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Hu R, Miao M, Zhang R, Li Y, Li J, Zhu K, Yang Y, Liu Z, Yang W. Ovary involvement of diffuse large B-cell lymphoma. AMERICAN JOURNAL OF CASE REPORTS 2012; 13:96-8. [PMID: 23569499 PMCID: PMC3616171 DOI: 10.12659/ajcr.882997] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 05/10/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND Primary ovarian non-Hodgkin's lymphoma (PONHL) is an uncommon entity; its pathology is usually diffuse large B cell lymphoma (DLBCL). CASE REPORTS We report 3 cases of ovary involvement of DLBCL, 1 of which rapidly developed to central nervous system involvement. Diagnosis and subsequent treatment are discussed and the literature on the origin, epidemiology, clinical presentation, diagnosis, treatment and prognosis of ovary lymphoma are reviewed. All patients were diagnosed as having DLBCL after ovary biopsy, and were subsequently given regular chemotherapy. Two of them obtained remission and 1 of them had central nervous system involvement. CONCLUSIONS Ovary involvement of DLBCL is rare; prognosis is related to the overall clinical manifestation and some serum biomarkers. Diagnosis is established by ovary biopsy. Inaccurate or delayed diagnosis is often due to the lesions presenting as a mass resembling ovary cancer and may lead to poor outcome. Treatment regimen mainly consists of chemotherapy (CHOP) associated with rituximab. Intrathecal chemotherapy may play an important role in prevention of central nervous system involvement.
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Affiliation(s)
- Rong Hu
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Miao Miao
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Rong Zhang
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Yingchun Li
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Jia Li
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Ke Zhu
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Ying Yang
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Zhuogang Liu
- Department of Hematology, Shengjing Hospital, China Medical University, China
| | - Wei Yang
- Department of Hematology, Shengjing Hospital, China Medical University, China
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2
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McCarty MJ, Vukelja SJ, Banks PM, Weiss RB. Angiofollicular lymph node hyperplasia (Castleman's disease). Cancer Treat Rev 1995; 21:291-310. [PMID: 7585657 DOI: 10.1016/0305-7372(95)90034-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This review provides a comprehensive assessment of angiofollicular lymph node hyperplasia (ALNH) or Castleman's disease including pathogenesis, clinical presentation, histomorphologic and immunophenotypic findings, laboratory results, treatment, and prognosis. A division of ALNH into clinically relevant subtypes provides a framework for the consideration of the disorder. A comprehensive search of the medical literature involving ALNH using Medline was performed. Reports judged to be significant for the understanding of the disorder were analyzed and their findings incorporated into this review. ALNH is divided into localized/unicentric ALNH and generalized/multicentric ALNH due to the profound clinical differences seen between these variants. Localized/unicentric ALNH is separated by clinical and histomorphologic criteria into hyaline-vascular (HV) and plasma-cell (PC) subtypes. Generalized/multicentric ALNH may be divided by clinical criteria into generalized/multicentric ALNH without neuropathy (non-neuropathic) and generalized/multicentric ALNH with neuropathy (POEMS-associated or neuropathic). The dichotomy between these two subtypes is not absolute, with considerable clinical overlap occurring among patients presenting with generalized disease. Immunophenotypic and molecular probe studies demonstrate clonal B-cell lymphocyte populations in some cases, particularly those with generalized/multicentric ALNH. However, the finding of clonal populations is of no value in predicting malignant clinical progression. We conclude that using this division of ALNH, patients presenting with symptoms and histomorphology consistent with ALNH can be subdivided into the appropriate category of ALNH. Localized or unicentric disease, either HV or PC subtype, has an excellent prognosis with surgery being curative in the majority of cases. Generalized or multicentric disease indicates a poor prognosis with short survival, with the neuropathic variant possessing resistance to steroids and chemotherapy and a corresponding worse prognosis.
