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Molecular Pathology : MP Jun 1997To evaluate the morphofunctional characteristics of lymph node cells from patients with Hodgkin's disease by measuring silver stained nucleolar organiser regions... (Comparative Study)
Comparative Study
AIM
To evaluate the morphofunctional characteristics of lymph node cells from patients with Hodgkin's disease by measuring silver stained nucleolar organiser regions (AgNORs).
METHODS
Nucleoli in Hodgkin's and Reed-Sternberg (HRS) cells, lymphocytes and prolymphocytes were investigated in cytological smears and histological sections of lymph nodes from 32 patients with Hodgkin's disease, and from 34 patients with reactive lymphadenopathy. According to the Rye histological classification of Hodgkin's disease, three cases were the lymphocyte predominant (LP) type, 14 the nodular sclerosing (NS) type, and 15 the mixed cellularity (MC) type. The investigation was done before treatment, by means of a one step silver staining method. In each case, 50 to 100 HRS cells, lymphocytes, and prolymphocytes were evaluated to determine the mean numbers of nucleoli and AgNORs per nucleus. The nonparametric Wilcoxon Mann-Whitney test was used to compare the groups.
RESULTS
The mean numbers of nucleoli and AgNORs were higher in lymphocytes and prolymphocytes compared with those from reactive lymph nodes used as controls. Numbers of nucleoli and AgNORs were higher (not significant) in the NS type of Hodgkin's disease than in the MC type. There was a significant increase in numbers of nucleoli in HRS cells, and their AgNOR counts were increased. The greatest number of nucleoli in HRS cells was found in the NS type. Furthermore, the nucleolar activity of HRS cells was greater in the NS type compared with the MC type (50.2 (SEM 3.9) v 37.7 (2.9) AgNORs per nucleus (p = 0.025)). Comparative analysis of cytological and histological samples showed that the AgNOR score was significantly higher in touch imprints than in tissue sections with tumours of the same histological type.
CONCLUSIONS
Assessment of cell activity in Hodgkin's disease patients by silver staining is more convenient and informative in lymph node imprints than in histological sections. The highest expression of interphase ribosomal RNA cistrons found in NS HRS cells is probably explained by their high proliferative activity and elevated production of transforming growth factor 1 which is known to be the most potent cytokine present in the NS subtype of Hodgkin's disease.
Topics: Adolescent; Adult; Aged; Female; Histocytological Preparation Techniques; Hodgkin Disease; Humans; Lymph Nodes; Lymphocytes; Male; Middle Aged; Nucleolus Organizer Region; Reed-Sternberg Cells; Silver Staining; Statistics, Nonparametric; Stem Cells
PubMed: 9292150
DOI: 10.1136/mp.50.3.149 -
[Rinsho Ketsueki] the Japanese Journal... Jun 1989A 78-year-old woman, who had axillary lymphadenopathy but no hepatosplenomegaly, was admitted because of lymphocytosis. The leukocyte count was 18.1 x 10(9)/l with 72%... (Review)
Review
A 78-year-old woman, who had axillary lymphadenopathy but no hepatosplenomegaly, was admitted because of lymphocytosis. The leukocyte count was 18.1 x 10(9)/l with 72% abnormal cells. Neither anemia nor thrombocytopenia was present. Many abnormal cells and erythroblasts were seen in the bone marrow. These abnormal cells had irregular nuclei but no granules in the cytoplasm. The surface markers of these cells were positive for E-rosette, CD 2, CD 3, and Leu 7 but negative for CD 4, CD 8, CD 11 (OKM 1), CD 16 (Leu 11), and HLA-DR. The DNA analysis revealed the rearrangement of T-cell receptor beta-chain genes. Direct Coombs test was positive and red-cell life-span (51Cr) was T 1/2 = 19.5 days. The patient was diagnosed as having T-CLL with mild autoimmune hemolysis and was followed without treatment. Seven months later, the leukemia cells of peripheral blood increased to 62.6 X 10(9)/l and the frank autoimmune hemolytic anemia developed. After prednisolone, vincristine and cyclophosphamide were administered, leukemia cells of blood decreased. Anemia with reticulocytopenia, however, persisted and direct Coombs test became negative. In the bone marrow at that time, many neutrophils and megakaryocytes besides leukemia cells were preserved, but erythroblasts were hardly seen, namely a pattern of red cell hypoplasia was observed. The patient deteriorated rapidly and died 26 months after initial recognition of lymphocytosis. When complement was added, the patient's serum obtained during red cell hypoplasia but not during autoimmune hemolysis inhibited BFU-E and CFU-GM in in vitro colony assays. This case indicates that not only B-CLL but also T-CLL is accompanied by immune hematocytopenia.
