RESUMEN

Chronic myelogenous leukemia (CML) has a typical progressive course with transition from a chronic phase to a terminal blast crisis phase. The mechanisms that lead to disease progression remain to be elucidated. To understand the role of aberrant methylation in the progression of CML, DNA methylation patterns in 16 patients with CML blast crisis were analyzed. Methylation status was analyzed by methylation-specific PCR (MSP) for 13 genes, including cell cycle regulating genes, DNA repair genes, apoptosis-related genes, a differentiation-associated gene and a cytokine signaling gene. The frequency of samples with methylation in each of the following genes were: p15, 18%; MGMT, 12%; RARß, 12%; p16, 6%; DAPK, 6% and FHIT, 6%. In total, four (25%) cases showed methylation of at least one gene. None of the 16 cases showed hypermethylation of the hMLH1 or hMSH2 genes. These results suggest that hypermethylation of cell cycle control genes, but not DNA mismatch repair genes, play a significant role in the progression of CML.

RESUMEN

Immunological phenotyping of acute leukemia have provided enormous and important information for the classification and lineage determination of leukemia. Forty-nine patients with CD7(+) CD56(+) acute myeloid leukemia (AML) were analyzed. There were 17 patients of M0, which corresponded to myeloid/NK cell precursor acute leukemia, and 32 patients of AML other than M0 (9 each for M1 and M2, one for M3, 3 for M4, 4 for M5 and 6 for M7). Age distribution was similar between these two groups, but CD7(+) CD56(+) M0 showed significant male predominance than CD7(+) CD56(+) M1-M7 (M:F = 15:2 vs. 15:17, P = 0.006). The disease localization and the hematological manifestations were different, showing fewer white blood cell counts and circulating leukemic blasts, less anemia, less thrombocytopenia and more frequent extramedullary involvement in M0 group. The prognosis was poor in both groups, and there was no statistical difference. These findings suggest that extramedullary involvement of myeloid/NK cell precursor acute leukemia is not directly derived from the presence of CD7 and CD56 antigens on leukemic cells. The poor prognosis of CD7(+) CD56(+) M1-M7 suggests that this phenotype may act as a prognostic factor for AML, but this should be confirmed in further studies.

Asunto(s)

Antígenos CD7/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/metabolismo , Antígeno CD56/metabolismo , Leucemia Mieloide Aguda , Adolescente , Adulto , Anciano , Ciclofosfamida/uso terapéutico , Recolección de Datos , Supervivencia sin Enfermedad , Doxorrubicina/uso terapéutico , Femenino , Citometría de Flujo , Humanos , Inmunofenotipificación , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidad , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Prednisona/uso terapéutico , Pronóstico , Inducción de Remisión , Distribución por Sexo , Análisis de Supervivencia , Vincristina/uso terapéutico , Adulto Joven

RESUMEN

INTRODUCTION: The uneven distribution of physicians in Japan disadvantages rural and remote patients with hematological malignancies to the extent that they may not receive standard treatments. There are 7 core regional medical centers in Tokushima Prefecture. A Tokushima rural medical center's clinical hematology division experienced difficulty in treating patients due to a lack of physicians despite an increasing number of patients with hematological malignancies. The aim of this pilot study was to investigate the regional medical supply and demand associated with newly diagnosed hematological malignancies in Tokushima Prefecture, Japan. METHODS: The study investigated the home addresses of patients with newly diagnosed acute leukemia, malignant lymphoma and multiple myeloma who were hospitalized in the 7 core Tokushima centers in 2006. The surveyed patients were compared with the estimated number of patients with those diseases that were newly developed, based on a calculation of incidence and population by age group. The survey also investigated the number and distribution of hematologists. RESULTS: A total of 248 patients were newly hospitalized in the 7 core centers in Tokushima Prefecture during the 1 year period. The surveyed number of patients was similar to the estimated number of patients in all secondary medical areas, except for one area where there was active traffic to and from adjacent prefectures. More than 70% (median 80%; range 72-100%) of the patients received their treatments within a radius of approximately 25 km from their homes. There were 24 hematologists in November 2006 and 63% of these worked in the city with the largest population. The mean estimated number of patients per unit population was significantly higher in rural and remote areas than in urban areas (p <0.01). Three regional centers had only one or two hematologists. CONCLUSIONS: Most patients with newly developed hematological malignancies in Tokushima Prefecture received treatment from intra-prefectural hematologists within a 25 km distance of their homes. Rural areas had a shortage of hematologists who were localized in urban areas. It is recommended that functions of core medical centres and rural clinics are redesigned according the availability of specialized treatments, and to maximize cooperation between physicians at rural clinics and hematologists at urban hospitals.

