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Hashimoto N, Hanada H, Miyoshi H, Nagaishi M, Sato K, Hontani H, Ohshima K, Takeuchi I. Multimodal Gated Mixture of Experts Using Whole Slide Image and Flow Cytometry for Multiple Instance Learning Classification of Lymphoma. J Pathol Inform 2024; 15:100359. [PMID: 38322152 PMCID: PMC10844119 DOI: 10.1016/j.jpi.2023.100359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/07/2023] [Accepted: 12/23/2023] [Indexed: 02/08/2024] Open
Abstract
In this study, we present a deep-learning-based multimodal classification method for lymphoma diagnosis in digital pathology, which utilizes a whole slide image (WSI) as the primary image data and flow cytometry (FCM) data as auxiliary information. In pathological diagnosis of malignant lymphoma, FCM serves as valuable auxiliary information during the diagnosis process, offering useful insights into predicting the major class (superclass) of subtypes. By incorporating both images and FCM data into the classification process, we can develop a method that mimics the diagnostic process of pathologists, enhancing the explainability. In order to incorporate the hierarchical structure between superclasses and their subclasses, the proposed method utilizes a network structure that effectively combines the mixture of experts (MoE) and multiple instance learning (MIL) techniques, where MIL is widely recognized for its effectiveness in handling WSIs in digital pathology. The MoE network in the proposed method consists of a gating network for superclass classification and multiple expert networks for (sub)class classification, specialized for each superclass. To evaluate the effectiveness of our method, we conducted experiments involving a six-class classification task using 600 lymphoma cases. The proposed method achieved a classification accuracy of 72.3%, surpassing the 69.5% obtained through the straightforward combination of FCM and images, as well as the 70.2% achieved by the method using only images. Moreover, the combination of multiple weights in the MoE and MIL allows for the visualization of specific cellular and tumor regions, resulting in a highly explanatory model that cannot be attained with conventional methods. It is anticipated that by targeting a larger number of classes and increasing the number of expert networks, the proposed method could be effectively applied to the real problem of lymphoma diagnosis.
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Affiliation(s)
- Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
| | - Hiroyuki Hanada
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Miharu Nagaishi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, 4668555, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
- Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
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Ito Y, Marouf A, Kogure Y, Koya J, Liévin R, Bruneau J, Tabata M, Saito Y, Shingaki S, Yuasa M, Yamaguchi K, Murakami K, Weil R, Vavasseur M, Andrieu GP, Latiri M, Veleanu L, Dussiot M, André I, Joshi A, Lagresle-Peyrou C, Magerus A, Chaubard S, Lavergne D, Bachy E, Brunet E, Fataccioli V, Brouzes C, Laurent C, De Leval L, Traverse-Glehen A, Bossard C, Parrens MC, Meignin V, Philippe L, Rossignol J, Suarez F, Michot JM, Tournilhac O, Damaj G, Lemonnier F, Bôle-Feysot C, Nitschké P, Tesson B, Laurent C, Molina T, Asnafi V, Watatani Y, Chiba K, Okada A, Shiraishi Y, Tsukita S, Izutsu K, Miyoshi H, Ohshima K, Sakata S, Dobashi A, Takeuchi K, Sanada M, Gaulard P, Jaccard A, Ogawa S, Hermine O, Kataoka K, Couronné L. Comprehensive genetic profiling reveals frequent alterations of driver genes on the X chromosome in extranodal NK/T-cell lymphoma. Cancer Res 2024:743244. [PMID: 38657099 DOI: 10.1158/0008-5472.can-24-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/22/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
Extranodal NK/T-cell lymphoma (ENKTCL) is an Epstein-Barr virus (EBV)-related neoplasm with male dominance and a poor prognosis. A better understanding of the genetic alterations and their functional roles in ENKTCL could help improve patient stratification and treatments. Here, we performed comprehensive genetic analysis of 177 ENKTCL cases to delineate the landscape of mutations, copy number alterations (CNAs), and structural variations, identifying 34 driver genes including six previously unappreciated ones, namely HLA-B, HLA-C, ROBO1, CD58, POT1, and MAP2K1. Among them, CD274 (24%) was the most frequently altered, followed by TP53 (20%), CDKN2A (19%), ARID1A (15%), HLA-A (15%), BCOR (14%), and MSN (14%). Chromosome X (chrX) losses were the most common arm-level CNAs in females (~40%), and alterations of four X-linked driver genes (MSN, BCOR, DDX3X, and KDM6A) were more frequent in males and females harboring chrX losses. Among X-linked drivers, MSN was the most recurrently altered, and its expression was lost in approximately one-third of cases using immunohistochemical analysis. Functional studies of human cell lines demonstrated that MSN disruption promoted cell proliferation and NF-κB activation. Moreover, MSN inactivation increased sensitivity to NF-κB inhibition in vitro and in vivo. In addition, recurrent deletions were observed at the origin of replication in the EBV genome (6%). Finally, by integrating the 34 drivers and 19 significant arm-level CNAs, non-negative matrix factorization and consensus clustering identified two molecular groups with different genetic features and prognosis irrespective of clinical prognostic factors. Together, these findings could help improve diagnostic and therapeutic strategies in ENKTCL.
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Affiliation(s)
- Yuta Ito
- National Cancer Center Research Institute, Tokyo, Japan
| | - Amira Marouf
- Institut Imagine - H�'pital Necker, Paris, France
| | | | - Junji Koya
- National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | | | - Julie Bruneau
- Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes Sorbonne Cité, Paris, France
| | - Mariko Tabata
- National Cancer Center Research Institute, Tokyo, Japan
| | - Yuki Saito
- National Cancer Center Research Institute, Tokyo, Japan
| | - Sumito Shingaki
- National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | | | | | | | | | | | | | | | | | - Michaël Dussiot
- INSERM UMR 1163 and CNRS ERL8654, Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, Paris, France
| | - Isabelle André
- Imagine Institute for Genetic Diseases, Paris, Ile de France, France
| | - Akshay Joshi
- University College London, london, United Kingdom
| | | | - Aude Magerus
- Imagine Institute for Genetic Diseases, Paris, France
| | | | - David Lavergne
- Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Emmanuel Bachy
- Université Lyon-1 ; Hospices Civils de Lyon, Pierre-Bénite cedex, France
| | - Erika Brunet
- Imagine Institute for Genetic Diseases, Paris, France
| | | | | | - Camille Laurent
- Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | | | | | - Céline Bossard
- Centre Hospitalier Universitaire Hôtel Dieu, Nantes, Nantes, France
| | | | | | | | | | | | | | | | | | - François Lemonnier
- Université Paris Est Créteil, INSERM, Institut Mondor de Recherche Biomédicale, Créteil, France
| | | | | | | | - Cécile Laurent
- Institut Curie, PSL Research University, Paris Cedex 05, France
| | - Thierry Molina
- Necker Enfants Malades Hospital, Université Paris, Paris, France
| | | | - Yosaku Watatani
- Graduate School of Medicine, Kyoto University, Kyoto city, Japan
| | | | - Ai Okada
- National Cancer Center Research Institute, Tokyo, Japan
| | | | - Sachiko Tsukita
- Advanced Comprehensive Research Organization (ACRO), Teikyo University, Japan
| | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | | | - Kengo Takeuchi
- Japanese Foundation For Cancer Research, Koto, Tokyo, Japan
| | - Masashi Sanada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | - Arnaud Jaccard
- Centre national de reference amylose AL et autres of Limoges, University Hospital and University of Limoges, Limoges, France
| | - Seishi Ogawa
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Olivier Hermine
- Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes Sorbonne Cité, Paris, France
| | - Keisuke Kataoka
- National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
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Moritsubo M, Furuta T, Miyoshi J, Komaki S, Sakata K, Miyoshi H, Morioka M, Ohshima K, Sugita Y. Increased expression of leucine-rich α-2 glycoprotein 1 as a predictive biomarker of favorable progression-free survival in meningioma. Neuropathology 2024; 44:96-103. [PMID: 37749948 DOI: 10.1111/neup.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
Most meningiomas, which are frequent central nervous system tumors, are classified as World Health Organization (WHO) grade 1 because of their slow-growing nature. However, the recurrence rate varies and is difficult to predict using conventional histopathological diagnoses. Leucine-rich α-2 glycoprotein 1 (LRG1) is involved in cell signal transduction, cell adhesion, and DNA repair and is a predictive biomarker in different malignant tumors; however, such a relationship has not been reported in meningiomas. We examined tissue microarrays of histological samples from 117 patients with grade 1 and 2 meningiomas and assessed their clinical and pathological features, including expression of LRG1 protein. LRG1-high meningiomas showed an increased number of vessels with CD3-positive cell infiltration (P = 0.0328) as well as higher CD105-positive vessels (P = 0.0084), as compared to LRG1-low cases. They also demonstrated better progression-free survival (hazard ratio [HR] 0.11, 95% confidence interval [CI] 0.016-0.841) compared to LRG1-low patients (P = 0.033). Moreover, multivariate analysis indicated that high LRG1 expression was an independent prognostic factor (HR, 0.13; 95% CI, 0.018-0.991; P = 0.049). LRG1 immunohistochemistry may be a convenient tool for estimating the prognosis of meningiomas in routine practice. Further studies are required to elucidate the key role of LRG1 in meningioma progression.