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Affiliation(s)
- M J McCarty
- Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
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3
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Roncella S, Di Celle PF, D'amore ESG, Casoli C, Cutrona G, Muzzulini C, Quaini F, Nicolo G, Foa R, Pistoia V. Cellular and Molecular Characterization of Two Cases of Castleman's Disease, Plasma Cell Variant. Leuk Lymphoma 1991; 5:391-6. [DOI: 10.3109/10428199109067634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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4
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Hall PA, Donaghy M, Cotter FE, Stansfeld AG, Levison DA. An immunohistological and genotypic study of the plasma cell form of Castleman's disease. Histopathology 1989; 14:333-46; discussion 429-32. [PMID: 2737612 DOI: 10.1111/j.1365-2559.1989.tb02162.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The plasma cell variant of Castleman's disease (angiofollicular hyperplasia) is an uncommon and poorly understood lymphoproliferative disorder which may be associated with a wide variety of systemic features. The clinical, pathological, immunophenotypic and genotypic features of a series of five cases are presented. The clinical manifestations were variable but systemic features were present in four cases. Histologically, all five cases were similar. The characteristic follicle-like structures are composed of concentric rings of B-lymphocytes with a mantle zone phenotype, surrounding an inner core of dendritic reticulum cells. The central regions are composed of plump cells that express Factor VIII related antigen, stain with Ulex europaeus I and are associated with laminin immunoreactivity. Many of these cells stain with Ki67 indicating cellular proliferation. Between these 'follicles', plasma cells are present interspersed between high endothelial venules. Using immunohistochemical techniques two cases were polyclonal, whilst in two others unequivocal lambda/IgA restriction was present; in the other case an intermediate picture of lambda/IgA predominance was apparent. Genotypic studies in three cases indicated immunoglobulin gene rearrangements but germ line T-cell receptor genes. The significance of the apparent clonal proliferation of plasma cells is discussed and a unifying model of Castleman's disease is proposed.
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Affiliation(s)
- P A Hall
- Department of Histopathology, St Bartholomew's Hospital, London, UK
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5
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Kyriazidou A, Brown PJ, Lucke VM. An immunohistochemical study of canine extramedullary plasma cell tumours. J Comp Pathol 1989; 100:259-66. [PMID: 2498400 DOI: 10.1016/0021-9975(89)90103-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Twenty-three cases of dog plasma cell tumours were investigated for the presence of monoclonal cytoplasmic immunoglobulin light chain types and heavy chain classes. The peroxidase-antiperoxidase method was applied to formalin-fixed, paraffin-embedded tissues, available as stored blocks. Twenty tumours showed a monoclonal light chain type and heavy chain class pattern, two showed a monoclonal light chain type and a biclonal heavy chain class pattern, findings which confirmed the neoplastic nature of the plasma cells. One tumour did not stain with any of the antisera. The results indicate that the method reliably establishes the monoclonality and, consequently, the neoplastic nature of plasma cell proliferations.
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Affiliation(s)
- A Kyriazidou
- University of Bristol, School of Veterinary Science, U.K
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6
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Kyriazidou A, Brown PJ, Lucke VM. Immunohistochemical staining of neoplastic and inflammatory plasma cell lesions in feline tissues. J Comp Pathol 1989; 100:337-41. [PMID: 2470792 DOI: 10.1016/0021-9975(89)90113-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two cases of feline plasmacytoma and nine cases of reactive plasma cell proliferations were examined for the presence of cytoplasmic immunoglobulin light chain types and heavy chain classes, by the peroxidase-anti-peroxidase technique on sections of formalin-fixed, paraffin-embedded tissues. This immunohistochemical technique is an important aid to conventional histological techniques. It helps to differentiate between neoplastic and dense inflammatory plasma cell proliferations by determining the presence of one, or more than one, light chain types in the cells, which corresponds with their neoplastic or reactive nature.
