Primary anaplastic large cell lymphoma arising from central nervous system
AbstractA 22-year-old man presented at the emergency department with progressive headache, vomiting and horizontal diplopia over 2-month period. He also developed blurred vision in his left eye. He complained of loss of appetite for the past 2 months, resulting in a 5-kg weight loss. Examination upon arrival revealed papilledema and bilateral abducens nerve palsy. Motor and sensory functions were intact. Magnetic resonance imaging (MRI) of the brain revealed multiple extra-axial nodular enhancing lesions with size of 5 –10 mm mainly along with both sides of falx cerebri and vasogenic brain oedema (Fig.1). Stereotactic br...
Source: Journal of Hematopathology - December 2, 2023 Category: Pathology Source Type: research
Anaplastic large cell lymphoma presenting as a mass in the uterine cervix: a case report
AbstractT-cell lymphoma is an extremely rare form of malignancy in the female genital tract. Most of the reported cases of lymphoma are B-cell lymphomas. A few cases of primary T-cell lymphomas involving the vagina or the vulva have been reported. We are reporting the first case of anaplastic large cell lymphoma (ALCL) presenting as a uterine cervical mass. The patient is a 24-year-old female who presented to the emergency room with a history of menorrhagia, night sweats and 40-pound weight loss. The diagnosis of ALCL was confirmed through immunohistochemical studies with strong CD30 and ALK expression. Fluorescent hybridi...
Source: Journal of Hematopathology - November 29, 2023 Category: Pathology Source Type: research
A rare case of fluid overload-associated large B-cell lymphoma and antigen loss at relapse
This report presents an unusual case of FO-LBCL with partial B cell antigen loss at relapse and reviews the characteristics, treatment, and prognosis of these patients to enhance our understanding of this disease. Immunophenotyping was performed through immunohistochemistry and flow cytometry. Immunoglobulin gene rearrangements were analyzed using BIOMED-2 multiplex primers.MYC,BCL2, andBCL6 gene rearrangements were detected by fluorescent in situ hybridization (FISH). Cell-free DNA (cfDNA) from pleural effusion and peripheral blood was subjected to somatic mutation evaluation using next-generation sequencing (NGS). In 202...
Source: Journal of Hematopathology - November 27, 2023 Category: Pathology Source Type: research
Two cases of mycosis fungoides with large cell transformation with KMT2A rearrangements
AbstractCutaneous T-cell lymphomas (CTCL) are a clinically and molecularly heterogeneous class of lymphomas of the skin-homing T cell, and their genetic profiles are not fully characterized. Previously, rearrangements of the Lysine Methyltransferase 2A (KMT2A) gene have been identified as driver mutations only in acute leukemias.KMT2A plays a role in epigenetic regulation, and cancers with such rearrangements are responsive to epigenetic therapy including hypomethylating agents. Here, we report two cases of CTCL with novel genetic profiles.KMT2A rearrangements were identified in two aggressive cases of mycosis fungoides wi...
Source: Journal of Hematopathology - November 23, 2023 Category: Pathology Source Type: research
Increased IgG4+ plasma cells are common in excised lymph nodes from children and adolescents without IgG4-related disease
This study was performed to further evaluate the frequency, pathologic features, and clinical significance of IgG4-LAD-like histologic changes in the pediatric setting. We analyzed 37 benign lymph nodes collected semi-consecutively from children aged 0 –18 years at our institution for both absolute and relative IgG4+ plasma cell abundance and recurrent histomorphologic patterns associated with IgG4-LAD. The combination of IgG4+/IgG+ plasma cell ratio>40% and IgG4+ plasma cell count ≥50 were considered as IgG4-LAD-like per expert consensus guidelines. Seven cases (19%) met both diagnostic criteria. The dominant histo...
Source: Journal of Hematopathology - November 9, 2023 Category: Pathology Source Type: research
Oral follicular lymphoma: a clinicopathologic and molecular study
AbstractFollicular lymphoma is a hematolymphoid neoplasm that originates from germinal center B cells. It is made up of a combination of small cleaved centrocytes and a varying quantity of larger non-cleaved centroblasts to describe the clinical, microscopic, immunohistochemical, and molecular features of oral follicular lymphomas. Follicular lymphomas affecting the oral cavity were retrieved from pathology files. Immunohistochemistry was performed to confirm the diagnosis, and fluorescence in situ hybridization (FISH) was employed to detect rearrangements inBCL2,BCL6, andMYC genes. Clinical and follow-up data were obtaine...
Source: Journal of Hematopathology - November 2, 2023 Category: Pathology Source Type: research
B-lymphoblastic leukemia with transient spontaneous remission in the setting of severe group A streptococcus infection
AbstractSpontaneous remission of B-lymphoblastic leukemia (B-ALL) in the setting of viral and bacterial infections has been reported. Here, we present a case of B-ALL that showed a complete remission in the setting of group A streptococcal bacteremia. The patient was an 11-year-old boy who presented with a sore throat, right ear pain, and rhinorrhea. Prior to the diagnosis of B-ALL, he was diagnosed with streptococcal pharyngitis and received a single dose of dexamethasone and azithromycin. One day later, he was found to be pancytopenic and an immunophenotypically abnormal B-lymphoblastic population was detected comprising...