Asunto(s)

Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Neoplasias Hematológicas , Medicina , Especialización , Anciano , Geografía , Encuestas de Atención de la Salud , Humanos , Japón , Área sin Atención Médica , Persona de Mediana Edad , Médicos/provisión & distribución , Proyectos Piloto , Población Rural

Asunto(s)

Trasplante de Células Madre de Sangre del Cordón Umbilical/efectos adversos , Diabetes Insípida/complicaciones , Encefalitis Viral/complicaciones , Herpesvirus Humano 6/aislamiento & purificación , Leucemia Mieloide Aguda/cirugía , Anciano , Encefalitis Viral/virología , Humanos , Leucemia Mieloide Aguda/complicaciones , Masculino

RESUMEN

A new cell line, designated UCH1, was established from a patient with splenic marginal zone lymphoma (SMZL). UCH1 cells feature a mature B-cell phenotype, characterized by surface IgM +, kappa+, CD5-, CD10-, CD19+ and CD20+. The BCL2 and BCL6 genes retained their germ-line configurations and overexpression of cyclin D1 was not detected. UCH1 cells carry numerical and structural aberrations in chromosome 3, but these were too complex to be analyzed with the conventional G-banding method. Spectral karyotyping (SKY) and fluorescence in situ hybridization analysis clearly demonstrated the presence of a balanced translocation between chromosomes 8 and 14 [t(8;14)(q24;q32)] in the complex aberrations involving chromosome 3. The results of Southern blot analysis supported this finding by showing rearrangement of the c-myc gene in UCH1 cells. SKY analysis also identified a translocation involving chromosome band 18q21, to which BCL2 and MALT1 genes were assigned, suggesting their implication in the development or progression of SMZL.

Asunto(s)

Línea Celular Tumoral , Cromosomas Humanos Par 3 , Linfoma/genética , Linfoma/patología , Translocación Genética , Anciano , Linfocitos B/metabolismo , Reordenamiento Génico , Humanos , Inmunoglobulina M/metabolismo , Inmunofenotipificación , Hibridación Fluorescente in Situ , Cariotipificación , Leucocitos Mononucleares/metabolismo , Masculino , Proteínas Proto-Oncogénicas c-myc/metabolismo

RESUMEN

Our objective was to evaluate the usefulness of cytomorphologic assessment in the accuracy of diagnosis of Hodgkin's disease (HD), using imprint cytological preparations over a 18-yr period. Imprint materials from 34 HD cases were reviewed using cytomorphological and immunocytochemical studies. Twenty-six cases (76.5%) were diagnosed to be HD and 6 cases (17.6%) were suspected to be HD, but 2 cases (5.9%) were cytologically diagnosed as reactive lesions, because of an insufficient number of Reed-Sternberg (RS) cells. The 6 suspected cases were definitively diagnosed as HD, using immunocytochemistry. Immunophenotyping of RS cells in 32 cases (excluding the two cases of reactive lesions) showed CD30+ in 31 (96.9%) cases, CD15+ in 22 (68.8%) cases and CD20+ in 12 (37.5%) cases. RS cells were immunophenotypically classified into five groups: A, (CD 30+, 15+, 20-) 15 (46.9%); B, (CD30+, 15-, 20-) 5 (15.6%); C, (CD 30+, 15+, 20+) 6 (18.8%); D, (CD30+, 15-, 20+) 5 (15.6%); and E, (CD30-, 15+, 20+) 1 (3.1%). Cytomorphologic differences in RS cells were identified between group D and other groups (CD15+ and/ or CD20-). The former had a low polymorphic shape (like popcorn), and the latter had a more classical polymorphic shape. Epstein-Barr virus (EBV)-latent membrane protein-1(LMP-1) was identified in 16 (50%) cases. LMP-1 expression was found not only in classic RS cells, but also in smaller variants. These variants did not match the morphologic criteria of RS cells, but expressed the common phenotype (CD30+, CD15+/-) of RS cells, suggesting the same cellular origin as RS cells. This study demonstrated that imprint cytology from lymph node biopsies can be a useful tool for the diagnosis and the evaluation of the cellular biology of HD.