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Affiliation(s)
- Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Junko Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Satoru Komaki
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sugita
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
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Nagaishi M, Miyoshi H, Kugler M, Sato K, Kohno K, Takeuchi M, Yamada K, Furuta T, Hashimoto N, Takeuchi I, Hontani H, Ohshima K. The Detection of Neoplastic Cells Using Objective Cytomorphologic Parameters in Malignant Lymphoma. J Transl Med 2024; 104:100302. [PMID: 38092181 DOI: 10.1016/j.labinv.2023.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 01/13/2024] Open
Abstract
Pathologic evaluation is the most crucial method for diagnosing malignant lymphomas. However, there are no established diagnostic criteria for evaluating pathologic morphology. We manually circled cell nuclei in the lesions of 10 patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and reactive lymphadenitis. Seventeen parameters related to nuclear shape, color, and other characteristics were measured. We attempted to compare the statistical differences between these subtypes and extract distinctive disease-specific populations on the basis of these parameters. Statistically significant differences were observed between the different types of lymphoma for many of the 17 parameters. Through t-distributed stochastic neighbor embedding analysis, we extracted a cluster of cells that showed distinctive features of DLBCL and were not found in follicular lymphoma or reactive lymphadenitis. We created a decision tree to identify the characteristics of the cells within that cluster. Based on a 5-fold cross-validation study, the average sensitivity, specificity, and accuracy obtained were 84.1%, 98.4%, and 97.3%, respectively. A similar result was achieved using a validation experiment. Important parameters that indicate the features of DLBCL include Area, ConcaveCount, MaxGray, and ModeGray. By quantifying pathologic morphology, it was possible to objectively represent the cell morphology specific to each lymphoma subtype using quantitative indicators. The quantified morphologic information has the potential to serve as a reproducible and flexible diagnostic tool.
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Affiliation(s)
- Miharu Nagaishi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan.
| | - Mauricio Kugler
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | | | - Ichiro Takeuchi
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan; Department of Mechanical Systems Engineering, Nagoya University, Nagoya, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
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5
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Muto R, Miyoshi H, Nakashima K, Takeuchi M, Hamasaki M, Ohshima K. Clinicopathological features of adult T-cell leukemia/lymphoma with T-follicular helper phenotype. Cancer Med 2024; 13:e7050. [PMID: 38506241 PMCID: PMC10952016 DOI: 10.1002/cam4.7050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 03/21/2024] Open
Abstract
AIMS T-follicular helper (TFH) cells are effector T-cells that are crucial for B-cell selection and differentiation. T-cell lymphomas derived from TFH cells have distinct characteristics. Additionally, in the World Health Organization (WHO) classification 5th edition, three lymphomas were introduced as independent disease entities with TFH cell origin. We aimed to investigate the clinicopathological features of adult T-cell leukemia/lymphoma (ATLL) with a TFH phenotype (TFHP). METHODS AND RESULTS We performed TFH immunohistochemistry analysis of five biomarkers for the biopsy specimen, with TFHP being indicated by a positive result for more than two markers. Among 75 cases of ATLL, 37.3% of them showed TFHP. Compared with cases of ATLL without TFHP, cases of ATLL with TFHP showed higher C-reactive protein levels (p = 0.0219) and increased high endothelial venule proliferation (p = 0.024). However, there were no significant between-group differences in overall survival as well as other clinical and morphological findings. Furthermore, there was no significant between-group difference in TFH markers and FOXP3 expression. CONCLUSION Some patients with ATLL may present a TFHP, which should not preclude the diagnosis of ATLL. Although presenting a TFHP does not affect prognosis, it is important to identify cases of ATLL with a TFHP since it may inform future treatment strategies.
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Affiliation(s)
- Reiji Muto
- Department of Pathology, National Hospital Organization (NHO)Kumamoto Medical CenterKumamotoJapan
- Department of PathologyKurume University School of MedicineKurumeJapan
- Department of PathologyFukuoka University School of MedicineFukuokaJapan
| | - Hiroaki Miyoshi
- Department of PathologyKurume University School of MedicineKurumeJapan
| | | | - Mai Takeuchi
- Department of PathologyKurume University School of MedicineKurumeJapan
| | - Makoto Hamasaki
- Department of PathologyFukuoka University School of MedicineFukuokaJapan
| | - Koichi Ohshima
- Department of PathologyKurume University School of MedicineKurumeJapan
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Kato S, Hamada M, Okamoto A, Yamashita D, Miyoshi H, Arai H, Satou A, Gion Y, Sato Y, Tsuyuki Y, Miyata-Takata T, Takata K, Asano N, Takahashi E, Ohshima K, Tomita A, Hosoda W, Nakamura S, Okuno Y. EBV+ nodal T/NK-cell lymphoma associated with clonal hematopoiesis and structural variations of the viral genome. Blood Adv 2024:bloodadvances.2023012019. [PMID: 38429084 DOI: 10.1182/bloodadvances.2023012019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
Epstein-Barr virus (EBV)+ nodal T- and NK-cell lymphoma (EBV+ nPTCL) is a peripheral T-cell lymphoma (PTCL) that presents as a primary nodal disease with T-cell phenotype and EBV harboring on tumor cells. To date, the genetic aspect of EBV+ nPTCL has not been fully investigated. In this study, whole-exome and/or genome sequencing was performed on 22 cases of EBV+ nPTCL. TET2 (68%) and DNMT3A (32%) were observed to be the most frequently mutated genes whose presence was associated with poor overall survival (p = 0.004). The RHOA p.Gly17Val mutation was identified in two patients who had TET2 and/or DNMT3A mutations. In four patients with TET2/DNMT3A alterations, blood cell-rich tissues (bone marrow [BM] or spleen) were available as paired normal samples. Three out of these four cases had at least one identical TET2/DNMT3A mutation in the BM or spleen. Additionally, the whole part of the EBV genome was sequenced and structural variations (SVs) were found frequent among the EBV genomes (63%). The most frequently identified type of SV was deletion. In one patient, four pieces of human chromosome 9, including PD-L1 were identified to be tandemly incorporated into the EBV genome. The 3'-untranslated region of PD-L1 was truncated, causing a high-level of PD-L1 protein expression. Overall, the frequent TET2 and DNMT3A mutations in EBV+ nPTCL seem to be closely associated with clonal hematopoiesis and, together with the EBV genome deletions, may contribute to the pathogenesis of this intractable lymphoma.
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Affiliation(s)
| | - Motoharu Hamada
- Nagoya City University Graduate School of Medical Science, Nagoya, Japan
| | | | | | | | - Haruto Arai
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Akira Satou
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yuka Gion
- Ehime Prefectural University of Health Sciences, Japan
| | - Yasuharu Sato
- Okayama University Graduate School of Medicine, Japan
| | | | - Tomoko Miyata-Takata
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Katsuyoshi Takata
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Naoko Asano
- Nagano Prefectural Shinshu Medical Center, Suzaka, Japan, Suzaka, Japan
| | | | | | - Akihiro Tomita
- Fujita Health University School of Medicine, Toyoake, Japan
| | | | | | - Yusuke Okuno
- Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Japan
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Mishina T, Miyoshi H, Takeuchi M, Miyawaki K, Nakashima K, Yamada K, Moritsubo M, Inoue-Mitsuyama K, Shimasaki Y, Imamoto T, Kawamoto K, Furuta T, Kohno K, Kato K, Akashi K, Ohshima K. Co-expression of regulatory B-cell markers, transforming growth factor β and interleukin-10 as a prognostic factor in diffuse large B-cell lymphoma. Pathol Res Pract 2024; 254:155117. [PMID: 38262270 DOI: 10.1016/j.prp.2024.155117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
Regulatory B cells (Bregs) suppress antitumor immunity by producing anti-inflammatory cytokines such as transforming growth factor β (TGF-β) and interleukin-10 (IL-10) and promoting tumor growth. It is unknown whether diffuse large B-cell lymphoma (DLBCL), a common subtype of B-cell malignancy, exhibits characteristics similar to those of Bregs. This study aimed to clarify the features of DLBCLs carrying Breg markers. In 123 DLBCL cases, we evaluated TGF-β and IL-10 expression in tumor biopsy samples using immunohistochemical staining and retrospectively analyzed their clinicopathological characteristics. Fifteen cases (12.2 %) classified as Breg-type DLBCL were positive for both TGF-β and IL-10. Breg-type DLBCL is mainly classified as having activated B cell-like cells of origin. Breg-type DLBCL cases showed significantly worse progression-free survival and overall survival (OS) than other DLBCL cases (P = 0.0016 and P = 0.042, respectively). In multivariate analysis, Breg-type DLBCL significantly affected OS (hazard ratio, 3.13; 95 % confidence interval 1.15-8.55; P = 0.025). Gene expression analysis showed that the expression of follicular dendritic cell-associated genes (FCER2, PIK3CD, FOXO1) was downregulated in Breg-type DLBCLs compared to other DLBCLs. These results suggest that the double expression of Breg markers, TGF-β and IL-10, in tumor cells indicates a poor prognosis in DLBCL patients. Further studies evaluating genomic abnormalities could confirm the characteristics of Breg-type DLBCL.
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Affiliation(s)
- Tatsuzo Mishina
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan; Division of Hematology-Oncology, Chiba Cancer Center, Chiba, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.
| | - Mai Takeuchi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kohta Miyawaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kazutaka Nakashima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | | | - Yasumasa Shimasaki
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Teppei Imamoto
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan; Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Keisuke Kawamoto
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kei Kohno
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
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8
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Wang Z, Muto R, Miyoshi H, Aoki M, Uesugi N, Murayama H, Masutani K, Hamasaki M. The first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma that deteriorated after COVID-19 vaccination. Pathol Int 2024; 74:87-92. [PMID: 38116849 DOI: 10.1111/pin.13398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
This is the first autopsy case of Epstein-Barr virus-positive marginal zone lymphoma (EBV + MZL) with an other iatrogenic immunodeficiency-associated lymphoproliferative disorders (LPD) (methotrexate [MTX]-associated LPD) that deteriorated after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. This case had a unique immunophenotype. A 71-year-old female patient with rheumatoid arthritis receiving MTX presented with fatigue 1 week after the SARS-CoV-2 vaccination. She was hospitalized due to hepatorenal dysfunction and pancytopenia. Computed tomography revealed systemic lymphadenopathy. Her physical condition deteriorated, and the patient died. The autopsy revealed systemic lymphadenopathy comprising medium-sized atypical lymphocytes and scattered Hodgkin/Reed-Sternberg (H/RS)-like cells. An immunohistochemical examination showed that atypical lymphocytes were positive for CD79a and MUM-1 and some were positive for CD20 and IRTA-1. H/RS-like cells were immunoreactive for CD30 and CD15 and ringed by T cells. Both cell types were positive for EBV-encoded small RNA. The majority of H/RS-like cells were positive for CD20, whereas a small number of CD3-positive cells were admixed. We herein presented the first autopsy case of EBV + MZL that deteriorated after the SARS-CoV-2 vaccination.