Source: Journal of Hematopathology - October 14, 2023 Category: Pathology Source Type: research
Indolent B-cell lymphoma with t(14;19) investigated from a molecular perspective
We describe this interesting case in the context of its genomic findings and how it contributes to the literature as a whole. (Source: Journal of Hematopathology)
Source: Journal of Hematopathology - October 13, 2023 Category: Pathology Source Type: research
Lupus erythematosus cells in a bone marrow aspirate
AbstractA teenage girl presented with fevers of unknown origin and pancytopenia. Complete blood count showed anemia (hemoglobin, 9.0 g/dL), neutropenia (1.7 × 109/L), and thrombocytopenia (66 × 109/L). The bone marrow was hypocellular with left shifted hematopoiesis and myeloid hypoplasia. Aspirate smears were notable for a prominent population of neutrophils with crescentic nuclei that engulfed blue amorphous material (Fig. 1 panels A and B, Wright-Giemsa, magnification × 1000). The trephine biopsy showed similar cells with crescentic nuclei and eosinophilic material (Fig.1 panels C and D, hematoxylin...
Source: Journal of Hematopathology - October 2, 2023 Category: Pathology Source Type: research
Chronic myeloid leukaemia (CML) presenting in B-lymphoblastic crisis: a diagnostic challenge
We report the case of a 75-year-old female presented with lethargy, Hb 93 g/L, WBC 64 x 109/L, platelet 110 x 109/L. Blood film showed blasts, myelocytes, metamyelocytes, neutrophils. Quantitative PCR detected p210BCR::ABL1 transcript in sorted CD19+ cells, and sorted CD19- cells. Bone marrow smear was packed with blasts. Flow cytometry and bone marrow histology revealed B-lymphoblasts. The patient was diagnosed with CML Blymphoblastic crisis. CML presenting in B-lymphoblastic crisis could resemble features of de novo Ph+ B-ALL, which makes the diagnosis challenging. These patients have inferior outcomes; therefore, it is ...
Source: Journal of Hematopathology - September 11, 2023 Category: Pathology Source Type: research
The role of IgG4-positive plasma cell population in classic Hodgkin lymphoma
Abstract The effect of IgG4, which constitutes the least of the IgG subclasses, on the pathogenesis and prognosis of lymphoma or solid tumors is one of the research topics of interest in recent years. The role of IgG4, which has been reported to suppress antitumor immunity, in classic Hodgkin ’s lymphoma (cHL), which is recognized by its pathognomonic microenvironment, is not yet clearly known. The aim of this study was to determine IgG4-positive plasma cell density in the cHL microenvironment and to compare it with histopathological and clinical parameters. In addition, the role of t he increase in IgG4-positive cell...
Source: Journal of Hematopathology - August 30, 2023 Category: Pathology Source Type: research
A rare case of embryonal rhabdomyosarcoma with tumor cells in peripheral blood mimicking acute leukemia
(Source: Journal of Hematopathology)
Source: Journal of Hematopathology - August 23, 2023 Category: Pathology Source Type: research
Monomorphic epitheliotropic intestinal T-cell lymphoma involving the central nervous system: a rare case report with comprehensive autopsy neuropathological examinations
We present detailed descriptions of clinical and autopsy neuropathological findings of a rare case of an elderly woman who had surgery and chemotherapy for MEITL of the small intestine. Following her surgery, she progressively exhibited neurologic decline towards the end of her treatment. The patient eventually succumbed to her illness and was found to have MEITL with intracranial involvement on autopsy. Brain autopsy was performed and examination of tissues with hematoxylin –eosin staining under optical microscopy with 100 X magnification. Immunostaining for CD3, CD4, CD5, CD7, CD8, CD56, CD20, beta-amyloid, c-Myc, TCR-...
Source: Journal of Hematopathology - August 12, 2023 Category: Pathology Source Type: research
“Quadruple-hit” primary testicular diffuse large B-cell lymphoma with MYD88 L265P mutation, IGH::MYC, and IRF4- and BCL6-rearrangements
We report a case of primary testicular diffuse large B-cell lymphoma (PT-DLBCL) with a hitherto unreported constellation of pathologic findings to illustrate the challenges of DLBCL classification. A standard hematopathology workup was followed by gene expression profiling (GEP) to determine the DLBCL cell of origin (COO). A 75-year-old man presented with a unilateral testicular mass that had developed over the course of 1 month. Pathologic examination demonstrated involvement by DLBCL. Clinical staging revealed no systemic disease. Genetic testing showed an MYD88 mutation, as well asIGH::MYC andIRF4- andBCL6-rearrangeme...
Source: Journal of Hematopathology - August 4, 2023 Category: Pathology Source Type: research
Iron-laden blasts in refractory acute myeloid leukemia
We report a case of refractory acute myeloid leukemia withDEK-NUP214 rearrangement showing circulating monocytic blasts with abundant green cytoplasmic granules on the Wright-Giemsa stain. The granules were strongly positive for Perls ’ Prussian blue, consistent with hemosiderin deposits. This previously unreported finding is suggestive of siderophage activity by leukemic blasts, likely associated with monocytic differentiation. (Source: Journal of Hematopathology)
Source: Journal of Hematopathology - July 29, 2023 Category: Pathology Source Type: research