Asunto(s)

Citodiagnóstico/métodos , Enfermedad de Hodgkin/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antígenos CD20/análisis , Niño , Femenino , Enfermedad de Hodgkin/metabolismo , Humanos , Inmunohistoquímica , Japón , Antígeno Ki-1/análisis , Antígeno Lewis X/análisis , Masculino , Persona de Mediana Edad , Células de Reed-Sternberg/química , Células de Reed-Sternberg/patología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Proteínas de la Matriz Viral/análisis

RESUMEN

The present study aimed to characterize the clinical and molecular-cytogenetic features of non-Hodgkin's lymphoma (NHL) with double translocation of the immunoglobulin heavy chain (IGH) gene. G-banding analysis, fluorescence in situ hybridization (FISH) with the IGH (Cgamma and VH) and oncogene (c-MYC, BCL1, BCL2, and BCL6) probes, and long-distance polymerase chain reaction (LD-PCR) were performed on 6 patients with B-cell lymphoma, one with angioimmunoblastic T-cell lymphoma, and one with acute lymphoblastic leukemia (ALL) with B-cell phenotype. G-banding analysis detected two different 14q32 translocations, t(14,18) and add (14)(q32) in a patient with ALL. Two distinct partners of double IGH translocation identified by FISH were as follows: c-MYC + BCL2 in 3 patients, c-MYC + BCL1 in 2, c-MYC + BCL6 in one, BCL2 + 9q22 in one, and 1q21 + 6q27 in one. Colocalization of BCL1 and c-MYC probes was demonstrated in a patient with mantle cell lymphoma. LD-PCR detected c-MYC/Cmu, c-MYC/Calpha and BCL6/Cmu, and c-MYC/Calpha fusion in each one patient. Seven of 8 patients showed high serum LDH. Central nervous system and leukemic involvement was observed in 5 and 6 patients, respectively. Median survival time of patients with c-MYC/IGH translocation was 9 months. The results defined a clinical subset of B-cell lymphoma/leukemia showing extremely poor prognosis. C-MYC/IGH translocation is possibly an evolutionary alteration following the primary IGH translocation with BCL1, BCL2, or BCL6. Furthermore, FISH identified one novel (9q22) and one cryptic chromosomal breakpoints (6q27) involved in IGH translocation.

Asunto(s)

Genes de Inmunoglobulinas/genética , Cadenas Pesadas de Inmunoglobulina/genética , Linfoma de Células B/genética , Linfoma de Células T/genética , Translocación Genética , Adulto , Anciano , Bandeo Cromosómico , Ciclina D1/genética , Análisis Citogenético , Proteínas de Unión al ADN/genética , Femenino , Humanos , Hibridación Fluorescente in Situ , Linfoma Folicular/genética , Linfoma de Células del Manto/genética , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas c-bcl-2/genética , Proteínas Proto-Oncogénicas c-bcl-6 , Proteínas Proto-Oncogénicas c-myc/genética , Factores de Transcripción/genética

Asunto(s)

Antineoplásicos/efectos adversos , Médula Ósea/patología , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Piperazinas/efectos adversos , Inhibidores de Proteínas Quinasas/efectos adversos , Pirimidinas/efectos adversos , Lesión Renal Aguda/complicaciones , Antineoplásicos/uso terapéutico , Benzamidas , Médula Ósea/efectos de los fármacos , Coagulación Intravascular Diseminada/complicaciones , Resultado Fatal , Femenino , Proteínas de Fusión bcr-abl/antagonistas & inhibidores , Humanos , Mesilato de Imatinib , Persona de Mediana Edad , Necrosis , Proteínas de Neoplasias/antagonistas & inhibidores , Piperazinas/uso terapéutico , Neumonía/complicaciones , Inhibidores de Proteínas Quinasas/uso terapéutico , Pirimidinas/uso terapéutico

RESUMEN

The receptor for hyaluronan mediated motility (RHAMM), a hyaluronan (HA) binding protein, has been shown to play an important role in the motility and invasiveness of malignant cells. We have developed a polyclonal antibody against human RHAMM. A new polyclonal antibody was raised against a mixture of C-terminal RHAMM, which is capable of binding to HA, and the central domain. The antibody showed immunoreactivity to these two peptides, and detected a 95 kDa protein. Immunohistochemically, RHAMM detected by the antibody was present in the cytoplasm and nucleus of malignant B cells. Binding of HA to RHAMM was almost completely blocked by this antibody. These findings suggest that our antibody recognizes RHAMM protein and is useful for blocking HA binding to RHAMM.

