RESUMO
Diffuse large B cell lymphoma, not otherwise specified (DLBCL, NOS) is the most frequent non-Hodgkin lymphoma subtype. This aggressive neoplasm may variably express the CD30 protein, which may be used as a therapeutic target for this tumor. However, CD30 expression in DLBCL NOS arising from the oral cavity and the oropharynx has not been investigated. Therefore, this study aims to determine the frequency of CD30 expression and its prognostic significance for patients affected by oral/oropharyngeal DLBCL NOS. Fifty cases were retrieved from pathology files and submitted to immunohistochemistry against CD30. Reactivity was accessed by two oral pathologists using two cut-off values (> 0% and > 20% of tumor cells) to determine positivity in each case. Clinical data were obtained from the patients' medical files to investigate the prognostic potential of the protein. Seven high-grade B cell lymphomas and two EBV-positive DLBCL NOS were identified. We found one CD30-positive case in each of these two groups of lymphomas. Among the remaining 41 DLBCL NOS, other four cases (three in the oral cavity and one in the oropharynx) were positive for CD30, but only two expressed the protein in > 20% of tumor cells, both in the oral cavity. Survival analysis demonstrated that CD30-positive cases had a higher five-year overall survival rate (75%) than CD30-negative cases (32.3%), although a statistically significant result was not achieved (p = 0.19). Only a minor subset of oral and oropharyngeal DLBCL NOS express CD30 and these patients seems to have a higher survival rate.
Assuntos
Antígeno Ki-1 , Linfoma Difuso de Grandes Células B , Humanos , Imuno-Histoquímica , Antígeno Ki-1/análise , Antígeno Ki-1/uso terapêutico , Linfoma Difuso de Grandes Células B/patologia , Orofaringe/química , Orofaringe/patologia , PrognósticoAssuntos
Infecções por Vírus Epstein-Barr/complicações , Herpesvirus Humano 4/isolamento & purificação , Antígeno Ki-1/análise , Úlceras Orais/diagnóstico , Adulto , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlceras Orais/complicações , Úlceras Orais/patologiaRESUMO
BACKGROUND: Primary cutaneous CD30+ lymphoproliferative disorders (pc-CD30-LPD) are a group of clonal T cell lymphoproliferative disorders that despite very similar tumor histology follow different and characteristic clinical courses, suggesting a homeostatic role of the tumor microenvironment. Little is known about tumor microenvironment and there is almost no literature about PD-L1 expression in pc-CD30-LPD. METHODS: This retrospective study presents a fully clinicopathologically characterized series of pc-CD30-LPDs from an academic medical center in Brazil, including 8 lymphomatoid papulomatosis (LyP), 9 primary cutaneous anaplastic large cell lymphoma (pcALCL) and 4 borderline lesions. All the cases were scored for FOXP3+ regulatory T-cells (Treg) and CD8+ cytotoxic tumor infiltrating lymphocytes (TIL) densities, as well as PD-L1 expression in tumor cells and tissue associated macrophages. The CD8+/FOXP3+ ratio was also evaluated. RESULTS: Among the 21 cases of pc-CD30-LPD, PD-L1 expression is frequent in both tumor cells and tissue associated macrophages in pc-CD30-LPD across categories, suggesting that the PD-L1 axis may be a common feature of pc-CD30-LPDs. While reactive T cell infiltrates vary widely from case to case, a common feature across pc-CD30-LPDs is higher density of CD8 than FOXP3 + T cells. The distribution of T cells within the lesions however differed between LyP and pcALCL: we found that LyP lesions tend to be permeated by CD8+ and FOXP3+ T cells, whereas pcALCL tend to be surrounded by a rim of CD8+ TIL and FOXP3+ Tregs with relatively lower density infiltrates in the center of the lesion. CONCLUSIONS: LyP has a trend to have denser immune cells throughout the lesion, with higher FOXP3+ Treg and CD8+ TIL in the center than the edge comparing with pcALCL. PD-L1+ is frequent in tumor cells and tissue associated macrophages in pc-CD30-LPD. The differential distribution of CD8+ and FOXP3+ TILs in LyP as compared to pcALCL could provide a clue to the relapsing/remitting course of LyP as compared to the less frequent spontaneous regression of pcALCL.