Topics: Aged; Anemia, Hemolytic, Autoimmune; Female; Humans; Leukemia, Prolymphocytic, T-Cell; Red-Cell Aplasia, Pure
PubMed: 2507801
DOI: No ID Found -
Leukemia & Lymphoma 2016Previous experiments demonstrated that survival and proliferation of chronic lymphocytic leukemia (CLL) cells depends upon complex cross-talk between CLL cells and...
Previous experiments demonstrated that survival and proliferation of chronic lymphocytic leukemia (CLL) cells depends upon complex cross-talk between CLL cells and accessory cells in the tissue microenvironment. To further dissect these interactions in situ, we analyzed lymph nodes from 43 different patients infiltrated by CLL cells for expression of the chemokine CCL3, Ki-67, macrophages, and T cell subsets by immunohistochemistry. CCL3 expression was detected in 24 of 43 cases (56%), particularly in prolymphocytes and paraimmunoblasts within the proliferation centers. Significantly higher numbers of CD3+ T cells and CD57+ cells were noticed in CCL3 positive cases. Furthermore, denser infiltration of CLL lymph node tissues by CD57+ cells correlated with higher proliferation rates of the CLL cells. In conclusion, we demonstrate an association of CCL3 expression by CLL cells with increased numbers of CD3+ T cells and CD57+ cells in the lymph node microenvironment, which may promote CLL cell survival and proliferation.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Chemokine CCL3; Disease Progression; Female; Gene Expression; Humans; Immunohistochemistry; Immunophenotyping; Leukemia, Lymphocytic, Chronic, B-Cell; Lymph Nodes; Lymphocyte Count; Macrophages; Male; Middle Aged; T-Lymphocyte Subsets; Tumor Microenvironment
PubMed: 26458057
DOI: 10.3109/10428194.2015.1068308 -
Blood Dec 1991We describe the clinical and laboratory findings of 78 adult patients with T-prolymphocytic leukemia (T-PLL) studied over the last 12 years. The main disease features...
We describe the clinical and laboratory findings of 78 adult patients with T-prolymphocytic leukemia (T-PLL) studied over the last 12 years. The main disease features were splenomegaly (73%), lymphadenopathy (53%), hepatomegaly (40%), skin lesions (27%), and a high leukocyte count (greater than 100 x 10(9)/L in 75%) with nucleolated prolymphocytes. A variant form with small, less typical cells was recognized in 19%. Membrane markers defined a postthymic phenotype TdT-, CD2+, CD3+, CD5+, CD7+; in 65%, the cells were CD4+ CD8-, in 21%, they coexpressed CD4 and CD8, and, in 13%, they were CD4- CD8+. Serology for human T-cell leukemia/lymphoma virus Type-I (HTLV-I) was negative in the 27 cases investigated. Cytogenetic analysis in 30 cases showed a consistent abnormality of chromosome 14, usually inv (14), with breakpoints at q11 and q32 in 76% of cases. Trisomy 8, including iso8q, was shown in 53%; t (11;14)(q13;q32) was documented in one case; and one had a normal karyotype. The clinical course was progressive with a median survival of 7.5 months. Thirty-one patients were treated with 2' deoxycoformycin and 15 responded (3 complete remissions and 12 partial remissions); the response rate (48%) increased to 58% in patients with a CD4+ CD8- phenotype. The median survival of responders was 16 months and of nonresponders 10 months; other treatments were less effective. T-PLL is a distinct clinico-pathologic entity with aggressive course and characteristic chromosome abnormalities. A subgroup of patients may benefit from deoxycoformycin.