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Affiliation(s)
- Ziyao Wang
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Reiji Muto
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
- Department of Pathology, National Hospital Organization (NHO) Kumamoto Medical Center, Kumamoto, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Mikiko Aoki
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Noriko Uesugi
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroyuki Murayama
- Department of Internal Medicine, Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kosuke Masutani
- Department of Internal Medicine, Division of Nephrology and Rheumatology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Makoto Hamasaki
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan
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9
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Tanaka K, Miyoshi H, Kawamoto K, Shimasaki Y, Nakashima K, Imamoto T, Yamada K, Takeuchi M, Moritsubo M, Furuta T, Kohno K, Tamura S, Sonoki T, Ohshima K. Clinicopathological analysis of CD47 and signal regulatory protein alpha expression in myeloid sarcoma patients: CD47 expression is a favourable prognostic factor. Pathology 2024; 56:81-91. [PMID: 38110323 DOI: 10.1016/j.pathol.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/04/2023] [Accepted: 10/02/2023] [Indexed: 12/20/2023]
Abstract
Myeloid sarcoma is a rare extramedullary haematopoietic malignancy. Interaction between CD47 and signal regulatory protein α (SIRPα) inhibits phagocytosis. CD47-positive tumours confer poor prognoses in various malignant tumours, including acute myeloid leukaemia. This study aimed to investigate the clinicopathological effects of CD47 and SIRPα expression in myeloid sarcoma. Immunohistochemistry (IHC) of CD47 and SIRPα was performed in 84 biopsy samples obtained from patients with myeloid sarcoma, some of which were CD47-positive. Patients were categorised into the following two groups based on IHC of SIRPα: those with SIRPα-positive neoplastic cells (nSIRPα) and, SIRPα expression on non-neoplastic stromal cells in tumour microenvironment (miSIRPα). In addition, patients with CD47 positivity had higher lymphocytic infiltration into the tumour microenvironment. Overall, these patients had significantly higher overall survival, however, no significant difference was observed in progression-free survival. No significant prognostic differences were observed between the nSIRPα and miSIRPα groups. This is the first study to demonstrate an association between CD47 expression and improved prognosis in myeloid sarcoma. Nonetheless, it will be necessary to conduct additional research on gene expression and genomic abnormalities to elucidate the corresponding pathogenesis of myeloid sarcoma.
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Affiliation(s)
- Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan; Department of Haematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
| | - Keisuke Kawamoto
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Shinobu Tamura
- Department of Haematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Takashi Sonoki
- Department of Haematology/Oncology, Wakayama Medical University, Wakayama, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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10
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Shimasaki Y, Miyoshi H, Kawamoto K, Yoshida N, Mishina T, Nakashima K, Imamoto T, Sugio T, Yanagida E, Kato T, Yamada K, Takeuchi M, Suzuki T, Moritsubo M, Furuta T, Imaizumi Y, Takizawa J, Kato K, Suzumiya J, Suzuki R, Ohshima K. Clinicopathological comparison between PTCL-TBX21 and PTCL-GATA3 in Japanese patients. Cancer Med 2024; 13:e6793. [PMID: 38234210 PMCID: PMC10905534 DOI: 10.1002/cam4.6793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
AIM Peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) is a heterogeneous disease that can be classified into the PTCL-TBX21 and PTCL-GATA3 subtypes. METHODS In this study, we compared the clinicopathological features of PTCL-NOS in a Japanese cohort, classified using an IHC algorithm. RESULTS One hundred patients with PTCL-NOS were categorized as having PTCL-TBX21 (n = 55), PTCL-GATA3 (n = 24), or PTCL-unclassified (n = 21). When comparing PTCL-TBX21 and PTCL-GATA3, PTCL-TBX21 showed significantly lower CD4 positivity (p = 0.047), lower counts of high endothelial venules (p = 0.032), and a tendency for a better response to initial treatment (p = 0.088). Gene expression analysis using the nCounter system showed higher expression of tumor immunity-related genes, such as PD-L1, LAG3, and IDO1, in PTCL-TBX21 than in PTCL-GATA3. PTCL-GATA3 had significantly worse overall survival (OS) than those with PTCL-TBX21 (p = 0.047), although a similar tendency was observed for progression-free survival (PFS) (p = 0.064). PTCL-GATA3 was a prognostic factor for OS in univariate analysis (HR 2.02; 95% CI, 1.09-3.77; p = 0.027), although multivariate analysis did not show significance (HR 2.07; 95% CI, 0.93-4.61; p = 0.074). In the PFS analysis, PTCL-GATA3 was an independent prognostic factor by univariate analysis (HR 1.96; 95% CI, 1.08-3.56; p = 0.027) and multivariate analysis (HR 2.34; 95% CI, 1.07-5.11; p = 0.032). CONCLUSION The classification of PTCL-NOS into PTCL-TBX21 and PTCL-GATA3 is useful for predicting the prognosis of Japanese patients and stratifying the administration of tumor immune checkpoint inhibitors in clinical practice.
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Affiliation(s)
- Yasumasa Shimasaki
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
- Department of HematologyShimane University HospitalIzumoJapan
| | - Hiroaki Miyoshi
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Keisuke Kawamoto
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
- Department of Hematology, Endocrinology, and Metabolism, Faculty of MedicineNiigata UniversityNiigataJapan
| | - Noriaki Yoshida
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
- Department of Clinical StudiesRadiation Effects Research FoundationHiroshimaJapan
| | - Tatsuzo Mishina
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
- Department of HematologyChiba University HospitalChibaJapan
| | | | - Teppei Imamoto
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
- Department of Surgical PathologyHokkaido University HospitalSapporoJapan
| | - Takeshi Sugio
- Department of Medicine and Biosystemic Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Eriko Yanagida
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Takeharu Kato
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine UnitNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Kyohei Yamada
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Mai Takeuchi
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Takaharu Suzuki
- Department of Hematology, Endocrinology, and Metabolism, Faculty of MedicineNiigata UniversityNiigataJapan
| | - Mayuko Moritsubo
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Takuya Furuta
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
| | - Yoshitaka Imaizumi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine UnitNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Jun Takizawa
- Department of Hematology, Endocrinology, and Metabolism, Faculty of MedicineNiigata UniversityNiigataJapan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | | | - Ritsuro Suzuki
- Department of HematologyShimane University HospitalIzumoJapan
| | - Koichi Ohshima
- Department of Pathology, School of MedicineKurume UniversityKurumeJapan
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11
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kawaji K, Kurata S, Matsuo K, Miyoshi H, Akiba J, Mouri F, Sumi A, Fujimoto K, Abe T. 18F-FDG PET/CT imaging of IgG4-producing MALT lymphoma with multiple site involvement. Asia Ocean J Nucl Med Biol 2024; 12:52-56. [PMID: 38164235 PMCID: PMC10757051 DOI: 10.22038/aojnmb.2023.73477.1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/07/2023] [Accepted: 10/04/2023] [Indexed: 01/03/2024]
Abstract
18F-FDG PET/CT is regarded as a modality utilized for the purpose of lesion localization, staging and assessment of treatment response in patients with lymphoma. However, it is difficult that we diagnose among multifocal lymphoma, IgG4-related disease (IgG4-RD), or a combination of both conditions when confronted with multiple sites of 18F-FDG uptake with heightened serum IgG4 levels. We present a case of a 72-year-old male who was suspected of Sjögren's syndrome based on symptoms of xerostomia accompanied by swelling of the bilateral upper eyelid and salivary glands. Following a diagnostic biopsy that revealed mucosa-associated lymphoid tissue (MALT) lymphoma as a possible finding, 18F-FDG PET/CT was conducted, which demonstrated multiple sites of 18F-FDG accumulation. While multifocal MALT lymphoma was initially suspected, the coexistence of IgG4-RD could not be definitively ruled out due to the elevated serum IgG4 levels. Subsequent histopathological and immunohistochemical examinations confirmed the diagnosis of IgG4-producing MALT lymphoma. After receiving systemic therapy with rituximab, the swelling of the bilateral upper eyelid and parotid glands resolved upon visual examination, and the serum IgG4 levels returned to within the normal range in a few months. No new lesions were detected during the subsequent follow-up examinations conducted over a period of 3 years.
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Affiliation(s)
- Kodai kawaji
- Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
| | - Seiji Kurata
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Katsuhisa Matsuo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Fumihiko Mouri
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Japan
| | - Akiko Sumi
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
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12
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Miki A, Tani M, Tsutsui K, Wakita T, Horibe Y, Kakuta Y, Tsutahara K, Ishiko J, Yamada K, Miyoshi H, Ohshima K, Takao T. Primary renal peripheral T-cell lymphoma, not otherwise specified, treated with partial nephrectomy. IJU Case Rep 2024; 7:11-13. [PMID: 38173457 PMCID: PMC10758893 DOI: 10.1002/iju5.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/29/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Renal involvement by non-Hodgkin's lymphoma is very rare, and the kidney as the primary site of this lymphoma is much more uncommon. We report a case of primary renal peripheral T-cell lymphoma, not otherwise specified, treated with partial nephrectomy. Case presentation A 63-year-old man was hospitalized with coronavirus infectious disease, emerged in 2019 in the emergency department. Computed tomography examination showed a 2-cm renal mass in the right kidney. Abdominal enhanced computed tomography examination revealed that the noted mass showed good enhancement in the corticomedullary phase and washout in the nephrogenic phase. No metastatic lesions were found. He was diagnosed as having cT1aN0M0 renal cell carcinoma, and robotic-assisted partial nephrectomy was carried out. The pathological diagnosis was peripheral T-cell lymphoma, not otherwise specified. He has been followed for 20 months after robotic-assisted partial nephrectomy without additional treatment and recurrence. Conclusion We experienced a primary renal peripheral T-cell lymphoma, not otherwise specified that was followed up without treatment after surgery.