Asunto(s)

Movimiento Celular , Proteínas de la Matriz Extracelular/inmunología , Receptores de Hialuranos/inmunología , Ácido Hialurónico/inmunología , Inmunoglobulina G/inmunología , Fragmentos de Péptidos/inmunología , Animales , Núcleo Celular , Citoplasma , Proteínas de la Matriz Extracelular/genética , Humanos , Receptores de Hialuranos/genética , Inmunización , Linfoma de Células B/inmunología , Linfoma de Células T/inmunología , Conejos , Proteínas Recombinantes de Fusión/inmunología , Células Tumorales Cultivadas

RESUMEN

Acute myeloblastic leukemia cases carrying the translocation t(8;16) (p11;p13) are characterized by the M4 and M5 subtypes, erythrophagocytosis by the blast cells and a poor prognosis, suggesting a new clinical entity. The t(8;16) fuses the MOZ gene which encodes a histone acetyltransferase, located on 8p11 with the CBP gene which also encodes a histone acetyltransferase, located on 16p13, and recent reports suggested that the chimeric transcription MOZ-CBP is essential for leukemogenesis. A 68-year-old woman who had been treated mainly with paclitaxel and carboplatin for preceding ovarian cancer was admitted to our hospital, complaining of right breast mass. She was diagnosed as having breast cancer and acute monocytic leukemia (M5b). Cytogenetic study with spectral karyotyping analysis revealed the development of 47 XX, + 8, t(8;16)(p11;p13). Eleven cases of therapy-related t(8;16) leukemia including the present case have been reported, but prior treatment with paclitaxel and carboplatin-based chemotherapy has never been reported. The relation of histone acetylase and therapy-related leukemia is discussed.

Asunto(s)

Cromosomas Humanos Par 16 , Cromosomas Humanos Par 8 , Leucemia Monocítica Aguda/genética , Neoplasias Primarias Secundarias/genética , Translocación Genética , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carboplatino/efectos adversos , Transformación Celular Neoplásica/genética , Femenino , Humanos , Leucemia Monocítica Aguda/inducido químicamente , Neoplasias Primarias Secundarias/inducido químicamente , Neoplasias Ováricas/complicaciones , Neoplasias Ováricas/tratamiento farmacológico , Paclitaxel/efectos adversos

RESUMEN

Osteolysis and hypercalcemia are observed in 5-15%, and 10%, respectively, of malignant lymphoma patients during their clinical course. However, both osteolysis and hypercalcemia are uncommon at onset of the disease. We encountered a 24-year-old male non-Hodgkin's lymphoma patient who had multiple osteolytic lesion from the onset of the disease and repeated episodes of hypercalcemia during the clinical course. The patient died with refractory disease. We studied the expression of chemokines which might affect bone resorption using the reverse transcriptase-polymerase chain reaction (RT-PCR) method. Increased expressions of MIP-1alpha, MIP-1beta and RANKL, which are osteoclast-activating factors, were observed in the RNA derived from the patient's lymphoma cells. The secretion of osteoclast-activating factors such as MIP-1alpha by the tumor cells (and/or bone marrow stromal cells) might be involved in the etiology of osteolysis and hypercalcemia in some malignant lymphoma cases.