Topics: Adult; Aged; Aged, 80 and over; Antigens, CD; Chromosome Aberrations; Chromosomes, Human, Pair 14; Female; Humans; Immunophenotyping; Karyotyping; Leukemia, Prolymphocytic; Male; Middle Aged; Pentostatin; Prognosis; Remission Induction; T-Lymphocytes
PubMed: 1742486
DOI: No ID Found -
Leukemia Feb 1993Forty Japanese patients with hairy cell leukemia (HCL) were reviewed. Nine cases were diagnosed as typical HCL, and two cases had the features of HCL variant...
Forty Japanese patients with hairy cell leukemia (HCL) were reviewed. Nine cases were diagnosed as typical HCL, and two cases had the features of HCL variant (prolymphocytic variant). The remaining 29 cases (72.5%) differed morphologically and hematologically from the other two groups in that they usually had a moderately high leukocyte count (average 27.9 x 10(3)/microliters), and abnormal cells showing a densely stained round nucleus and an inconspicuous nucleolus. Tartrate-resistant acid phosphatase reaction was weak, and their cells exhibited generally smooth or slightly irregular, cellular outlines in smears. The cells showed weak expression of surface immunoglobulin G (IgG) with kappa-chain predominance. CD25 antigen was not detected. Some of these findings resemble those of B-cell chronic lymphocytic leukemia, but the patients also had several important features of HCL. They had splenomegaly without significant lymphadenopathy. The abnormal cells were CD20+, CD11c+ and showed typical 'hairy morphology' under phase-contrast and scanning electron microscopy. Furthermore, spleen sections revealed diffuse infiltration by the abnormal cells in the red pulp. From these findings, we speculated that this group of patients constitute a distinct subtype of HCL which is commonly seen in Japan. We propose to term the disease as HCL Japanese variant.
Topics: Acid Phosphatase; Adult; Aged; Aged, 80 and over; Antigens, Surface; Drug Resistance; Female; Humans; Japan; Leukemia, Hairy Cell; Male; Microscopy, Electron, Scanning; Middle Aged; Tartrates
PubMed: 8426471
DOI: No ID Found -
Journal of Clinical and Experimental... 2014An 80-year-old man was referred to our department because of lymphocytosis. His white cell count was 17.1 × 10(3)/μL, with 64% prolymphocytes. He did not exhibit...
An 80-year-old man was referred to our department because of lymphocytosis. His white cell count was 17.1 × 10(3)/μL, with 64% prolymphocytes. He did not exhibit splenomegaly or lymphadenopathy. Prolymphocytes were CD5(+), CD10(-), CD19(+), CD20(+), CD21(+weak), CD22(+), CD23(-), and HLA-DR(+), and expressed μδ/λ cell-surface immunoglobulins. G-banding and fluorescence in situ hybridization using c-MYC and immunoglobulin heavy-chain (IgH) gene probe revealed that leukemia cells carried the t(8;14)(q24;q32)/c-MYC-IgH fusion gene, and breakage and reunion occurred within the non-coding region of c-MYC exon 1 as well as the α switch region of IgH. Nine months after the initial presentation, the patient's hemoglobin level fell to 5.7 g/dL. Coombs' test was positive and marked hypoplasia of erythroid precursors was detected in his bone marrow. The patient was treated with prednisolone followed by 4 weekly doses of rituximab, which led to resolution of the anemia and complete response of the underlying leukemia. The role of t(8;14)(q24;q32)/c-MYC-IgH in the pathogenesis of B-cell prolymphocytic leukemia (B-PLL) may not be identical to that in aggressive lymphoid neoplasms, and, in the present case, autoantibodies targeting both mature red cells and erythroid precursors may have been concurrently produced in the setting of B-PLL.