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Affiliation(s)
- Airi Miki
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | - Masaru Tani
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | - Kenji Tsutsui
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | - Teppei Wakita
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | - Yuki Horibe
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | - Yoichi Kakuta
- Department of UrologyOsaka General Medical CenterOsakaJapan
| | | | - Jun Ishiko
- Department of Hematology/OncologyOsaka General Medical CenterOsakaJapan
| | - Kyohei Yamada
- Department of PathologyKurume University School of MedicineKurumeJapan
| | - Hiroaki Miyoshi
- Department of PathologyKurume University School of MedicineKurumeJapan
| | - Koichi Ohshima
- Department of PathologyKurume University School of MedicineKurumeJapan
| | - Tetsuya Takao
- Department of UrologyOsaka General Medical CenterOsakaJapan
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13
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Takeuchi M, Miyoshi H, Semba Y, Yamada K, Nakashima K, Sato K, Furuta T, Moritsubo M, Ogura Y, Tanaka K, Imamoto T, Arakawa F, Kohno K, Ohshima K. Co-stimulatory and immune checkpoint molecules are important in the tumor microenvironment of Hodgkin-like adult T-cell leukemia/lymphoma. Haematologica 2023; 108:3496-3501. [PMID: 37439334 PMCID: PMC10690911 DOI: 10.3324/haematol.2023.283163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023] Open
Abstract
Not available.
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Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Yuichiro Semba
- Department of Medicine and Biosystemic Science, Kyusyu University Faculty of Medicine, Fukuoka city, Fukuoka
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Yusuke Ogura
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume city, Fukuoka.
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14
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Tanaka K, Miyoshi H, Yamashita Y, Iwamoto R, Yokoya Y, Tochino Y, Arakawa F, Tamura S, Murata SI, Sonoki T, Ohshima K. Angioimmunoblastic T-Cell Lymphoma after Treatment of Classic Hodgkin Lymphoma: A Case Report. Hematol Rep 2023; 15:662-669. [PMID: 38132275 PMCID: PMC10742454 DOI: 10.3390/hematolrep15040067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/30/2023] [Accepted: 11/13/2023] [Indexed: 12/23/2023] Open
Abstract
We report a case of a 24-year-old man who developed angioimmunoblastic T-cell lymphoma (AITL) after treatment for refractory lymphocyte-rich classic Hodgkin lymphoma (LR-CHL). This patient was treated with the BV+AVD (brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine) protocol for LR-CHL but progressed before completing chemotherapy. The pathological imaging showed the typical findings of LR-CHL at the first onset and first progression. Rescue chemotherapy and high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation (AHSCT) were performed for refractory LR-CHL, and complete remission was achieved. However, the recurrence was suspected 6 months after AHSCT. The pathological findings of the lymph node biopsy at this time were different from those of the previous two lymph node biopsies, demonstrating findings of AITL. The finding of the immunohistochemical staining and polymerase chain reaction results supported the diagnosis. Although it has been reported that the risk for the development of non-Hodgkin lymphoma after treatment for Hodgkin lymphoma is increased, most are B-cell lymphomas, and few cases of AITL have been reported. AITL is a type of peripheral T-cell lymphoma that generally occurs in middle-aged and elderly people and that rarely occurs in young people. Here, we were able to make an accurate diagnosis by performing re-examination even when recurrence of LR-CHL was suspected. As there are no detailed case reports of AITL developing into secondary non-Hodgkin lymphoma, here we report on an identified case.
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Affiliation(s)
- Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume 8300011, Japan; (K.T.); (F.A.); (K.O.)
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume 8300011, Japan; (K.T.); (F.A.); (K.O.)
| | - Yusuke Yamashita
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Ryuta Iwamoto
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama 6418509, Japan; (R.I.); (S.-I.M.)
| | - Yuma Yokoya
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Yuichi Tochino
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Kurume 8300011, Japan; (K.T.); (F.A.); (K.O.)
| | - Shinobu Tamura
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Shin-Ichi Murata
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama 6418509, Japan; (R.I.); (S.-I.M.)
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan; (Y.Y.); (Y.Y.); (Y.T.); (S.T.); (T.S.)
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume 8300011, Japan; (K.T.); (F.A.); (K.O.)
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15
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Toyoda K, Yasunaga JI, Shichijo T, Arima Y, Tsujita K, Tanaka A, Salah T, Zhang W, Hussein O, Sonoda M, Watanabe M, Kurita D, Nakashima K, Yamada K, Miyoshi H, Ohshima K, Matsuoka M. HTLV-1 bZIP Factor-Induced Reprogramming of Lactate Metabolism and Epigenetic Status Promote Leukemic Cell Expansion. Blood Cancer Discov 2023; 4:374-393. [PMID: 37162520 PMCID: PMC10473166 DOI: 10.1158/2643-3230.bcd-22-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/17/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
Acceleration of glycolysis is a common trait of cancer. A key metabolite, lactate, is typically secreted from cancer cells because its accumulation is toxic. Here, we report that a viral oncogene, HTLV-1 bZIP factor (HBZ), bimodally upregulates TAp73 to promote lactate excretion from adult T-cell leukemia-lymphoma (ATL) cells. HBZ protein binds to EZH2 and reduces its occupancy of the TAp73 promoter. Meanwhile, HBZ RNA activates TAp73 transcription via the BATF3-IRF4 machinery. TAp73 upregulates the lactate transporters MCT1 and MCT4. Inactivation of TAp73 leads to intracellular accumulation of lactate, inducing cell death in ATL cells. Furthermore, TAp73 knockout diminishes the development of inflammation in HBZ-transgenic mice. An MCT1/4 inhibitor, syrosingopine, decreases the growth of ATL cells in vitro and in vivo. MCT1/4 expression is positively correlated with TAp73 in many cancers, and MCT1/4 upregulation is associated with dismal prognosis. Activation of the TAp73-MCT1/4 pathway could be a common mechanism contributing to cancer metabolism. SIGNIFICANCE An antisense gene encoded in HTLV-1, HBZ, reprograms lactate metabolism and epigenetic modification by inducing TAp73 in virus-positive leukemic cells. A positive correlation between TAp73 and its target genes is also observed in many other cancer cells, suggesting that this is a common mechanism for cellular oncogenesis. This article is featured in Selected Articles from This Issue, p. 337.
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Affiliation(s)
- Kosuke Toyoda
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Jun-ichirou Yasunaga
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takafumi Shichijo
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuichiro Arima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- International Research Center for Medical Sciences (IRCMS), Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Center for Metabolic Regulation of Healthy Aging (CMHA), Kumamoto University, Kumamoto, Japan
| | - Azusa Tanaka
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tarig Salah
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Wenyi Zhang
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Osama Hussein
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Miyu Sonoda
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Miho Watanabe
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Daisuke Kurita
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Masao Matsuoka
- Department of Hematology, Rheumatology, and Infectious Disease, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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16
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Furuta T, Negoto T, Miyoshi H, Moritsubo M, Nakamura H, Morioka M, Akiba J, Ohshima K, Sugita Y. Intratumoral thrombosis as a histological biomarker for predicting epidermal growth factor receptor alteration and poor prognosis in patients with glioblastomas. J Neurooncol 2023; 164:633-641. [PMID: 37710025 DOI: 10.1007/s11060-023-04447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE Intratumoral thrombosis is a specific finding in glioblastomas and considered the origin of palisading necrosis. Its distribution and contribution to the glioblastoma pathophysiology and systemic thrombosis are obscure, although deep vein thrombosis is a common complication in glioblastoma cases. METHODS Clinicopathological and genetic analyses were performed on 97 glioblastoma tissue specimens to elucidate the role of thrombotic events and associated molecular abnormalities. RESULTS Morphologically, intratumoral thrombosis was observed more frequently in vessels composed of single-layered CD34-positive endothelium and/or αSMA-positive pericytes in the tumor periphery, compared to microvascular proliferation with multi-channeled and pericyte-proliferating vessels in the tumor center. Intratumoral thrombosis was significantly correlated with the female sex, high preoperative D-dimer levels, and epidermal growth factor receptor (EGFR) amplification. The presence of one or more thrombi in 20 high-power fields was a predictive marker of EGFR amplification, with a sensitivity of 81.5% and specificity of 52.6%. RNA sequencing demonstrated that the group with many thrombi had higher EGFR gene expression levels than the group with few thrombi. The tumor cells invading along the vessels in the tumor periphery were positive for wild-type EGFR but negative for EGFRvIII, whereas the cells around the microvascular proliferation (MVP) in the tumor center were positive for both wild-type EGFR and EGFRvIII. Intratumoral thrombosis is an independent poor prognostic factor. CONCLUSIONS Aberrant but exquisitely regulated EGFR can induce thrombosis in non-MVP vessels in the tumor invasion area and then promote palisading necrosis, followed by hypoxia, abnormal angiogenesis, and further tumor cell invasion.