Asunto(s)

Hipercalcemia/diagnóstico , Linfoma de Células B/diagnóstico , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma no Hodgkin/diagnóstico , Proteínas Inflamatorias de Macrófagos/biosíntesis , Osteólisis/diagnóstico , Fosfatasa Ácida/metabolismo , Adulto , Biopsia , Células de la Médula Ósea/citología , Resorción Ósea , Proteínas Portadoras/biosíntesis , Quimiocina CCL3 , Quimiocina CCL4 , Quimiocinas/biosíntesis , Resultado Fatal , Humanos , Inmunofenotipificación , Isoenzimas/metabolismo , Dolor de la Región Lumbar , Linfoma de Células B/patología , Linfoma de Células B Grandes Difuso/patología , Linfoma no Hodgkin/patología , Imagen por Resonancia Magnética , Masculino , Glicoproteínas de Membrana/biosíntesis , Osteoclastos/metabolismo , Ligando RANK , Receptor Activador del Factor Nuclear kappa-B , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Fosfatasa Ácida Tartratorresistente

Asunto(s)

Linfoma de Células B/metabolismo , Neuropilina-1/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Líquido Ascítico/inmunología , Líquido Ascítico/patología , Biomarcadores de Tumor/metabolismo , Línea Celular Tumoral , Humanos , Inmunohistoquímica , Inmunofenotipificación , Linfoma de Células B/inmunología , Linfoma de Células B/patología , Neuropilina-1/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , ARN Neoplásico/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factor A de Crecimiento Endotelial Vascular/genética

RESUMEN

Methylation profile was analyzed in eleven cases of therapy-related leukemia (t-leukemia) for p14, p15, p16, Rb, hMLH1, hMSH2, MGMT, APC, RAR beta, DAPK, RIZ1, FHIT, and SOCS-1 genes by using methylation specific polymerase chain reaction (MSP) analysis. Six (55%) of eleven cases showed methylation of at least one gene. The average time to the development of t-leukemia after the treatment of the primary tumor was significantly shorter in patients with methylation than those without methylation (49.3 months vs. 133.2 months, P=0.044). These results suggest that hypermethylation might be involved in the development of t-leukemia.

Asunto(s)

Islas de CpG , Metilación de ADN , Leucemia/tratamiento farmacológico , Leucemia/genética , Leucemia/radioterapia , Regiones Promotoras Genéticas , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Células de la Médula Ósea/metabolismo , Reparación del ADN , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Radioterapia/efectos adversos

RESUMEN

Th2 dominancy in the peripheral T helper (Th) cell subsets were reported to be involved in the pathogenesis of pure red cell aplasia (PRCA). We encountered a PRCA case secondary to plasma cell dyscrasia that showed Th2 dominancy at the relapse of PRCA. Increased expression of c-maf, a transcriptional factor which induces Th2 differentiation of naive T-cells, and elevated expression of interleukin (IL)-4 were observed in the RNA derived from patient's bone marrow at relapse of PRCA. Following the administration of methylprednisolone which improved PRCA, normalization of Th1/Th2 ratio and decreased expression of c-maf and IL-4 were observed, which suggests that the upregulation of c-maf might have played a role in the pathogenesis of PRCA secondary to plasma cell dyscrasia.

Asunto(s)

Proteínas de Unión al ADN/biosíntesis , Regulación de la Expresión Génica , Paraproteinemias/complicaciones , Proteínas Proto-Oncogénicas/biosíntesis , Aplasia Pura de Células Rojas/metabolismo , Anciano , Médula Ósea/metabolismo , Diferenciación Celular , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/fisiología , Humanos , Cadenas kappa de Inmunoglobulina/análisis , Cadenas lambda de Inmunoglobulina/análisis , Inmunosupresores/uso terapéutico , Interferón gamma/biosíntesis , Interferón gamma/genética , Interleucina-4/biosíntesis , Interleucina-4/genética , Interleucinas/biosíntesis , Interleucinas/genética , Masculino , Metilprednisolona/uso terapéutico , Paraproteinemias/metabolismo , Paraproteínas/análisis , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas/fisiología , Proteínas Proto-Oncogénicas c-maf , ARN Mensajero/biosíntesis , ARN Mensajero/genética , Recurrencia , Aplasia Pura de Células Rojas/tratamiento farmacológico , Aplasia Pura de Células Rojas/etiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Células Th2/inmunología , Trombocitosis/etiología

RESUMEN

Myelofibrosis following peripheral T-cell lymphoma has rarely been reported. Described here is a case of peripheral T-cell lymphoma with myelofibrosis and elevated transforming growth factor beta (TGF-beta). A 69 years old male was admitted due to anemia and thrombocytopenia. His bone marrow showed fibrosis and was infiltrated with small lymphoid cells and a few residual normal hematopoietic cells. He had presented with hepatosplenomegaly and left inguinal lymph node swelling. Biopsy of the left inguinal lymph node revealed diffuse mature small lymphoid cells with atypical nuclei. Immunophenotyping of the small lymphoid cells were positive for CD3, CD8, TCR alphabeta and HLA-DR and were negative for CD4, CD19, CD20 and CD56. T-cell receptor beta-chain gene was rearranged in bone marrow cells. He was diagnosed as having peripheral T-cell lymphoma complicated with myelofibrosis. Chemotherapy was administrated which improved his pancytopenia and symptoms. Two years later, anemia and thrombocytopenia developed rather quickly, he died because of progression of myelofibrosis with severe pancytopenia.

