Edneia Tani

Flow Cytometric Immunophenotyping Including Bcl-2 Detection on Fine Needle Aspirates in the Diagnosis of Reactive Lymphadenopathy and Non-Hodgkin's Lymphoma

Fine‐needle aspiration (FNA) with immunophenotyping by immunocytochemistry (IC) on cytospins has recently received increased consideration in the diagnosis of lymphoma. The aim of our study was to establish the diagnostic value of a four‐color flow cytometric (FCM) panel, including cytoplasmic Bcl‐2, in cytologic diagnosis of malignant non‐Hodgkins lymphoma (NHL) and reactive lymphoid hyperplasia (RH).

The Clinical Value of Image Cytometry DNA Analysis in Distinguishing Branchial Cleft Cysts From Cystic Metastases of Head and Neck Cancer

Objectives/Hypothesis A branchial cleft cyst presents as a lump in the neck that, generally, is easily cured by surgical excision. The preoperative diagnosis is based on clinical examination and, especially in the Scandinavian countries, fine‐needle aspiration cytology. However, at times, the histopathological analysis of the excised cyst reveals a cystic metastasis of squamous cell carcinoma of the head and neck. If adequate diagnosis could be obtained preoperatively, patients would most likely fare better. The study was performed to investigate whether the diagnostic accuracy for these lesions could be improved preoperatively by image cytometry DNA analysis of the fine‐needle aspiration cytology specimen.

Image Cytometry DNA-Analysis of Fine Needle Aspiration Cytology to Aid Cytomorphology in the Distinction of Branchial Cleft Cyst from Cystic Metastasis of Squamous Cell Carcinoma: A Prospective Study†

Objective: Frequently, the distinction between branchial cleft cyst and cystic metastases from squamous cell carcinoma is difficult by cytomorphology. In a prospective study, we investigated the need for, and the value of, image cytometry DNA‐analysis as a complement to cytologic evaluation of cystic lesions in the neck.

Detection of central nervous system involvement in childhood acute lymphoblastic leukemia by cytomorphology and flow cytometry of the cerebrospinal fluid

Therapy directed at the central nervous system (CNS) is an essential part of the treatment for childhood acute lymphoblastic leukemia (ALL). The current evaluation of CNS involvement based on cytomorphological examination of the cerebrospinal fluid (CSF) alone is not as sensitive with low cell counts as flow cytometric immunophenotyping (FCI) of the CSF. However, the importance of low CSF blasts counts at diagnosis is uncertain. We sought to determine the significance of FCI in relation to conventional morphological examination.

Difference in hormone receptor content in breast cancers from Vietnamese and Swedish women

Abstract Background. The aim of the present study was to compare both estrogen (ER) and progesterone receptor (PgR) content in operable breast cancers from Vietnamese and Swedish patients. Material and methods. Primary breast cancer tissues were randomly selected from 249 Vietnamese patients treated in Hanoi, Vietnam between 2002 and 2004 and 1 257 Swedish patients treated in Stockholm, Sweden between 2002 and 2003. Clinical information was available for all patients in the study. The hormone receptor content in tumors from Vietnam was analyzed by immunohistochemistry using an automated slide stainer (Bench MarkXT, Ventana) in combination with anti-ER (SP1 250), and anti-PgR (clone 1E2) rabbit monoclonal antibody. Tumors with ≥ 10% stained nuclei were considered as receptor positive. Tumors from Swedish patients were analyzed with an enzyme immunoassay with a cut-off point of ≥ 0.10 fmol/μg DNA as positive. The hormone receptor frequencies between populations were compared according to clincopathology features. Results. The ER positive rate was higher in premenopausal and lower in postmenopausal Vietnamese patients as compared to Swedish patients with similar menopausal status (71% versus 58%, OR 1.75, p = 0.007; 44% versus 72%, OR 0.32, p < 0.001, respectively). PgR positive tumors were found in 58% and 25% of pre- and postmenopausal Vietnamese patients, respectively. The corresponding figures for Swedish patients were 73% and 66%, respectively. Conclusions. There were significant differences in the frequency of ER/PgR positivity between Vietnam and Swedish breast cancer patients. These differences were independent on menopausal status and age of patients at diagnosis can not be explained by these factors and they can be contributed to knowledge about both basic biology features and prognoses.

Fine-needle aspiration biopsy in lacrimal gland pleomorphic adenoma

imaging. Histopathology confirmed the diagnosis with classical granulomatous inflammation with eosinophilic infiltration. CT imaging, blood tests, and histopathology ruled out lacrimal gland tumour, Wegener’s granulomatosis and sarcoidosis. Takanashi et al reported two cases of CSS, one of which presented as chronic dacryoadenitis, the other with vasculitis. It has been proposed that CSS evolves through an allergic phase to eosinophilic tissue infiltration and then a final vasculitic stage. Indeed, various case reports have reported ocular involvement from both ends of this disease spectrum. Although CSS may have varied ophthalmic presentation, asthma, eosinophilia, and multisystem involvement should raise suspicion of this condition. Early diagnosis and treatment could avoid complications and relapses, not uncommon in CSS.

Fine-Needle Aspiration Biopsy in Orbital Lesions: A Retrospective Study of 225 Cases.

PURPOSEnTo describe and analyze results from the fine-needle aspiration biopsy (FNAB) technique, used as a diagnostic tool, in patients with orbital lesions.nnnDESIGNnRetrospective case series.nnnMETHODSnsetting: Institutional (Karolinska Hospital, Stockholm).nnnSTUDY POPULATIONn207 patients with 210 orbital lesions.nnnINTERVENTIONn225 FNABs of the orbit.nnnMAIN OUTCOME MEASURESnSuccessful diagnosis from FNAB.nnnRESULTSnOf the 210 orbital lesions evaluated with FNAB, a successful cytologic diagnosis was achieved in 176 (84%). In more than half of the orbital lesions (54%), the FNAB diagnosis in addition to imaging appearance, clinical appearance, and clinical history provided sufficient information for treatment, and the patient did not require an incisional or excisional biopsy. Ninety-seven patients underwent additional excisional or incisional biopsy; FNAB diagnoses and the histopathologic diagnoses corresponded in 87% of the cases with an intraclass correlation coefficient of 0.84 (95% confidence interval [CI] 0.76-0.90). The difference was statistically significant between the ability to make a successful cytologic FNAB diagnosis in palpable lesions vs nonpalpable lesions (successful diagnosis in 90% [CIxa0= 85%-95%] vs 75% [CIxa0= 66%-84%];xa0Pxa0<xa0.01). Neither the orbital quadrant location, nor the radiologic appearance (diffuse vs encapsulated), nor size of the lesion affected the success of FNAB diagnoses (all P > .7). There was a complication in 6 cases (3%). All complications were temporary and none led to permanent damage.nnnCONCLUSIONSnFNAB proved effective and exceedingly safe. With the current healthcare climate of minimally invasive surgery and cost control, FNAB should be considered as a valid alternative to open surgery in the evaluation and management of orbital lesions.

B cell neoplasms.

Mature B Cell Neoplasms * Chronic lymphocytic leukemia/small lymphocytic lymphoma * B cell prolymphocytic leukemia * Lymphoplasmacytic lymphoma * Splenic marginal zone lymphoma * Hairy cell leukemia * Plasma cell myeloma Monoclonal gammopathy of undetermined signi ficance * Solitary plasmacytoma of bone * Extraosseous plasmacytoma Primary amyloidosis Heavy chain diseases * Extranodal marginal zone B cell lymphoma of mucosaassociated lymphoid tissue (MALT lymphoma) * Nodal marginal zone B cell lymphoma * Follicular lymphoma * Mantle cell lymphoma * Diffuse large B cell lymphoma * Mediastinal (thymic) large B cell lymphoma Intravascular large B cell lymphoma Primary effusion lymphoma (see chap. 9 ‘Extranodal lymphomas’) * Burkitt lymphoma1/leukemia2 * Lymphomatoid granulomatosis

T cell neoplasms.

Cytology (fig. 5.1a) The smear pattern is monomorphic of smallto mediumsized cells. The nuclei are mostly round but may in some cases show more nuclear irregularity and distinct nucleoli. Cases of PLL have a relatively abundant nongranular cytoplasm with frequent protrusions [2–4]. Differential diagnosis: B-CLL, mycosis fungoides (MF) and adult T cell lymphoma/leukemia. Immunocytochemistry: The T-PLL cell is positive for T cell antigens (CD2, CD3, CD5 and CD7) (fig. 5.1b). CD4 is found in the majority of cases either without (2/3) or with (1/4) coexpression of CD8. Usually, a small ( 5%) fraction of the cells is MIB-1 positive (fig. 5.1c). Genetics: The T cell receptor is always rearranged. In addition, several abnormalities such as translocation (14;14), (8;8) and (X:14) have been reported.

Lymphoma look-alike.

Clinical Features (fig. 10.1a) Marked enlargement of lymph nodes can be seen in a variety of conditions such as (1) reactive follicular hyperplasia as a response to local infection, rheumatoid arthritis, systemic lupus erythematosus and HIV infection, and (2) paracortical hyper plasia which most often follows viral infections such as infectious mononucleosis but may be induced by medication or vaccination. In many cases of reactive hyperplasia, the two types, follicular and paracortical hyperplasia, are present together.