Assuntos
Antígeno Ki-1/imunologia , Transtornos Linfoproliferativos/patologia , Dermatopatias/patologia , Neoplasias Cutâneas/patologia , Microambiente Tumoral/fisiologia , Centros Médicos Acadêmicos , Adulto , Idoso , Brasil , Feminino , Humanos , Antígeno Ki-1/análise , Linfócitos do Interstício Tumoral/patologia , Linfoma de Células T Periférico/patologia , Transtornos Linfoproliferativos/diagnóstico , Masculino , Pessoa de Meia-Idade , Dermatopatias/diagnóstico , Neoplasias Cutâneas/diagnósticoRESUMO
Lymphomatoid papulosis (LyP) is an uncommon CD30 lymphoproliferative disorder with a relatively excellent prognosis. Ten to twenty percent of cases, however, are associated with a lymphoma, typically systemic or cutaneous anaplastic large cell lymphoma, mycosis fungoides, or Hodgkin lymphoma. Subtypes divide LyP into infiltrate-descriptive categories along a spectrum of histological manifestation. Classically, LyP shows a patchy, wedge-shaped, perivascular dermal infiltrate of small- to intermediate-sized lymphoid cells, larger lymphoid, with one, 2, or multiple prominent nucleoli, and a variable admixture of neutrophils, eosinophils, and histiocytes. Follicular LyP shares these characteristics, although its infiltrate is folliculocentric. Variable folliculotropism, follicular dilation, rupture, and mucinosis can occur. This entity is commonly misdiagnosed and underreporting likely because its histopathologic features can masquerade as more common follicular-based entities. The authors present 2 cases of this rare variant to underscore the importance of clinicopathologic correlation in diagnosis. To the best of the authors' knowledge, this is the first report of the follicular LyP variant with concurrent mycosis fungoides. In the context of a literature review, diagnostic pitfalls and classification of this variant are discussed.
Assuntos
Foliculite/diagnóstico , Folículo Piloso/patologia , Papulose Linfomatoide/patologia , Neoplasias Cutâneas/patologia , Pré-Escolar , Diagnóstico Diferencial , Humanos , Antígeno Ki-1/análise , Papulose Linfomatoide/metabolismo , Masculino , Neoplasias Cutâneas/químicaAssuntos
Eritema/patologia , Linfoma Anaplásico de Células Grandes/patologia , Quinase do Linfoma Anaplásico , Antígenos CD5/análise , Criança , Eritema/etiologia , Humanos , Antígeno Ki-1/análise , Linfoma Anaplásico de Células Grandes/complicações , Linfoma Anaplásico de Células Grandes/diagnóstico , Masculino , Receptores Proteína Tirosina Quinases/análise , TóraxRESUMO
OBJECTIVE: The aim of this study was to describe the clinicopathological and immunohistochemical features of 19 cases of oral eosinophilic ulcers and discuss the hypothesis that this entity could represent a spectrum of the CD30(+) lymphoproliferative disorder. MATERIAL AND METHODS: Clinical data concerning gender, age, affected site, and clinical presentation of 19 patients were collected and a broad immunohistochemical panel was carried out. Eosinophil distribution in relation to muscular tissue was evaluated using an Aperio ScanScope CS scanner. RESULTS: The mean age of the patients was 58.6 years, with a male preponderance. A single painful ulcer in the tongue was the most common clinical presentation. There was no predilection of eosinophils for surrounding muscular fibers because this population was equally distributed in areas adjacent to and distant from these structures. The inflammatory infiltrate was mainly formed by cytotoxic T lymphocytes and CD30 expression was not limited to large atypical cells; it also stained small reactive lymphocytes. CONCLUSIONS: Considering the clinical, histopathological, and immunohistochemical characteristics, oral eosinophilic ulcers must be considered a self-limiting reactive condition.