Asunto(s)

Linfoma de Células T Periférico/complicaciones , Linfoma de Células T Periférico/diagnóstico , Mielofibrosis Primaria/etiología , Anciano , Anemia/etiología , Resultado Fatal , Reordenamiento Génico de la Cadena beta de los Receptores de Antígenos de los Linfocitos T , Humanos , Inmunofenotipificación , Linfoma de Células T Periférico/tratamiento farmacológico , Masculino , Trombocitopenia/etiología , Factor de Crecimiento Transformador beta/sangre

RESUMEN

We investigated whether hyaluronan (HA) was produced by a malignant lymphoma cell line with a primary effusion lymphoma immunophenotype, OHK. OHK secreted high levels of HA into the culture supernatant, and reverse transcription polymerase chain reaction showed mRNA for the HA synthases 2 and 3. HA binding protein-reactive HA was present in the plasma membrane and in the cytoplasm. The inoculation of OHK into severe combined immunodeficiency disease mice produced marked viscid ascites with concentrated HA and a vascular-rich mesenteric solid tumour. These results show that HA is produced and secreted by the malignant lymphoma cell line OHK.

Asunto(s)

Ácido Hialurónico/metabolismo , Linfoma/fisiopatología , Animales , Humanos , Inmunofenotipificación , Linfoma/inmunología , Ratones , Ratones SCID , Neoplasias Experimentales , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/análisis , Células Tumorales Cultivadas

RESUMEN

OBJECTIVE: 67Ga scintigraphy has a well-documented role in nodal lymphoma for both disease staging and assessment of treatment response. The objective of the present study was to examine the role of 67Ga scintigraphy in diagnosis and assessment of treatment response, in patients with extranodal malignant lymphoma. METHODS: Seventy-one patients with extranodal malignant lymphoma were studied. Whole body scans in all and SPECT scans in some selected patients were performed 72 hours after injection of 67Ga-citrate. The influence of tumor site, histological classification and tumor size on 67Ga scintigraphy sensitivity was analyzed. Twenty-one of the seventy-one patients also had a second 67Ga scintigraphy to assess response to treatment. RESULTS: The overall 67Ga scintigraphy sensitivity was 83.1% (59/71). The sensitivity was low in patients whose extranodal lymphoma occurred in skin (0/3) and urinary bladder (0/1), as compared to other tumor sites. According to the histological classification of the lesion, the sensitivity was lower in low-grade than in intermediate and high-grade lymphoma. According to the tumor size, the sensitivity was low in lesions less than 2 cm in diameter than those more than 2 cm in diameter. The results changed from positive to negative accumulation in 20 (95.2%) of the 21 patients who had 67Ga scintigraphy to assess the response to treatment. These 20 patients showed a good clinical course. CONCLUSIONS: Although 67Ga scintigraphy did not show positive accumulation in patients with skin and urinary bladder lymphoma, it was helpful to confirm the diagnosis and to evaluate the therapeutic effect in most patients with extranodal malignant lymphoma.

Asunto(s)

Citratos , Galio , Linfoma/diagnóstico por imagen , Neoplasias/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Metástasis Linfática , Linfoma/patología , Masculino , Persona de Mediana Edad , Neoplasias/patología , Radiofármacos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tomografía Computarizada de Emisión de Fotón Único/métodos , Recuento Corporal Total/métodos

