. Assessment is usually done qualitatively. Objectives.—To assess CD5 expression levels by quantitative flow cytometry immunophenotyping and to determine possible differences among various small B-cell neoplasms. Design.—We performed 4-color flow cytometry analysis on specimens of peripheral blood and bone marrow aspirate and quantified CD5 expression in various small B-cell lymphomas and leukemias. We also assessed CD5 levels in peripheral blood samples of healthy blood donors. Results.—Cases of chronic lymphocytic leukemia and mantle cell lymphoma had higher levels of CD5 compared with control B cells (P < .001). Cases of marginal zone lymphoma and hairy cell leukemia had CD5 levels similar to control B cells (P = .35 and P = .14, respectively), whereas cases of follicular lymphoma and lymphoplasmacytic lymphoma had significantly lower CD5 levels than control B cells (P < .001 and P = .04, respectively). In B-cell neoplasms, a high level of CD5 expression was correlated with a homogeneous pattern of positive events, whereas lower CD5 levels were correlated with heterogeneous patterns of positive events. Conclusions.—Using flow cytometric immunophenotypic analysis to quantify CD5 levels can aid in diagnosis. CD5 expression levels are higher in patients with chronic lymphocytic leukemia and mantle cell lymphoma, and expression is observed in a homogeneous pattern, as compared with other B-cell neoplasms that are either negative for CD5 or express CD5 at lower levels with a heterogeneous pattern. However, there is some overlap in CD5 expression levels between a subset of atypical chronic lymphocytic leukemia and marginal zone lymphoma cases. [ABSTRACT FROM AUTHOR]