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Affiliation(s)
- Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sugita
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
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17
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Takeuchi M, Miyoshi H, Semba Y, Yamada K, Nakashima K, Sato K, Furuta T, Moritsubo M, Ogura Y, Tanaka K, Imamoto T, Arakawa F, Kohno K, Ohshima K. Digital spatial profiling of CD4 + T cells in classic Hodgkin lymphoma. Virchows Arch 2023; 483:255-260. [PMID: 37270432 DOI: 10.1007/s00428-023-03562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/06/2023] [Accepted: 05/13/2023] [Indexed: 06/05/2023]
Abstract
Classic Hodgkin lymphoma (CHL) harbors a small number of Hodgkin-Reed-Sternberg (HRS) cells scattered among numerous lymphocytes. HRS cells are surrounded by distinct CD4+ T cells in a rosette-like manner. These CD4+ T cell rosettes play an important role in the tumor microenvironment (TME) of CHL. To elucidate the interaction between HRS cells and CD4+ T cell rosettes, we completed digital spatial profiling to compare the gene expression profiles of CD4+ T cell rosettes and other CD4+ T cells separated from the HRS cells. Immune checkpoint molecules including OX40, programed cell death-1 (PD-1), and cytotoxic T lymphocyte associated protein 4 (CTLA-4) expression was higher in CD4+ T cell rosettes compared to other CD4+ T cells. Immunohistochemistry confirmed variable PD-1, CTLA-4, and OX40 expression in the CD4+ T cell rosettes. This study introduced a new pathological approach to study the CHL TME, and provided deeper insight into CD4+ T cells in CHL.
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Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Yuichiro Semba
- Department of Medicine and Biosystemic Science, Kyusyu University Faculty of Medicine, Fukuoka City, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Yusuke Ogura
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume City, Fukuoka, Japan.
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18
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Hashimoto N, Takagi Y, Masuda H, Miyoshi H, Kohno K, Nagaishi M, Sato K, Takeuchi M, Furuta T, Kawamoto K, Yamada K, Moritsubo M, Inoue K, Shimasaki Y, Ogura Y, Imamoto T, Mishina T, Tanaka K, Kawaguchi Y, Nakamura S, Ohshima K, Hontani H, Takeuchi I. Case-based similar image retrieval for weakly annotated large histopathological images of malignant lymphoma using deep metric learning. Med Image Anal 2023; 85:102752. [PMID: 36716701 DOI: 10.1016/j.media.2023.102752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
In the present study, we propose a novel case-based similar image retrieval (SIR) method for hematoxylin and eosin (H&E) stained histopathological images of malignant lymphoma. When a whole slide image (WSI) is used as an input query, it is desirable to be able to retrieve similar cases by focusing on image patches in pathologically important regions such as tumor cells. To address this problem, we employ attention-based multiple instance learning, which enables us to focus on tumor-specific regions when the similarity between cases is computed. Moreover, we employ contrastive distance metric learning to incorporate immunohistochemical (IHC) staining patterns as useful supervised information for defining appropriate similarity between heterogeneous malignant lymphoma cases. In the experiment with 249 malignant lymphoma patients, we confirmed that the proposed method exhibited higher evaluation measures than the baseline case-based SIR methods. Furthermore, the subjective evaluation by pathologists revealed that our similarity measure using IHC staining patterns is appropriate for representing the similarity of H&E stained tissue images for malignant lymphoma.
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Affiliation(s)
- Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Yusuke Takagi
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Hiroki Masuda
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Miharu Nagaishi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Keisuke Kawamoto
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kanako Inoue
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yusuke Ogura
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Tatsuzo Mishina
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yoshino Kawaguchi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan.
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19
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Kameda T, Kataoka K, Kamiunten A, Hidaka M, Miyoshi H, Nakano N, Nosaka K, Yoshimitsu M, Yasunaga JI, Kogure Y, Shide K, Miyahara M, Sakamoto T, Akizuki K, Hidaka T, Kubuki Y, Koya J, Kawano N, Yamashita K, Kawano H, Toyama T, Maeda K, Marutsuka K, Imaizumi Y, Kato K, Sugio T, Tokunaga M, Tashiro Y, Takaori-Kondo A, Miyazaki Y, Akashi K, Ishitsuka K, Matsuoka M, Ohshima K, Watanabe T, Kitanaka A, Utsunomiya A, Ogawa S, Shimoda K. Integrated genetic and clinical prognostic factors for aggressive adult T-cell leukemia/lymphoma. Haematologica 2023. [PMID: 36794502 PMCID: PMC10388278 DOI: 10.3324/haematol.2022.281510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Indexed: 02/17/2023] Open
Abstract
The prognosis of aggressive adult T-cell leukemia/lymphoma (ATL) is poor, and allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is a curative treatment. To identify favorable prognostic patients after intensive chemotherapy, and who therefore might not require upfront allo-HSCT, we aimed to improve risk stratification of aggressive ATL patients aged.
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Affiliation(s)
- Takuro Kameda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - Keisuke Kataoka
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan; Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo
| | - Ayako Kamiunten
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - Michihiro Hidaka
- National Hospital Organization Kumamoto Medical Center, Kumamoto
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima
| | - Kisato Nosaka
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine, Kumamoto
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima
| | - Jun-Ichirou Yasunaga
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine, Kumamoto, Japan; Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto
| | - Yasunori Kogure
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo
| | - Kotaro Shide
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | | | - Takashi Sakamoto
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Keiichi Akizuki
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - Tomonori Hidaka
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - Yoko Kubuki
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - Junji Koya
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo
| | - Noriaki Kawano
- Department of Internal medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki
| | - Kiyoshi Yamashita
- Department of Internal medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki
| | - Hiroshi Kawano
- Department of Internal medicine, Koga General Hospital, Miyazaki
| | - Takanori Toyama
- Department of Internal medicine, Miyazaki Prefectural Nobeoka Hospital, Miyazaki
| | - Kouichi Maeda
- National Hospital Organization Miyakonojo Medical center, Miyazaki
| | - Kosuke Marutsuka
- Department of Anatomic Pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki
| | - Yoshitaka Imaizumi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka
| | - Takeshi Sugio
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka
| | | | - Yukie Tashiro
- Department of Pathology, Imamura General Hospital, Kagoshima
| | - Akifumi Takaori-Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka
| | - Kenji Ishitsuka
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima
| | - Masao Matsuoka
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University of Medicine, Kumamoto
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume
| | - Toshiki Watanabe
- Department of Practical Management of Medical Information, St Marianna University, Graduate School of Medicine, Tokyo
| | - Akira Kitanaka
- Department of Laboratory Medicine, Kawasaki Medical School, Kurashiki
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Kazuya Shimoda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki.
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20
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Yanagida E, Kubota A, Miyoshi H, Ohshima K, Kawakita T, Murayama T. The case of T-ALL presenting with NK phenotype after COVID-19 vaccination. Pathol Res Pract 2023; 242:154310. [PMID: 36706586 PMCID: PMC9840814 DOI: 10.1016/j.prp.2023.154310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/09/2023] [Accepted: 01/14/2023] [Indexed: 01/16/2023]
Abstract
NK-lymphoblastic leukemia/lymphoma (NK-LL) is an extremely rare hematopoietic tumor consisting of natural killer (NK) precursor cells, and their lineage overlaps with T-cells, making it challenging to diagnose. COVID-19 vaccination is recommended for people with a risk of aggravation such as cancer-bearing patients, including hematopoietic tumors. We present a 55-year-old man who had cervical lymph node swelling post vaccination for COVID-19. Hematological malignancy was suspected due to the presence of atypical lymphoid cells with an elevated IL-2R in laboratory data. Tumor cells were positive for CD7, CD56, cyCD3, and terminal deoxynucleotidyl transferase (TdT) evidenced through flow cytometry of the bone marrow and the lymph node. The histopathological findings showed monotonous tumor cell proliferation, the cells being positive for CD3 and TdT in the bone marrow and they were positive for CD3, TdT, and CD56 in lymph node. Even though these findings suggested NK-LL, clonal T-cell receptor (TCR) β gene rearrangement by Southern blot hybridization was observed in the bone marrow. TCRβ rearrangement led to the final diagnosis of T-cell lymphoblastic leukemia (T-ALL). The causal relationship between COVID-19 vaccination and carcinogenesis is not clear, and more cases need to be studied in order to elucidate the relationship between the two factors.
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Affiliation(s)
- Eriko Yanagida
- Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan; Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Akira Kubota
- Department of Hematology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Toshihiko Murayama
- Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
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21
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Takagi Y, Hashimoto N, Masuda H, Miyoshi H, Ohshima K, Hontani H, Takeuchi I. Transformer-based personalized attention mechanism for medical images with clinical records. J Pathol Inform 2023; 14:100185. [PMID: 36691660 PMCID: PMC9860154 DOI: 10.1016/j.jpi.2022.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/10/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
In medical image diagnosis, identifying the attention region, i.e., the region of interest for which the diagnosis is made, is an important task. Various methods have been developed to automatically identify target regions from given medical images. However, in actual medical practice, the diagnosis is made based on both the images and various clinical records. Consequently, pathologists examine medical images with prior knowledge of the patients and the attention regions may change depending on the clinical records. In this study, we propose a method, called the Personalized Attention Mechanism (PersAM) method, by which the attention regions in medical images according to the clinical records. The primary idea underlying the PersAM method is the encoding of the relationships between medical images and clinical records using a variant of the Transformer architecture. To demonstrate the effectiveness of the PersAM method, we applied it to a large-scale digital pathology problem involving identifying the subtypes of 842 malignant lymphoma patients based on their gigapixel whole-slide images and clinical records.
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Affiliation(s)
- Yusuke Takagi
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 1030027, Japan
| | - Hiroki Masuda
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 8300011, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 8300011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 1030027, Japan,Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 4648603, Japan,Corresponding author.