Topics: Aged, 80 and over; Anemia, Hemolytic, Autoimmune; Chromosomes, Human, Pair 14; Chromosomes, Human, Pair 8; Humans; Leukemia, Prolymphocytic, B-Cell; Male; Red-Cell Aplasia, Pure; Translocation, Genetic
PubMed: 25501113
DOI: 10.3960/jslrt.54.219 -
Thyroid : Official Journal of the... Aug 2014T-cell prolymphocytic leukemia (T-PLL) is rare, accounting for only 0.06% of all malignant lymphomas, and is classified as a T-cell mature lymphoma. The disease affects...
BACKGROUND
T-cell prolymphocytic leukemia (T-PLL) is rare, accounting for only 0.06% of all malignant lymphomas, and is classified as a T-cell mature lymphoma. The disease affects mainly elderly patients and is characterized by splenomegaly, lymphadenopathy, skin infiltration, and a high leukocyte count, but thyroid filtration has never been detected as far as we could determine. We report here a case of infiltration of the thyroid gland by T-PLL.
PATIENT FINDINGS
An 89-year-old woman who had been treated for Hashimoto's thyroiditis for 20 years presented with a progressively enlarging thyroid mass accompanied by dyspnea and dysphasia. Atypical lymphocytes with irregular nuclei were observed in the peripheral blood. An open biopsy of the thyroid provided pathological evidence of T-PLL, and bone marrow examination showed infiltration by T-PLL. The diagnosis was therefore infiltration of the thyroid gland by T-PLL. Chemotherapy was initiated, but six months after termination, recurrence of neck swelling was observed. The patient was then treated with radiotherapy, but she died of a major stroke 15 months after onset.
SUMMARY AND CONCLUSION
This is the first report of T-PLL infiltration of the thyroid gland, reminding physicians to keep in mind a broad differential diagnosis when encountering a patient with diffuse thyroid lesions and abnormal lymphocytes in the peripheral blood.
Topics: Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Cladribine; Combined Modality Therapy; Cyclophosphamide; Doxorubicin; Fatal Outcome; Female; Hashimoto Disease; Humans; Leukemia, Prolymphocytic, T-Cell; Leukocyte Count; Lymphatic Diseases; Mitoxantrone; Neck; Prednisone; Skin; Splenomegaly; Thyroid Gland; Thyroid Neoplasms; Tomography, X-Ray Computed; Vincristine
PubMed: 24762052
DOI: 10.1089/thy.2013.0462 -
Zhonghua Xue Ye Xue Za Zhi = Zhonghua... Oct 2013To investigate the clinical and laboratory characteristics and survival of Chinese patients with T- cell prolymphocytic leukemia (T-PLL).
OBJECTIVE
To investigate the clinical and laboratory characteristics and survival of Chinese patients with T- cell prolymphocytic leukemia (T-PLL).
METHODS
Eleven patients with T-PLL admitted in our hospital from Jan 2006 to Oct 2012 were retrospectively analyzed.
RESULTS
Of the 11 patients, nine were males and two females, with the median age of 56.0(19-69) years old. All the patients, except for three, presented with leukocytosis. The incidence of hyperleukocytosis (1/11) was less frequent than that in the British series (75%) (P=0.000). Lymphocyte counts in peripheral blood were increased in 9 of the 11 patients with the median absolute lymphocyte count (ALC) of 17.22(0.58-148.83)×10⁹/L. Superficial lymphadenopathy and splenomegaly were the most common physical signs. It was common that serum lactate dehydrogenase (LDH) and beta 2 microglobulin(β2-MG)were higher than normal level. All cases were positive for CD2/CD3/CD5/TCRαβ, negative for CD1a /HLA-DR and TdT, and most of them were strong positive for CD7 expression. By chromosome analyses, most cases. (9/10) have normal chromosome. This rate is significantly higher than that of the British and American series (3% and 25%, respectively) (P=0.000, P=0.001). The 14q11 abnormality and trisomy 8q, which are common among Western cases, were not observed in any of our cases. With a median follow-up of 23.0 months, three patients died. Two year progress free survival (PFS) and overall survival (OS) were 53.3% and 50%, respectively. There were 3 patients with PFS over a number of years, whether it should be considered as the T-chronic lymphocytic leukemia (T-CLL) is worthy of further studies.
CONCLUSION
The common clinical manifestations of T-PLL patients were increased lymphocyte counts and lymphadenopathy as well as splenomegaly. And most cases have high level of blood LDH and β2- MG and normal chromosome karyotype.
Topics: Adult; Aged; Bone Marrow Examination; China; Female; Humans; Leukemia, Prolymphocytic, T-Cell; Male; Middle Aged; Retrospective Studies; Young Adult
PubMed: 24171956
DOI: 10.3760/cma.j.issn.0253-2727.2013.10.004 -
British Journal of Haematology Jan 1979We report clinical, morphological and surface marker studies on seven patients with the common type of chronic lymphocytic leukaemia (CLL) whose disease underwent an...
We report clinical, morphological and surface marker studies on seven patients with the common type of chronic lymphocytic leukaemia (CLL) whose disease underwent an insidious though progressive change in character with increasing refractoriness to treatment. This transformation was accompanied by the appearance of a population of immature-appearing cells in the peripheral blood which resembled prolymphocytes, both at light and electron microscopy. The characteristic morphological feature was the presence of two distinct populations of cells, the typical CLL lymphocytes and the 'prolymphocytoid' cells. These cells retained the surface characteristics of CLL, i.e. the information of mouse RBC rosettes and sparse surface-bound immunoglobulin. This transformation can be distinguished by morphological and surface marker criteria from acute leukaemia occurring in CCL, Richter's syndrome and prolymphocytic leukaemia. The recognition of this group of CLL patients may add a new prognostic index to CLL and may help plan subsequent trials for the treatment of the disease.
Topics: Aged; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Leukocyte Count; Lymphocytes; Microscopy, Electron; Middle Aged; Prognosis; Receptors, Antigen, B-Cell; Rosette Formation
PubMed: 420739
DOI: 10.1111/j.1365-2141.1979.tb03676.x -
Autopsy & Case Reports 2021B-cell prolymphocytic leukemia (B-PLL) is an extremely rare disease, accounting for approximately 1% of the lymphocytic leukemias. B-PLL generally occurs in older...
De novo chronic lymphocytic leukemia/prolymphocytic leukemia or B-cell prolymphocytic leukemia? The importance of integrating clinico-morphological and immunophenotypic findings in distinguishing chronic lymphoproliferative diseases with circulating phase.
B-cell prolymphocytic leukemia (B-PLL) is an extremely rare disease, accounting for approximately 1% of the lymphocytic leukemias. B-PLL generally occurs in older people. It is characterized by the presence of more than 55% prolymphocytes in the peripheral blood (PB), no or minimal lymphadenopathy, massive splenomegaly, and very high white blood cell counts. The prognosis of B-PLL patients is generally poor, with a median survival of 3 years, although a subset of patients may show a prolonged survival. Herein, we report a case of a 70-year-old male with weakness, generalized lymphadenopathy, and moderate splenomegaly at the initial presentation. Hematologic examination revealed lymphocytic leukocytosis, favoring a chronic lymphoproliferative disorder (CLPD). The key to decoding the precise CLPD was a combination of the clinical profile, morphologic findings on the peripheral blood and the bone marrow, immunophenotypic analysis, and cytogenetic study. The best diagnosis proffered was a de novo chronic lymphocytic leukemia/prolymphocytic leukemia. There was no prior history of lymphoproliferative disorder or lymphocytic leukocytosis. Discriminating this entity from other lymphoproliferative disorders is crucial as the treatment and prognosis are varied compared to the other lymphoproliferative disorders. The diagnostic conundrum encountered and the incredible utility of ancillary studies in such a scenario are highlighted in this study.
PubMed: 34277479
DOI: 10.4322/acr.2020.196