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Affiliation(s)
- A Kyriazidou
- University of Bristol, School of Veterinary Science, U.K
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7
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Radaszkiewicz T, Hansmann ML, Lennert K. Monoclonality and polyclonality of plasma cells in Castleman's disease of the plasma cell variant. Histopathology 1989; 14:11-24. [PMID: 2925176 DOI: 10.1111/j.1365-2559.1989.tb02110.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Castleman's disease of the plasma cell variant observed in 21 patients was investigated morphologically and by immunohistochemistry. The male to female ratio was 2.5:1. The age ranged from 18 to 71 years (mean age 47.6 years). Histologically, the lesions were characterized by numerous, evenly distributed germinal centres ranging from large hyperplastic to small hyaline-vascular types with moderate to extensive sheets of plasma cells in between. In all cases with generalized lymph node enlargement dilated sinuses could be found. Immunohistochemical studies demonstrated a polyclonal plasma cell population in 11 of 18 lesions. Seven lesions contained a monoclonal plasma cell population, five with IgG/lambda and two with IgA/lambda; clinically, two of these patients had generalized lymphadenopathy; in none could manifestation of a plasmacytoma be found outside the lymph node lesion; only two of the seven patients exhibited a paraproteinaemia (IgG/lambda and IgA/lambda, respectively) corresponding to the Ig type of the proliferated plasma cells. Six patients with polyclonal lesions had constitutional symptoms such as fever, anaemia, polyclonal hypergammaglobulinaemia; one of these six patients manifested symptoms consistent with a diagnosis of Takatsuki syndrome. The monoclonal plasma cell type of Castleman's disease did not progress to a generalized disease. This monoclonal variant may be a lymph nodebased type of benign monoclonal gammopathy.
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Abstract
Primary small intestinal lymphoma (PSIL) represents a heterogenous group of disorders with variable clinical and pathologic features and a characteristic age, socioeconomic, and geographic distribution. In developed countries, PSIL usually occurs as a localized ileal tumor, shows a bimodal age distribution, and most frequently presents with abdominal pain and obstructive symptoms. Histologically, most of these tumors are diffuse histiocytic, lymphocytic, or undifferentiated lymphomas. Other variants of PSIL, collectively referred to as immunoproliferative small intestinal disease, occur most often among young patients of poor socioeconomic status in Third World countries, mostly in the Middle East and Mediterranean area. They are characterized by involvement of long loops of the upper small intestine and commonly present with abdominal pain, diarrhea, malabsorption, and clubbing of the fingers. A subgroup of these patients shows a serological abnormality with the appearance of part of the alpha heavy chain of IgA in the serum. Histologically, the lesion appears as a dense diffuse lymphoplasmacytic infiltrate of the mucosa of the upper jejenum or duodenum. A form of malignant lymphoma of true histiocytic origin complicates long-standing celiac disease. The contrasting clinical, epidemiological, histopathological, and immunological features of these variants of PSIL raise interesting questions about the pathogenesis of small bowel lymphoma.
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9
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Immunohistochemical staining of Langerhans cells and macrophages in oral lichen planus. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1985; 60:396-402. [PMID: 2414707 DOI: 10.1016/0030-4220(85)90262-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty patients with clinically and microscopically confirmed lichen planus were studied immunohistochemically. Monoclonal antibody to HLA-DR antigens and polyclonal antisera to S-100 protein and muramidase were applied to paraffin-embedded sections for the purpose of elaborating on the pathogenesis of this disease. Trypsin incubation of sections was also done in order to determine its effect on immunostaining. Langerhans cells were identified with anti-S-100 and anti-HLA-DR, and macrophages were identified with antimuramidase and anti-HLA-DR. Keratinocytes also expressed HLA-DR membrane activity in lichen planus tissue. Trypsinization significantly improved the expression of S-100 protein and muramidase antigens. It was concluded that Langerhans cells, macrophages, and keratinocytes play important roles in antigen processing and/or phagocytosis during the natural history of this disease.