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22
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Kato T, Imaizumi Y, Itonaga H, Sato S, Ando K, Sawayama Y, Ichinose K, Miyoshi H, Ohshima K, Miyazaki Y. [Methotrexate-related lymphoproliferative disease showing different histological findings at recurrence]. Rinsho Ketsueki 2023; 64:97-101. [PMID: 36990739 DOI: 10.11406/rinketsu.64.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
A 55-year old female patient was treated with methotrexate (MTX) and infliximab (IFX) for rheumatoid arthritis (RA). She experienced unknown fever, generalized lymphadenopathy, and liver tumors. Histological examination of the inguinal lymph node and a liver tumor resulted in the pathological diagnosis of classic Hodgkin lymphoma, with many Reed-Sternberg cells with the positivity of Epstein-Barr virus (EBV). She was diagnosed with MTX-related lymphoproliferative disorders (MTX-LPDs). She received chemotherapy after the cessation of MTX and IFX and achieved complete remission. RA showed recurrence after a while, and she was treated with steroids or other drugs. Six years after the chemotherapy, she experienced low-grade fever and anorexia. Whole computed tomography images showed an appendix tumor and enlargement of the surrounding lymph nodes. Appendectomy with the radical lymph nodes dissection was performed. The pathological diagnosis was diffuse large B-cell lymphoma, resulting in the clinical diagnosis of the relapse of MTX-LPD. EBV was negative at this point. The pathological findings of MTX-LPD may change at relapse; thus, biopsy should be considered when the relapse of MTX-LPD is suggested.
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Affiliation(s)
- Takeharu Kato
- Department of Hematology, Nagasaki University Hospital
| | | | | | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital
| | - Koji Ando
- Department of Hematology, Nagasaki University Hospital
| | | | | | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine
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23
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Nishimura K, Miyazaki K, Suzuki K, Hachiya K, Tono Y, Tamaru S, Imai H, Miyoshi H, Ohshima K, Okugawa Y, Tawara I, Yamaguchi M. Combined use of pathological and genomic alteration analyses for the diagnosis of gray zone lymphoma. J Clin Exp Hematop 2022; 62:253-257. [PMID: 36575002 PMCID: PMC9898712 DOI: 10.3960/jslrt.22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare malignancy showing morphologic and immunophenotypic features of histiocytes. HS has morphologic overlap with many other diseases, including various kinds of lymphomas. Gray zone lymphoma (GZL) is a rare B-cell lymphoma subtype characterized by overlapping features between diffuse large B-cell lymphoma and classic Hodgkin lymphoma. The histologic overlap with other diverse diseases of HS and the pathological diversity of GZL make it difficult to render a diagnosis. A 44-year-old woman who was initially diagnosed with HS was diagnosed with GZL after reexamination, including a genetic alteration test. After 6 cycles of brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine, she achieved a complete response. Genomic alteration assessment may be useful for the accurate diagnosis of malignant lymphomas, which are difficult to diagnose, such as GZL.
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Affiliation(s)
- Komei Nishimura
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kazutaka Suzuki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kensuke Hachiya
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yasutaka Tono
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Satoshi Tamaru
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Imai
- Pathology Division, Mie University Hospital, Tsu, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | | | - Isao Tawara
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoko Yamaguchi
- Department of Hematological Malignancies, Mie University Graduate School of Medicine, Tsu, Japan
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24
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Yanagida E, Miyoshi H, Takeuchi M, Shimono J, Nakashima K, Yamada K, Kawamoto K, Moritsubo M, Shimasaki Y, Inoue K, Imamoto T, Furuta T, Kohno K, Ohshima K. Clinicopathological analysis of immunohistochemical expression of immune checkpoint molecules in follicular lymphoma. Hematol Oncol 2022; 40:530-540. [PMID: 35122292 DOI: 10.1002/hon.2972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/23/2021] [Accepted: 01/19/2022] [Indexed: 11/06/2022]
Abstract
Follicular lymphoma (FL) is characterized by an indolent clinical course and a high relapse rate, and often exhibits a diffuse pattern beyond the follicular area. Our group previously reported that immune checkpoint (ICP) pathways, such as programmed cell death (PD-1) and programmed death ligand 1 (PD-L1), are poor prognostic factors for diffuse large B-cell lymphoma and adult T-cell leukemia/lymphoma.In this study, the association between the expression of multiple ICP molecules according to immunohistochemistry and clinicopathological features in FL was determined via immunostaining of 173 biopsy samples. Membrane and/or cytoplasm expression of CD86 (nCD86) and PD-L1 (nPD-L1) was found in tumor cells, whereas PD-1 (miPD-1), Galectin-9 (miGalectin-9), OX40 (miOX40), CTLA-4 (miCTLA-4), Tim-3 (miTim-3), OX40L (miOX40L), and LAG-3 (miLAG-3) were expressed in non-neoplastic stromal cells. MiPD-1 expression was significantly higher in the follicular area than in the diffuse area (p=0.0450). Expression of miOX40 and miCTLA-4 was significantly higher in the diffuse area than in the follicular area (respectively, p=0.0053 and p=0.0092). MiTim-3 tended to be higher in the diffuse area than in the follicular area (p=0.0616). MiTim-3 was significantly higher in relapse cases than in new-onset cases (p=0.0440); miLAG-3 tended to be higher in relapse cases than in new-onset cases (p=0.0622, not significant). The miOX40L-high FL group had a significantly worse overall survival than the miOX40L-low group (p=0.0320).The expression of multiple ICP molecules on several cells reflects activated anti-tumor immunity and the unique FL microenvironment. Further studies on gene expression or genomic abnormalities will reveal the clinical and biological significance of ICP molecules in FL. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Eriko Yanagida
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Joji Shimono
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Keisuke Kawamoto
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kanako Inoue
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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25
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Hori Y, Yamamoto H, Kawatoko S, Nozaki Y, Torisu T, Kato K, Koga Y, Miyoshi H, Ohshima K, Tateishi Y, Nakamura S, Kitazono T, Oda Y. Lymphoid and myeloid proliferative disorders associated with inflammatory bowel disease: A clinicopathological study of 15 cases. Hum Pathol 2022; 120:88-98. [PMID: 34990621 DOI: 10.1016/j.humpath.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/22/2021] [Indexed: 11/19/2022]
Abstract
Lymphoproliferative disorder (LPD) can occur in patients with inflammatory bowel disease (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). On rare occasion, patients with IBD develop myeloid neoplasms; however, the frequency and clinicopathological features of IBD-associated lymphoid and myeloid proliferative disorder (LMPD) in Japanese patients is still unclear. In this study, we reviewed 2474 Japanese patients with IBD, and found that LMPD occurred in 12 (0.5%) patients with UC (n=7) or CD (n=5). Together with an additional 3 cases, we analyzed a total of 15 cases of LMPD for clinicopathological and histological features. Based on the status of using immunosuppressants such as biologics and immunomodulators, Epstein-Barr virus (EBV) infection, and histopathology, the 15 cases were classified into the Group I (high-grade LPD; n=7), Group II (low-grade LPD; n=5), and Group III (myeloid neoplasms; n=3). Most patients in Group I were undergoing strong immunosuppressive therapy, and the LPD lesions corresponded to high-grade B-cell or T/NK-cell lymphoma often with EBV infection. Discontinuation of immunosuppressive drugs alone did not resolve these LPDs; Group I patients required chemotherapy, and eventually 4 of them (57%) died of the tumor. Most cases in Group II were low-grade B-cell lymphoma without EBV infection and had an indolent clinical course with excellent prognosis. All patients in Group III developed acute myeloid leukemia (AML) during the course of CD. Two (67%) of these patients died of AML. Our study suggests that IBD-associated LMPD is very rare, but can follow an aggressive clinical course.
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Affiliation(s)
- Yoshifumi Hori
- Department of Anatomic Pathology, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan.
| | - Shinichiro Kawatoko
- Department of Anatomic Pathology, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Yui Nozaki
- Department of Anatomic Pathology, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Takehiro Torisu
- Department of Medicine and Clinical Science, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Yuhki Koga
- Department of Pediatrics, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 830-0011, Kurume, Japan
| | - Yuki Tateishi
- Department of Pathology, Japan Community Health Care Organization (JCHO), Kyushu Hospital, 806-8501, Kitakyushu, Japan
| | - Shotaro Nakamura
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 028-3695, Morioka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Kyushu University Graduate School of Medicine Sciences, 812-8582, Fukuoka, Japan
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26
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Fujiwara T, Miyoshi H, Mitsuya Y, Yamada NL, Wakabayashi Y, Otake Y, Hino M, Kino K, Tanaka M, Oshima N, Takahashi H. Neutron flat-panel detector using In-Ga-Zn-O thin-film transistor. Rev Sci Instrum 2022; 93:013304. [PMID: 35104992 DOI: 10.1063/5.0066557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
Neutron imaging is a powerful tool for observing the internal structure of an object without destroying the object. Neutron imaging (neutron radiography) is a prominent application of neutrons but still requires significant improvements, for example, in sensitivity, resolution, radiation hardness, and handling of neutron imaging detectors. This paper presents the development and the first neutron imaging results of a neutron flat-panel detector (nFPD) based on an In-Ga-Zn-O (IGZO) thin-film transistor (TFT)/photodiode array coupled with a LiF/ZnS scintillator sheet. Direct photo-coupling to the scintillator increases the light collection efficiency. Moreover, unlike lens-coupled neutron cameras, the proposed detector is compact and easy to handle. Owing to the high off-state resistance of IGZO TFTs, their leakage current is lower than that of conventional TFTs, enabling the IGZO TFTs to hold an accumulated charge for a longer period of time and allowing longer exposure times for imaging. This would be a powerful feature for imaging at compact neutron sources with limited flux. This paper reports on the first neutron imaging results with an IGZO nFPD, its performance evaluation, and a demonstration of three-dimensional computed tomography with neutrons.
