Sang Mee Hwang

p15INK4b methylation correlates with thrombocytopenia, blast percentage, and survival in myelodysplastic syndromes in a dose dependent manner: quantitation using pyrosequencing study.

We investigated how the quantity of p15INK4b methylation related to International Prognosic Scoring System variables and survival in 74 patients with de novo myelodysplastic syndrome (MDS). Pyrosequencing of 11 consecutive CpG sites of the p15INK4b promotor region was performed, with the extent of CpG cytosine methylation assessed in terms of methylation level (MtL). Patients with >5% bone marrow blasts had higher MtL than patients with <5% blasts (10.1% vs. 6.1%, p=0.030, respectively). Methylation was not associated with chromosomal aberrations. The MtL of patients with thrombocytopenia were higher than patients without thrombocytopenia (11.2% vs. 6.2%, p=0.036, respectively); they were higher in patients with cytopenias in > or =2 lineages than in patients with either unilineage or no cytopenia (9.8% vs. 4.1%, p=0.036, respectively). The survival of patients with >7% MtL was worse than patients with <7% MtL (p=0.031). Heavy p15INK4b methylation in MDS is associated with IPSS predictors of poor prognosis and adverse survival.

Necklace-like microvacuoles of tumor cells in blastic plasmacytoid dendritic cell neoplasm

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. A 73-year-old man presented with abdominal distension and general weakness for 3 weeks. One month prior to visit, brown-colored patchy skin lesion on left flank had appeared. Axillary lymph nodes were palpable on physical examination. Peripheral blood examination showed bicytopenia, leukoerythroblastic features and abnormal cells. Bone marrow aspiration revealed numerous medium-sized tumor cells with cytoplasmic microvacuoles localized along the cell membrane and pseudopodia (Left). Bone marrow biopsy showed diffuse infiltration of tumor cells (Right). Tumor myeloperoxidase and EBV. The diagnosis of blastic plasmacytoid dendritic cell neoplasm was made and the patient received chemotherapy but expired soon after, due to disseminated disease. The characteristic morphology with necklace like cytoplasmic microvacules localized along the cell border can be a diagnostic clue to blastic plasmacytoid dendritic cell neoplasm, even in the era of high technology medicine.