Assuntos
Eosinofilia/patologia , Úlceras Orais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos CD20/análise , Complexo CD3/análise , Antígenos CD8/análise , Diagnóstico Diferencial , Eosinófilos/patologia , Feminino , Granuloma Piogênico/diagnóstico , Granzimas/análise , Humanos , Hiperplasia , Antígeno Ki-1/análise , Linfócitos/patologia , Transtornos Linfoproliferativos/diagnóstico , Masculino , Mastócitos/patologia , Pessoa de Meia-Idade , Fibras Musculares Esqueléticas/patologia , Necrose , Peroxidase/análise , Estudos Retrospectivos , Linfócitos T Citotóxicos/patologia , Doenças da Língua/patologia , Neoplasias da Língua/diagnóstico , Tuberculose Bucal/diagnósticoRESUMO
INTRODUCTION: We evaluated the immunohistochemical expression of p53, Ki67, CD30, and CD117 and correlated it with histological features and presence of clinical metastasis at diagnosis of testicular seminomas. MATERIALS AND METHODS: A retrospective study of 62 patients was performed in patients with pure seminoma. The retroperitoneum was staged with computed tomography scan and the thorax with simple x-rays and/or computed tomography scan. Pathologists were unaware of the clinical stage of the patients. Manual microarrays were created from a tissue representative of tumor. The expression of p53, Ki67, CD30, and CD117 was evaluated as negative, any degree of expression, and expression in more than 50% of neoplastic cells. Univariate and multivariate analysis were performed. RESULTS: Sixty-two cases were analyzed: 43 cases were in clinical stage I (69.4%), 17 were in clinical stage II (27.4%), and 2 were in clinical stage III (3.2%). Fifty-six cases expressed CD117 (90%), 42 p53 (68%), 8 CD30 (13%), and all cases Ki67. There were no differences in p53, Ki67, CD30, and CD117 expression between testicular seminoma with and without clinical metastasis at diagnosis, regardless of the magnitude of expression. Neither of them found positive association between these marker expressions and morphologic risk factors such as tumor size greater than 6 cm and rete testis invasion. CONCLUSIONS: This study shows that expression of p53, Ki67, and CD30 and loss of CD117 expression fail to predict the presence of clinical metastasis at diagnosis of testicular seminoma and do not correlate with other histopathological risk factors in clinical stage I patients.
Assuntos
Biomarcadores Tumorais/análise , Seminoma/diagnóstico , Seminoma/patologia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Expressão Gênica , Humanos , Imuno-Histoquímica , Antígeno Ki-1/análise , Antígeno Ki-1/genética , Antígeno Ki-67/análise , Antígeno Ki-67/genética , Masculino , Metástase Neoplásica , Estadiamento de Neoplasias , Proteínas Proto-Oncogênicas c-kit/análise , Proteínas Proto-Oncogênicas c-kit/genética , Estudos Retrospectivos , Seminoma/genética , Seminoma/metabolismo , Neoplasias Testiculares/genética , Neoplasias Testiculares/metabolismo , Testículo , Tomografia Computadorizada por Raios X , Proteína Supressora de Tumor p53/análise , Proteína Supressora de Tumor p53/genéticaRESUMO
Th2 type lymphocytes are characterized by high expression of CD30 glycoprotein. Increased serum levels of CD30 and Th2 IL-4 producing T-cells are found during AIDS progression. Since HIV-positive patients are more susceptible to periodontal disease, quantitative analysis of positive cells for the CD30 receptor in chronic gingivitis of both HIV-infected and non-infected patients (NSG) would help to clarify the immunoregulation of HIV-associated periodontal diseases. The purpose of this study was to evaluate CD30+ lymphocytes in gingival biopsies from sites exhibiting chronic gingivitis on HIV-positive patients (CG-HIV) and NSG. A biotin-streptavidin amplified system was used for identification of the CD30 receptor. The results demonstrated increased proportions of Th2 cells in CG-HIV as compared to NSG. Additional studies are necessary to understand the importance of these cells to the biological activity or inactivity of the disease.