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Affiliation(s)
- Takeshi Fujiwara
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568, Japan
| | | | - Yuki Mitsuya
- Institute of Engineering Innovation, School of Engineering, The University of Tokyo, Bunkyo, Tokyo 113-8656, Japan
| | - Norifumi L Yamada
- Institute of Material Structure Science, High Energy Accelerator Research Organization (KEK), Tokai, Ibaraki 319-1106, Japan
| | - Yasuo Wakabayashi
- RIKEN Center for Advanced Photonics, Neutron Beam Technology Team, RIKEN, Wako, Saitama 351-0198, Japan
| | - Yoshie Otake
- RIKEN Center for Advanced Photonics, Neutron Beam Technology Team, RIKEN, Wako, Saitama 351-0198, Japan
| | - Masahiro Hino
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
| | - Koichi Kino
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568, Japan
| | - Masahito Tanaka
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568, Japan
| | - Nagayasu Oshima
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki 305-8568, Japan
| | - Hiroyuki Takahashi
- Institute of Engineering Innovation, School of Engineering, The University of Tokyo, Bunkyo, Tokyo 113-8656, Japan
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27
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Tanaka Y, Mishina T, Miyoshi H, Ohshima K, Nohgawa M. Intestinal T-Cell Lymphoma With Lung and Lymph Node Involvement at Relapse. J Med Cases 2022; 13:15-20. [PMID: 35211230 PMCID: PMC8827255 DOI: 10.14740/jmc3830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
Patients with intestinal T-cell lymphomas (ITLs) usually present with perforation of the small intestine and colon at diagnosis. At relapse or in the advanced stage, ITLs involve in other extranodal sites, but biopsy-proven lung involvement has been rarely reported. A 76-year-old male presented with sudden-onset abdominal pain, which was found to be caused by the perforation of colon. Emergency operation was carried out, and histopathological examination of the resected colon led to the diagnosis of ITL, not otherwise specified (NOS). He achieved complete metabolic remission (CMR) after eight courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy. Two months later, computed tomography showed infiltration and ground-glass opacity in the left pulmonary area in addition to the enlargement of mediastinal and left subclavian lymph nodes, although he did not complain of any pulmonary symptoms. Histopathological findings of the biopsied samples from the pulmonary area were consistent with relapsed ITL, NOS. He achieved CMR after three courses of GDP (gemcitabine, dexamethasone, and cisplatin) chemotherapy; but 1 month after the completion of GDP chemotherapy, he relapsed again with involvement of multiple lymph nodes, not in the pulmonary area. He died owing to the progression of disease. This is the third case of ITLs with lung involvement. Active biopsy should be performed when pulmonary nodules, infiltration, or ground-glass opacity are found in ITLs. A regimen for salvage chemotherapy specifically for ITLs is not yet established, and GDP chemotherapy may be an alternative option for relapsed ITLs in addition to new agents, such as romidepsin and pralatrexate.
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Affiliation(s)
- Yasuhiro Tanaka
- Department of Hematology, Japanese Red Cross Wakayama Medical Center, Komatsubaradori 4-20, Wakayama City, Wakayama 640-8558, Japan,Corresponding Author: Yasuhiro Tanaka, Department of Hematology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubaradori, Wakayama City, Wakayama 640-8558, Japan.
| | - Tatsuzo Mishina
- Department of Pathology, School of Medicine, Kurume University, Asashimachi 67, Kurume City, Fukuoka 830-0011, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Asashimachi 67, Kurume City, Fukuoka 830-0011, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Asashimachi 67, Kurume City, Fukuoka 830-0011, Japan
| | - Masaharu Nohgawa
- Department of Hematology, Japanese Red Cross Wakayama Medical Center, Komatsubaradori 4-20, Wakayama City, Wakayama 640-8558, Japan
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28
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Arakawa F, Miyoshi H, Yoshida N, Nakashima K, Watatani Y, Furuta T, Yamada K, Moritsubo M, Takeuchi M, Yanagida E, Shimasaki Y, Kohno K, Kataoka K, Ohshima K. Expression of telomerase reverse transcriptase in peripheral T-cell lymphoma. Cancer Med 2021; 10:6786-6794. [PMID: 34477310 PMCID: PMC8495278 DOI: 10.1002/cam4.4200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/17/2021] [Accepted: 07/31/2021] [Indexed: 12/15/2022] Open
Abstract
Telomere length is maintained by the activation of telomerase, which causes continuous cell division and proliferation in many carcinomas. A catalytic reverse transcriptase protein (TERT) encoded by the TERT gene plays a critical role in the activation of telomerase. We performed a molecular and pathological analysis of the TERT against three different peripheral T‐cell lymphoma (PTCL) subtypes: PTCL, not otherwise specified (PTCL‐NOS), angioimmunoblastic T‐cell lymphoma (AITL), and adult T‐cell leukemia/lymphoma (ATLL). Immunohistochemical analysis demonstrated TERT expression in 31% of AITL, 11% of PTCL‐NOS, and 5% of ATLL. Among them, AITL frequently showed high TERT expression with statistical significance. TERT promoter mutation analysis and genomic copy number evaluation were performed. TERT promoter mutation was observed in two cases of PTCL‐NOS (2/40) and not in other PTCLs. Genome copy number amplification was detected in 33% of PTCL‐NOS, 33% of AITL, and 50% of ATLL cases. We evaluated the relationship between the analyzed TERT genomic abnormalities and protein expression; however, no apparent relationship was observed. Furthermore, immunostaining showed TERT expression in the PTCL cytoplasm, suggesting the existence of mechanisms other than the maintenance of telomere length. Statistical analysis of the effect of TERT expression on the prognosis in PTCL cases revealed that TERT expression tended to have a poor prognosis in PTCL‐NOS. Since TERT expression was not an independent factor in multivariate analysis, further research will be needed to clarify the poor prognosis of PTCL‐NOS in TERT expression.
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Affiliation(s)
- Fumiko Arakawa
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Noriaki Yoshida
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.,Department of Clinical Studies, Radiation Effects Research Foundation Hiroshima Laboratory, Hiroshima, Japan
| | - Kazutaka Nakashima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Yosaku Watatani
- Departments of Hematology and Rheumatology, Faculty of Medicine, Kindai University Hospital, Osaka, Japan
| | - Takuya Furuta
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Eriko Yanagida
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kei Kohno
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Keisuke Kataoka
- Division of Hematology Department of Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
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29
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Muto R, Kawakita T, Miyoshi H, Arakawa F, Nakashima K, Ohshima K, Murayama T. The first case of methotrexate-associated lymphoproliferative disorder presenting as follicular T-cell lymphoma. Pathol Int 2021; 71:765-770. [PMID: 34473863 DOI: 10.1111/pin.13155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
This is the first case of follicular T-cell lymphoma (FTCL) presenting as methotrexate-associated lymphoproliferative disorders (MTX-LPDs). A 69-year-old man treated rheumatoid arthritis with methotrexate presented with cervical swelling, hoarseness and fever. Imaging studies revealed multiple lymphadenopathy and lymphoma was suspected. Lymph node biopsy was performed to confirm the diagnosis. Pathologically, the lymph node was composed of atypical lymphocytes with a follicular growth pattern and area of necrosis. Immunohistochemical examination showed the atypical lymphocytes were positive for CD3, CD4, programmed cell death protein 1, and inducible T-cell co-stimulator. These findings are consistent with FTCL. During hospitalization, the patient's fever subsided and cervical lymphadenopathy improved, probably due to discontinuation of MTX. Here we presented the first case of FTCL presenting as MTX-LPDs. The T-cell phenotype MTX-LPDs are relatively rare and accounts for only 3.4%-6.3% of all MTX-LPD cases. Therefore, detailed clinicopathological features have not been clarified sufficiently. It is hoped that similar cases should be accumulated and studied to better understand the clinical and pathological features of this condition.
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Affiliation(s)
- Reiji Muto
- Department of Pathology, Fukuoka University School of Medicine, Fukuoka, Japan.,Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.,Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Toshihiko Murayama
- Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
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30
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Saito H, Miyoshi H, Shibayama H, Toda J, Kusakabe S, Ichii M, Fujita J, Fukushima K, Maeda T, Mizuki M, Oritani K, Seto M, Yokota T, Kanakura Y, Hosen N, Ohshima K. High numbers of programmed cell death-1-positive tumor infiltrating lymphocytes correlate with early onset of post-transplant lymphoproliferative disorder. Int J Hematol 2021; 114:53-64. [PMID: 33765256 DOI: 10.1007/s12185-021-03129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/26/2022]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of transplantation. In addition to reactivation of Epstein-Barr virus in immunocompromised patients, impaired tumor immunity is suggested to be a risk factor for PTLD. However, it remains unclear whether immune suppressive tumor-infiltrating lymphocytes (TILs) correlate with the occurrence or prognosis of PTLD. We analyzed TILs in 26 patients with PTLD to elucidate the clinicopathological significance of the expression of PD-1 and FoxP3, which are associated with exhausted T-cells and regulatory T-cells (Tregs), respectively. Numbers of PD-1+ TILs in the PTLD specimens were significantly higher in patients who developed PTLD early after transplantation (P = 0.0040), while numbers of FoxP3+ TILs were not (P = 0.184). There was no difference in overall response rate regardless of the expression of PD-1 or FoxP3. FoxP3high patients tended to have a shorter time to progression compared with FoxP3low patients, especially in the case of FoxP3high patients with diffuse large B-cell lymphoma-subtype PTLD (P = 0.011), while PD-1high patients did not. These results suggest that T-cell exhaustion may be mainly associated with PTLD development, while immune suppression by Tregs may be dominant in enhanced progression of PTLD following disease occurrence.
