A. De Renzo

Fine needle aspiration cytology and flow cytometry immunophenotyping of non-Hodgkin lymphoma: can we do better?

P. Zeppa, E. Vigliar, I. Cozzolino, G. Troncone, M. Picardi, A. De Renzo, F. Grimaldi, F. Pane, A. Vetrani and L. Palombini
Fine needle aspiration cytology and flow cytometry immunophenotyping of non‐Hodgkin lymphoma: can we do better?

Intravascular B-cell Lymphoma: Report of Two Cases with Different Clinical Presentation but Rapid Central Nervous System Involvement

Intravascular lymphomatosis (IVL) is a rare large-cell lymphoproliferative disorder characterized by a widespread lymphoma proliferation within the lumen of medium and small vessels, frequently presenting with skin and/or central nervous system (CNS) manifestations. The tumor is of B-cell origin in most cases. Prognosis is poor with a reported median survival of 5-7 months. We describe here two cases of IVL. The first was that of a 55-year-old woman with a large B-cell lymphoma of the leg, successfully treated with conventional chemotherapy (CHT) followed by autologous peripheral stem cell transplantation. At 3 months from the autograft she relapsed with a picture of hemophagocytic syndrome (HPS) and CNS symptoms. She died before any specific treatment, and post-mortem examination revealed the intravascular proliferation of lymphoma B-cells in the brain and bone marrow. The second case was that of a 60-year-old male with CNS involvement at diagnosis. He responded poorly to CHOP-like CHT, and died 2 months after diagnosis and 6 months after onset of symptoms. Failure of CHT at least in some IVL patients may be related to a delay in the initiation of therapy due to non-specific neurological symptoms. Therefore, early diagnosis based upon aggressive attempts immediately followed by adequate therapy may prove beneficial to these patients. In the present report, we performed an extended medline-based review of the published series of patients with IVL.

A Phase II Trial on Alpha-Interferon α IFN) Effect in Patients with Monoclonal IgM Gammopathy

Waldenstroms macroglobulinemia (WM) is an incurable disorder of B cells. Following occasional reports of response to α interferon (IFN) and in view of its effectiveness in hairy cell leukemia, we tested this agent in a relatively large group (n = 88) of patients who had an IgM monoclonal component (MC) greater than 10 g/1. Thirty eight patients had a MC >30 g/1 and were classified as Waldenstroms macroglobulinemia (WM), while fifty had either WM in an early stage or an IgM monoclonal gammopathy of undeterminated significance (all of them operationally classified as IgM-MGUS). All patients received IFN 3 MU/day for one month and then 3 times/week. Response to treatment was mainly based on MC reduction in two consecutive determinations (>50%: major response; 25-50%: minor response). Of 36 evaluable WM patients, 12 had a major and 6 a minor response; of 41 evaluable IgM-MGUS patients, 2 had a major and 6 a minor response. In WM patients with a major response, MC reduction was associated with disappearance ...

Occult hepatitis B virus infection in patients with non‐Hodgkin lymphoma: the need for early diagnosis in anti‐Hbc positive patients

Occult hepatitis B virus (HBV) infection can be defined as the long lasting persistence of viral genome in the liver tissue of patients without HBV surface antigen (HBsAG), with or without antibodies to hepatitis B core antigen (anti-HBc) or hepatitis B surface antigen (anti-HBs).1 The clinical relevance of occult B infection is well documented.2–6 Immunosuppressive therapy can promote viral replication and disease progression. Discontinuation of immunosuppressive drugs may lead to the reconstitution of the immune response to the virus and hence to immune mediated destruction of infected hepatocytes. This is a well recognised occurrence in patients with hepatitis B infection or non-Hodgkin lymphoma (NHL).7,8 We studied the prevalence of occult HBV infection in 58 consecutive NHL patients, six of whom were HBsAG positive and 52 were …

Cytoplasmic GpIIb-IIIa and Cytokine Secretion by Blasts in a Case of Megakaryoblastic Transformation of Essential Thrombocythemia

A 49-year-old woman with a four year history of therapy resistant essential thrombocythemia, progressed to acute leukemia that also proved refractory to chemotherapy. Blast cell features including immunophenotype, cytogenetics and in vitro cell cultures, suggested megakaryoblastic leukemia. In serum-free culture, blasts released GM-CSF and IL-6 which sustained autocrine growth and promoted normal myeloid and megakaryocytic colony formation.

Diagnosis of anaplastic large cell lymphoma on late peri-implant breast seroma: Management of cytological sample by an integrated approach

Peri‐implant breast seroma is a late clinical presentation of reconstructive surgery or augmentation mammoplasty with breast implants. Pre‐operative cytological evaluation of the peri‐implant breast seroma is a common clinical approach, showing mainly an inflammatory reaction or more rarely a breast implant‐associated anaplastic large cell lymphoma. Herein, we reported the role of cytology in the evaluation of peri‐implant breast seroma and its critical pre‐operative implications.