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10
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McDonald GB, Schuffler MD, Kadin ME, Tytgat GN. Intestinal pseudoobstruction caused by diffuse lymphoid infiltration of the small intestine. Gastroenterology 1985; 89:882-9. [PMID: 4029567 DOI: 10.1016/0016-5085(85)90587-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Four young women presented with diarrhea, malabsorption, and intestinal pseudoobstruction. Intestinal biopsy specimens (both peroral and full-thickness) showed flat small intestinal mucosa, sparsity of crypts, and a widespread lymphoid infiltrate in the lamina propria, muscularis propria, and myenteric plexus. There was no neuron or nerve fiber loss or damage in the plexus; muscle cell absence in the vicinity of lymphoid cell infiltration in the muscularis propria probably accounted for the pathogenesis of pseudoobstruction. Immunochemical stains showed that the infiltrate was polyclonal, and none of the patients has developed lymphoma on clinical follow-up of 4-16 yr. Transient improvement in symptoms occurred after antibiotic therapy in 3 patients, and 1 patient had improvement after treatment with cyclophosphamide and prednisone; however, symptoms of pseudoobstruction persist in all. These cases illustrate yet another cause of intestinal pseudoobstruction which is histologically distinct from visceral myopathies and neuropathies. The pathogenesis of this illness may be related to that of diffuse immunoproliferative diseases seen in Third World countries.
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11
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Abstract
The clinical and pathologic findings in 36 patients with primary pulmonary non-Hodgkin's lymphoma were retrospectively evaluated. Each lymphoma was classified according to the Rappaport, Lukes-Collins, Working Formulation, and Kiel criteria. Twenty-one (58%) of the 36 patients had lymphomas classified as lymphoplasmacytic/lymphoplasmacytoid type or LP immunocytoma (LPI) according to the Kiel classification. The remainder of the patients (42%) had lymphomas distributed among the follicular center cell (FCC) types and immunoblastic sarcoma in the Lukes-Collins classification. Survival of patients with LPI was significantly longer than that of patients with other types of lymphoma (88% versus 47% 5-year actuarial survival estimate), and the LPIs were more often confined to the lung without hilar or mediastinal lymph node involvement. Seven (33%) of the 21 LPI eventually recurred after a mean follow-up of 69 months, and 4 of these 7 developed serum paraproteins. Most of the patients with lymphomas other than LPI had persistent disease or an early recurrence. LPI, as described by Lennert, seems prone to arise in extranodal sites and to recur late. Measurement of serum immunoglobulins may be helpful in detecting recurrences of LPI.
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12
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Keren DF, Appelman HD, Dobbins WO, Wells JJ, Whisenant B, Foley J, Dieterle R, Geisinger K. Correlation of histopathologic evidence of disease activity with the presence of immunoglobulin-containing cells in the colons of patients with inflammatory bowel disease. Hum Pathol 1984; 15:757-63. [PMID: 6378760 DOI: 10.1016/s0046-8177(84)80167-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Immunofluorescence of formalin-fixed, paraffin-embedded tissues was performed to study the plasma cell population in 114 colonic specimens from 58 patients. Correlation of the histopathologic stage of disease activity with the isotypes and numbers of immunoglobulin-containing cells in the lamina propria demonstrated highly significant (P less than 0.001) increases in the mean numbers of IgG- (18-fold), IgA- (twofold) and IgM- (sixfold) containing cells in specimens from patients with active inflammatory bowel disease as compared with control specimens. Increased numbers of immunoglobulin-containing cells were uncommon in inactive inflammatory bowel disease and in reactive mucosa. No deposition of immunoglobulin-containing immune complexes was found at any stage of disease activity. These findings suggest that immune complex-mediated damage does not play a major role in the epithelial damage in inflammatory bowel disease. In future studies, it will be of importance to determine whether the antibody from immunoglobulin-containing cells seen in patients with inflammatory bowel disease can effect damage via an antibody-dependent cell-mediated cytotoxicity mechanism.