RESUMEN

The development of central pontine myelinolysis (CPM) has rarely been reported in association with hemophagocytic syndromes (HPS). Here we report a unique case of Epstein-Barr Virus (EBV)-related HPS which was accompanied with CPM. A 72-year-old man who had no significant medical history was admitted to our hospital due to high fever and progressing dysphasia and dysarthria. Physical examination revealed anisocoria of the right pupil, fixed reaction to light, and paralysis of the left vagus nerves. Magnetic resonance imaging revealed low signal intensity on T1-weighted images and high signal intensity T2-weighted images in the patient's central midpontine lesion. Initial work-up showed anemia and thrombocytopenia with elevated levels of serum ferritin, lactate dehydrogenase, and soluble IL-2 receptor. Bone marrow aspiration revealed hemophagocytosis. The EBV genome was detected in the peripheral blood using the polymerase chain reaction method. He was diagnosed as having EBV-related HPS and CPM. Despite intensive treatment with methylpredonisolone, immunoglobulin, and etoposide, he died due to progressive disease and fungal septicemia. The etiology and relation between CPM and HPS are discussed.

Asunto(s)

Infecciones por Virus de Epstein-Barr/complicaciones , Histiocitosis de Células no Langerhans/complicaciones , Mielinólisis Pontino Central/complicaciones , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Examen de la Médula Ósea , Infecciones por Virus de Epstein-Barr/diagnóstico , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Resultado Fatal , Histiocitosis de Células no Langerhans/diagnóstico , Histiocitosis de Células no Langerhans/tratamiento farmacológico , Humanos , Imagen por Resonancia Magnética , Masculino , Mielinólisis Pontino Central/diagnóstico , Mielinólisis Pontino Central/tratamiento farmacológico , Mielinólisis Pontino Central/etiología

RESUMEN

Thrombocytosis is a rare finding in acute myeloblastic leukemia (AML). Here, we describe a patient with AML who relapsed with marked thrombocytosis. The patient was initially diagnosed as having AML (M4) with a low platelet count. The patient was started on combination chemotherapy including high-dose etoposide and achieved complete remission. However, the patient relapsed six months later with an extremely high platelet count (72.5 x 10(4)/microl). Cytogenetic analysis at relapse revealed the development of t(2;14)(p13;q32). Despite the repeated combination chemotherapy, the patient died with progressive disease. This case suggests that the additional chromosomal aberration t(2;14)(p13;q32) may be related to abnormal thrombocytosis in AML.

Asunto(s)

Cromosomas Humanos Par 14 , Cromosomas Humanos Par 2 , Leucemia Mielomonocítica Aguda/complicaciones , Trombocitosis/genética , Translocación Genética , Adulto , Análisis Citogenético , Progresión de la Enfermedad , Resultado Fatal , Humanos , Leucemia Mielomonocítica Aguda/diagnóstico , Leucemia Mielomonocítica Aguda/genética , Masculino , Recuento de Plaquetas , Recurrencia , Trombocitosis/etiología

RESUMEN

CD5+ diffuse large B-cell lymphoma(CD5+DLBCL) is known to have different characteristics than CD5-DLBCL and mantle cell lymphoma(MCL). 9 patients with CD5+DLBCL were reviewed, and the results were compared with those of 8 CD5-DLBCL and 3 cyclin D1+MCL patients. CD5+DLBCL was more closely related to many aggressive clinical features or parameters than CD5-DLBCL: 67% of the patients were older than 60 years, 67% with performance status > or = 2, 89% with serum lactate dehydrogenase level higher than normal, 78% with stage III/IV disease at diagnosis, and 78% with more than one extranodal lesion. The overall International Prognostic Index score for the patients with CD5+DLBCL was thus significantly higher than that for those with CD5-DLBCL. Immunophenotypically, CD5+DLBCL was characterized by CD5+CD10-CD19+CD20+CD21-CD23-cyclin D1-phenotype and the predominant expression of surface IgM. Of particular interest is that the survival rate of CD5+DLBCL patients was significantly inferior to that of patients with CD5-DLBCL. To further characterize CD5+DLBCL, we semi-quantified the CD5 expression in DLBCL cells. Our findings suggest that CD5+DLBCL may constitute a unique subgroup of DLBCL and, moreover, CD5+DLBCL may consist of several subgroups.

Asunto(s)

Antígenos CD5/análisis , Citometría de Flujo , Linfoma de Células B/clasificación , Linfoma de Células B Grandes Difuso/clasificación , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Linfoma de Células B/mortalidad , Linfoma de Células B Grandes Difuso/mortalidad , Masculino , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia