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World Journal of Clinical Cases Nov 2020Reactive lymphoid hyperplasia (RLH) of the liver is a rare liver lesion. It is considered difficult to differentiate radiologically from hepatocellular carcinoma,...
BACKGROUND
Reactive lymphoid hyperplasia (RLH) of the liver is a rare liver lesion. It is considered difficult to differentiate radiologically from hepatocellular carcinoma, metastatic liver tumor and other pathologies.
CASE SUMMARY
A 54-year-old woman presented to our hospital with RLH of the liver. The patient had a diagnosis of metastatic carcinoma of the liver from an unknown origin and subsequently underwent partial hepatectomy. However, histopathological analysis revealed RLH. The lesion showed perinodular enhancement in the arterial phase on contrast-enhanced computed tomography and magnetic resonance imaging. On diffusion-weighted imaging (DWI), we encountered linear hyperintensity along the portal tract consecutive to the liver lesion, which is a new characteristic radiologic finding. This finding corresponded to the lymphoid cell infiltration of the portal tract. Furthermore, there was strongly restricted diffusion on the apparent diffusion coefficient map. We used these characteristic radiologic findings to diagnose the lesion as a lymphoproliferative disease.
CONCLUSION
The linear hyperintensity consecutive to the liver lesion on DWI provided additional valuable diagnostic information.
PubMed: 33269264
DOI: 10.12998/wjcc.v8.i21.5313 -
Revista Espanola de Enfermedades... Jul 2021Hepatic reactive lymphoid hyperplasia (HRLH) is an uncommon lesion. We present the case of a 58-year-old patient with a liver nodule incidentally found by abdominal...
Hepatic reactive lymphoid hyperplasia (HRLH) is an uncommon lesion. We present the case of a 58-year-old patient with a liver nodule incidentally found by abdominal ultrasonography (US). Liver function, tumor markers, viral serology and immunology were normal. Magnetic resonance imaging (MRI) showed a 16 mm nodule in segment VI-VII, with hypervascular enhancement in the arterial phase, wash-out in late phases, without contrast-retention in the hepatobiliary phase and restriction on diffusion-weighted imaging, suggestive of hepatocellular carcinoma (HCC).
Topics: Carcinoma, Hepatocellular; Contrast Media; Diagnosis, Differential; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Middle Aged; Pseudolymphoma
PubMed: 33256424
DOI: 10.17235/reed.2020.7462/2020 -
Blood Nov 2020
Topics: Aged; B-Lymphocytes; Cardiomyopathies; Chagas Disease; Heart Transplantation; Humans; Lymph Nodes; Lymphadenopathy; Macrophages; Male; Mexico; Postoperative Complications; Pseudolymphoma; Trypanosoma cruzi
PubMed: 33211840
DOI: 10.1182/blood.2020008815 -
Dermatology (Basel, Switzerland) 2021
Topics: Adult; Aged; Dermoscopy; Female; Humans; Lymphoma; Male; Middle Aged; Pseudolymphoma; Skin Neoplasms
PubMed: 32854093
DOI: 10.1159/000508900 -
Scientific Reports Jul 2020Aluminium hydroxide is a well-known adjuvant used in vaccines. Although it can enhance an adaptive immune response to a co-administered antigen, it causes adverse...
Aluminium hydroxide is a well-known adjuvant used in vaccines. Although it can enhance an adaptive immune response to a co-administered antigen, it causes adverse effects, including macrophagic myofasciitis (MMF), subcutaneous pseudolymphoma, and drug hypersensitivity. The object of this study is to demonstrate pediatric cases of aluminium hydroxide-induced diseases focusing on its rarity, under-recognition, and distinctive pathology. Seven child patients with biopsy-proven MMF were retrieved from the Seoul National University Hospital (SNUH) pathology archives from 2015 to 2019. The medical records and immunisation history were reviewed, and a full pathological muscle examination was carried out. The mean age was 1.7 years (8.9-40 months), who had records of vaccination against hepatitis B, hepatitis A, and tetanus toxoid on the quadriceps muscle. The chief complaints were muscle weakness (n = 6), delayed motor milestones (n = 6), instability, dysarthria, and involuntary movement (n = 1), swallowing difficulty (n = 1), high myopia (n = 1), and palpable subcutaneous nodules with skin papules (n = 1). Muscle biopsy showed MMF (n = 6) and pseudolymphoma (n = 1) with pathognomic basophilic large macrophage infiltration, which had distinctive spiculated inclusions on electron microscopy. The intracytoplasmic aluminium was positive for PAS and Morin stains. Distinctive pathology and ultrastructure suggested an association with aluminium hydroxide-containing vaccines. To avoid misdiagnosis and mistreatment, we must further investigate this uncommon condition, and pharmaceutical companies should attempt to formulate better adjuvants that do not cause such adverse effects.
Topics: Adjuvants, Immunologic; Aluminum Hydroxide; Child, Preschool; Drug Hypersensitivity; Fasciitis; Female; Hepatitis A; Hepatitis B; Humans; Infant; Macrophages; Male; Muscle Weakness; Myositis; Pseudolymphoma; Subcutaneous Tissue; Tetanus; Vaccination; Viral Vaccines
PubMed: 32678281
DOI: 10.1038/s41598-020-68849-8 -
Diagnostic Pathology Jul 2020Primary intestinal follicular lymphoma (PI-FL) is a rare and indolent lymphoma and is challenging for diagnosis with endoscopic biopsy specimens. Whole slide imaging...
BACKGROUND
Primary intestinal follicular lymphoma (PI-FL) is a rare and indolent lymphoma and is challenging for diagnosis with endoscopic biopsy specimens. Whole slide imaging (WSI) has been increasingly used for assisting pathologic diagnosis, but not for lymphoma yet, probably because there are usually too many immunostained sections in a single case. In this study we attempted to identify morphological clues of PI-FL in the endoscopic biopsy specimens by measuring various parameters using WSI.
METHODS
We retrospectively investigated 21 PI-FL cases, and scanned the HE sections from 17 of these cases with endoscopic biopsy specimens. Sections from 17 intestinal biopsies showing reactive lymphoid hyperplasia were scanned for comparison. The density and diameter of lymphoid follicles and the shortest distance of these follicles to the surface epithelia were measured on WSI. Comparisons of the aforementioned parameters were made between the neoplastic and reactive follicles.
RESULTS
The density of follicles was significantly higher in PI-FL than that of reactive hyperplasia (median 0.5 vs. 0.2/mm; p < 0.01). Furthermore, the neoplastic follicles were significantly larger (median diameter 756.9 vs. 479.7 μm; p < 0.01). The shortest distance of follicles to the surface epithelia tended to be closer in PI-FL (104.7 vs. 177.8 μm, p = 0.056), but not statistically significant.
CONCLUSIONS
In this study we found that in PI-FL the density and diameter of lymphoid follicles as measured from WSI were significantly different from that of intestinal reactive lymphoid hyperplasia. When facing the diagnostic challenge between these two entities in routine practice, pathologists might be alerted by these morphological clues and request for immunohistochemistry for differential diagnosis.
Topics: Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Hyperplasia; Image Interpretation, Computer-Assisted; Intestinal Diseases; Intestinal Neoplasms; Lymphoma, Follicular; Male; Middle Aged; Pseudolymphoma; Retrospective Studies
PubMed: 32635930
DOI: 10.1186/s13000-020-00991-3 -
Dermatology Online Journal May 2020Pseudolymphomatous folliculitis is a benign entity that is included within pseudolymphomas. Because of its rapid clinical growth and suspicious histology it has to be...
Pseudolymphomatous folliculitis is a benign entity that is included within pseudolymphomas. Because of its rapid clinical growth and suspicious histology it has to be differentiated from malignant entities. Given its low frequency, the dermatoscopic characteristics of this entity are not well-characterized and have been described only once previously. We present a middle-aged woman with a facial erythematous plaque of 6 months' evolution, with dermatoscopy in which follicular plugs on an erythematous base were appreciated. The histology showed a dense lymphocytic infiltrate with folliculotropism and follicular alteration, with numerous peripheral histiocytes positive for S100 and CD1a. The lesion partially disappeared after the biopsy, and completely after topical treatment.
Topics: Adult; Dermoscopy; Diagnosis, Differential; Female; Folliculitis; Humans; Middle Aged; Pseudolymphoma; Skin; Skin Diseases
PubMed: 32621704
DOI: No ID Found -
Journal of Hematology & Oncology Jun 2020Hippo-Yes-associated protein (YAP) signaling is a key regulator of organ size and tumorigenesis, yet the underlying molecular mechanism is still poorly understood. At...
BACKGROUND
Hippo-Yes-associated protein (YAP) signaling is a key regulator of organ size and tumorigenesis, yet the underlying molecular mechanism is still poorly understood. At present, the significance of the Hippo-YAP pathway in diffuse large B-cell lymphoma (DLBCL) is ill-defined.
METHODS
The expression of YAP in DLBCL was determined in public database and clinical specimens. The effects of YAP knockdown, CRISPR/Cas9-mediated YAP deletion, and YAP inhibitor treatment on cell proliferation and the cell cycle were evaluated both in vitro and in vivo. RNA sequencing was conducted to detect dysregulated RNAs in YAP-knockout DLBCL cells. The regulatory effects of insulin-like growth factor-1 receptor (IGF-1R) on Hippo-YAP signaling were explored by targeted inhibition and rescue experiments.
RESULTS
High expression of YAP was significantly correlated with disease progression and poor prognosis. Knockdown of YAP expression suppressed cell proliferation and induced cell cycle arrest in DLBCL cells. Verteporfin (VP), a benzoporphyrin derivative, exerted an anti-tumor effect by regulating the expression of YAP and the downstream target genes, CTGF and CYR61. In vitro and in vivo studies revealed that deletion of YAP expression with a CRISPR/Cas9 genome editing system significantly restrained tumor growth. Moreover, downregulation of IGF-1R expression led to a remarkable decrease in YAP expression. In contrast, exposure to IGF-1 promoted YAP expression and reversed the inhibition of YAP expression induced by IGF-1R inhibitors.
CONCLUSIONS
Our study highlights the critical role of YAP in the pathogenesis of DLBCL and uncovers the regulatory effect of IGF-1R on Hippo-YAP signaling, suggesting a novel therapeutic strategy for DLBCL.
Topics: Adaptor Proteins, Signal Transducing; Aged; Animals; Apoptosis; B-Lymphocytes; CRISPR-Cas Systems; Cell Cycle Checkpoints; Cell Line, Tumor; Cell Transformation, Neoplastic; Female; Gene Expression Regulation, Neoplastic; Hippo Signaling Pathway; Humans; Insulin-Like Growth Factor I; Lymphoma, Large B-Cell, Diffuse; Male; Mice; Mice, SCID; Middle Aged; Neoplasm Proteins; Podophyllotoxin; Protein Serine-Threonine Kinases; Pseudolymphoma; RNA Interference; RNA, Small Interfering; Random Allocation; Receptor, IGF Type 1; Signal Transduction; Transcription Factors; Tyrphostins; Verteporfin; Xenograft Model Antitumor Assays; YAP-Signaling Proteins
PubMed: 32546241
DOI: 10.1186/s13045-020-00906-1 -
JAAD Case Reports Jun 2020
PubMed: 32490108
DOI: 10.1016/j.jdcr.2020.03.020 -
Laboratory Investigation; a Journal of... Oct 2020A pathological evaluation is one of the most important methods for the diagnosis of malignant lymphoma. A standardized diagnosis is occasionally difficult to achieve...
A pathological evaluation is one of the most important methods for the diagnosis of malignant lymphoma. A standardized diagnosis is occasionally difficult to achieve even by experienced hematopathologists. Therefore, established procedures including a computer-aided diagnosis are desired. This study aims to classify histopathological images of malignant lymphomas through deep learning, which is a computer algorithm and type of artificial intelligence (AI) technology. We prepared hematoxylin and eosin (H&E) slides of a lesion area from 388 sections, namely, 259 with diffuse large B-cell lymphoma, 89 with follicular lymphoma, and 40 with reactive lymphoid hyperplasia, and created whole slide images (WSIs) using a whole slide system. WSI was annotated in the lesion area by experienced hematopathologists. Image patches were cropped from the WSI to train and evaluate the classifiers. Image patches at magnifications of ×5, ×20, and ×40 were randomly divided into a test set and a training and evaluation set. The classifier was assessed using the test set through a cross-validation after training. The classifier achieved the highest levels of accuracy of 94.0%, 93.0%, and 92.0% for image patches with magnifications of ×5, ×20, and ×40, respectively, in comparison to diffuse large B-cell lymphoma, follicular lymphoma, and reactive lymphoid hyperplasia. Comparing the diagnostic accuracies between the proposed classifier and seven pathologists, including experienced hematopathologists, using the test set made up of image patches with magnifications of ×5, ×20, and ×40, the best accuracy demonstrated by the classifier was 97.0%, whereas the average accuracy achieved by the pathologists using WSIs was 76.0%, with the highest accuracy reaching 83.3%. In conclusion, the neural classifier can outperform pathologists in a morphological evaluation. These results suggest that the AI system can potentially support the diagnosis of malignant lymphoma.
Topics: Algorithms; Deep Learning; Diagnosis, Computer-Assisted; Histological Techniques; Humans; Image Interpretation, Computer-Assisted; Lymphoma; Lymphoma, Follicular; Lymphoma, Large B-Cell, Diffuse; Neural Networks, Computer; Observer Variation; Pathologists; Pseudolymphoma
PubMed: 32472096
DOI: 10.1038/s41374-020-0442-3