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13
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Burg G, Kerl H, Kaudewitz P, Braun-Falco O, Mason DY. Immunoenzymatic typing of lymphoplasmacytoid skin infiltrates. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1984; 10:284-90. [PMID: 6423709 DOI: 10.1111/j.1524-4725.1984.tb00900.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Monoclonal immunoglobulin-producing lymphomas (immunocytomas, plasmacytomas, and immunoblastomas) constitute 15 to 20% of all cutaneous lymphomas. Their differentiation from polymorphous lymphoplasmacytoid inflammatory or pseudolymphomatous infiltrates may be difficult if sections are stained for a single light chain only. It was the aim of the study to elucidate the ratio of the kappa- to lambda-positive cells in 10 lymphoproliferative, 5 pseudolymphomatous, and 42 inflammatory lymphoplasmacytoid cutaneous infiltrates and to characterize them by the type of Ig (alpha, gamma, mu, kappa, or lambda) synthesized intracellularly. An indirect immunoenzymatic double-labeling method (alkaline phosphatase and peroxidase) was used for the simultaneous demonstration of kappa and lambda light chains and alpha, gamma, and mu heavy chains in paraffin sections. Ig-producing lymphomas of the skin show patchy monoclonal proliferations of cells synthesizing kappa IgM in almost 50% of the cases (5 of 10). Monoclonality is claimed if the ratio of lambda- to kappa-positive cells is at least 1:10, or vice versa. In polyclonal inflammatory and pseudolymphomatous infiltrates, the lambda/kappa ratio never exceeds 1:5. The most common cell type found in these reactive infiltrates produces gamma heavy chain; some produce alpha chain, but only a few produce mu chain. In high-grade malignant lymphomas, the tumor cells may lose their capacity for Ig production.
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14
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Gordon J. Molecular aspects of immunoglobulin expression by human B cell leukemias and lymphomas. Adv Cancer Res 1984; 41:71-154. [PMID: 6428177 DOI: 10.1016/s0065-230x(08)60015-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
MESH Headings
- Antibodies, Monoclonal/immunology
- Antibodies, Neoplasm/genetics
- Antibodies, Neoplasm/immunology
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- Burkitt Lymphoma/genetics
- Burkitt Lymphoma/immunology
- Humans
- Immunoglobulin Heavy Chains/immunology
- Immunoglobulin Light Chains/immunology
- Immunoglobulins/biosynthesis
- Immunoglobulins/genetics
- Immunoglobulins/immunology
- Leukemia/genetics
- Leukemia/immunology
- Leukemia, Hairy Cell/genetics
- Leukemia, Hairy Cell/immunology
- Leukemia, Lymphoid/genetics
- Leukemia, Lymphoid/immunology
- Lymphocyte Activation/drug effects
- Lymphoma/genetics
- Lymphoma/immunology
- Mitogens/pharmacology
- Models, Biological
- Phenotype
- Phorbol Esters/pharmacology
- Preleukemia/genetics
- Preleukemia/immunology
- Receptors, Antigen, B-Cell/immunology
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Regezi JA, Zarbo RJ, Keren DF. Plasma cell lesions of the head and neck: immunofluorescent determination of clonality from formalin-fixed, paraffin-embedded tissue. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1983; 56:616-21. [PMID: 6361654 DOI: 10.1016/0030-4220(83)90079-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
An immunofluorescent technique was used on formalin-fixed, paraffin-embedded tissue to characterize and diagnose plasma cell lesions of the head and neck. Infiltrates were classified as either monoclonal or polyclonal with rhodamine and fluorescein staining of light chains and heavy chains. In the cases in which histopathologic diagnoses were relatively certain, immunofluorescence provided good correlation. In those cases in which histopathologic diagnoses were equivocal, immunofluorescence distinguished between reactive and neoplastic infiltrates through the determination of clonality of the infiltrates.
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Abstract
The authors review the clinical, radiographic, and pathologic features of the benign pulmonary lymphoid disorders. The essential role of immunopathologic techniques in distinguishing pulmonary lymphoid hyperplasias from malignant lymphoma is stressed. A theory regarding the development of pulmonary lymphoid hyperplasia is proposed as a basis for understanding these disorders. The authors suggest that lymphoid hyperplasia is a basic inflammatory response of the lung.
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