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Affiliation(s)
- Hideaki Saito
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| | - Jun Toda
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shinsuke Kusakabe
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Michiko Ichii
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Jiro Fujita
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Kentaro Fukushima
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Tetsuo Maeda
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
- Department of Hematology, Suita Municipal Hospital, Osaka, Japan
| | - Masao Mizuki
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Kenji Oritani
- Department of Hematology, Graduate School of Medical Sciences, International University of Health and Welfare, Chiba, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takafumi Yokota
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
- Department of Hematology, Sumitomo Hospital, Osaka, Japan
| | - Naoki Hosen
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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31
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Harada T, Iwasaki H, Muta T, Urata S, Sakamoto A, Kohno K, Takase K, Miyamura T, Sawabe T, Asaoku H, Oryoji K, Fujisaki T, Mori Y, Yoshimoto G, Ayano M, Mitoma H, Miyamoto T, Niiro H, Yamamoto H, Oshiro Y, Miyoshi H, Ohshima K, Takeshita M, Akashi K, Kato K. Outcomes of methotrexate-associated lymphoproliferative disorders in rheumatoid arthritis patients treated with disease-modifying anti-rheumatic drugs. Br J Haematol 2021; 194:101-110. [PMID: 33822354 DOI: 10.1111/bjh.17456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/12/2021] [Indexed: 12/20/2022]
Abstract
Recently, the use of targeted synthetic or biological disease-modifying anti-rheumatic drugs (ts/bDMARDs) in addition to conventional synthetic (cs)DMARDs including methotrexate (MTX) for rheumatoid arthritis (RA) has increased. However, whether ts/bDMARDs are associated with the development and clinicopathological features of MTX-associated lymphoproliferative disorder (MTX-LPD) in patients with RA remains unknown. Therefore, we evaluated the clinical outcomes of 121 patients with MTX-LPD. Results showed that prior use of ts/bDMARDs was not associated with the different histopathological subtypes of MTX-LPD. Patients with polymorphic-type LPD had a better event-free survival than those with diffuse large B-cell lymphoma (DLBCL), classical Hodgkin lymphoma and peripheral T-cell lymphoma. The pathological subtype of lymphoma could predict the clinical outcome of MTX-LPD. In patients with DLBCL, the use of tumour necrosis factor-alpha (TNF-α) inhibitors prior to MTX-LPD onset was associated with a higher non-relapse mortality. Further, patients with RA previously treated with Janus kinase (JAK) inhibitors more commonly required chemotherapy than those treated with csDMARDs alone, indicating disease aggressiveness. Hence, special caution should be observed when managing patients with MTX-LPD previously treated with JAK or TNF-α inhibitors for RA.
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Affiliation(s)
- Takuya Harada
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.,Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Tsuyoshi Muta
- Department of Haematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Shingo Urata
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Aiko Sakamoto
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Kentaro Kohno
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Ken Takase
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Tomoya Miyamura
- Department of Internal Medicine and Rheumatology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Takuya Sawabe
- Department of Rheumatology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Hideki Asaoku
- Department of Haematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Kensuke Oryoji
- Centre for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Masahiro Ayano
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroki Mitoma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroaki Niiro
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Yumi Oshiro
- Department of Diagnostic Pathology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University Faculty of Medicine, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University Faculty of Medicine, Fukuoka, Japan
| | - Morishige Takeshita
- Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
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Mitobe M, Kawamoto K, Suzuki T, Suwabe T, Shibasaki Y, Masuko M, Inoue K, Miyoshi H, Ohshima K, Sone H, Takizawa J. DA-EPOCH-R therapy for high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements in a patient with renal dysfunction. J Clin Exp Hematop 2021; 61:42-47. [PMID: 33551436 PMCID: PMC8053571 DOI: 10.3960/jslrt.20043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements, also known as double-hit lymphoma, has been reported as refractory to R-CHOP therapy and requires more intensive regimens. However, intensive and safe regimens for patients with renal dysfunction are unknown. Herein, we report the successful use of DA-EPOCH-R therapy for double-hit lymphoma in a 64-year-old man with renal dysfunction. The patient had lymphoma-induced bilateral ureteral obstruction. Although renal dysfunction remained after removing the obstruction using R-CHOP therapy, we completed six cycles of DA-EPOCH-R therapy without any major adverse events. DA-EPOCH-R therapy may be a safe regimen for renal dysfunction patients.
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Affiliation(s)
- Masaki Mitobe
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Keisuke Kawamoto
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Takaharu Suzuki
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Tatsuya Suwabe
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Yasuhiko Shibasaki
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Masayoshi Masuko
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Kanako Inoue
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
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Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a malignancy caused by the human T-cell leukemia virus type 1. Aggressive ATLL is refractory to conventional chemotherapy and has a poor prognosis. Better therapeutic approaches, including cancer immunotherapy, are required to improve survival and prognosis. The genetic landscape of ATLL reveals frequent genetic alterations in genes associated with immune surveillance, including major histocompatibility complex (MHC) class I, CD58 antigen, and programmed cell death ligand 1. Clinicopathological investigations also revealed tumor immunity mechanisms in ATLL, including immune checkpoint molecules, MHC molecules, tumor-associated macrophages, and chemokines. However, the tumor microenvironment of ATLL remains complex because ATLL itself originates from T-cells, usually expressing regulatory T-cell markers. In this review, we discuss the recent literature describing the tumor microenvironment of ATLL.
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Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Kurume University, Kurume, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, Kurume, Fukuoka, Japan
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Abstract
Thymoma is a relatively rare malignancy, which is categorized as thymic epithelial tumor but known as the most common pathology that is developed in the anterior mediastinum. Complete resection is recommended for localized tumors and usually favorable prognosis can be obtained. However, poor survival period has been reported in unresectable cases exhibiting extensive invasion or distant metastasis, as effective chemotherapeutic regimens are restrained. We previously assessed expression of programmed death ligand 1 (PD-L1) and programmed death 1 (PD-1) and discussed their prospective application in the immunotherapy of thymic epithelial tumors. After our publication, additional studies using reliable PD-L1 antibodies, which are currently administered to predict efficacy of PD-1/PD-L1 blockade therapy were performed and further characterized PD-L1 in thymoma. Herein, recent knowledge in relation to the significance of PD-L1 expression in thymoma is reviewed based on recent findings using qualified PD-L1 clones. Most studies coherently found high expression of PD-L1 on the cell membrane and cytoplasm of tumor epithelial cells in accordance with previous reports, which is a predictive marker for effectiveness of anti-PD-1/PD-L1 drugs, even when approved PD-L1 antibodies were employed. On the other hand, PD-L1 expression on tumor infiltrating immune cells remains to be sufficiently determined. High PD-L1 expression can be expected in cases with high grade histological subtypes, such as type B2/B3 thymomas, or those with advanced stages III or IV of the disease. Interestingly, the level of PD-L1 expression was found to be upregulated after chemotherapy compared with that before, which could be explained by immunogenic cell death. The prognostic impact of PD-L1 expression in thymoma might be found only when thymic carcinoma patients were excluded. Furthermore, it also could be identified when we analyzed thymomas completely resected, distinct from biopsy and incompletely resected cases.
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Affiliation(s)
- Shintaro Yokoyama
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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Kasai S, Itonaga H, Niino D, Miyoshi H, Kato T, Imanishi D, Fujioka M, Furumoto T, Sato S, Sawayama Y, Taguchi J, Imaizumi Y, Hata T, Yoshida S, Moriuchi Y, Ohshima K, Miyazaki Y. Correction to: Programmed death 1 ligand (PD-L1) in solid cancers after allogeneic hematopoietic stem cell transplantation: a retrospective analysis by the Nagasaki Transplant Group. Int J Hematol 2020; 112:906. [PMID: 33085031 DOI: 10.1007/s12185-020-03019-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the original publication of the article, the authors would like to alter the color of characters in the Supplemental Table 1 and 2.
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Affiliation(s)
- Sachie Kasai
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan.
| | - Daisuke Niino
- Department of Pathology, Sasebo City General Hospital, Sasebo, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Daisuke Imanishi
- Department of Hematology, Nagasaki Prefecture Gotochuoh Hospital, Goto, Japan
| | - Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Takafumi Furumoto
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | | | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | | | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
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Muto R, Uemura N, Mitsui N, Arakawa F, Negishi T, Miyoshi H, Ohshima K, Murayama T. The first reported case of primary extranodal counterpart of follicular T-cell lymphoma of submandibular gland. Pathol Int 2020; 70:1027-1031. [PMID: 33048405 DOI: 10.1111/pin.13031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/02/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022]
Abstract
This is the first reported case of follicular T-cell lymphoma (FTCL) that primarily developed in the extranodal site of the right submandibular gland. An 86-year-old man was detected with a right cervical mass suspected to be malignant lymphoma during his physical examination. Imaging studies revealed that the mass was a submandibular gland tumor. The tumor was excised for diagnosis and treatment. Pathologically, the tumor was composed of densely aggregated lymphocytes with a follicular growth pattern. The immunohistochemical investigation showed that the lymphoma cells expressed CD3, CD4, programmed cell death protein 1, BCL6, chemokine (C-X-C motif) ligand 13, and BCL2. Staining of the follicular dendritic cell revealed its meshwork structure limited in the germinal center. Monoclonal rearrangement of the T-cell receptor was detected using polymerase chain reaction. These findings are consistent with the characteristics of FTCL. Here, we describe the first reported case of extranodal counterpart of FTCL of the submandibular gland. Accumulation and investigation of such extranodal cases is essential.
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Affiliation(s)
- Reiji Muto
- Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Japan.,Department of Pathology, Kurume University School of Medicine, Japan
| | - Naoki Uemura
- Department of Otolaryngology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Norikazu Mitsui
- Department of Hematology, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Takanori Negishi
- Department of Radiology, National Hospital Organization, Kumamoto medical center, Kumamoto, Japan
| | | | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Toshihiko Murayama
- Department of Pathology, National Hospital Organization, Kumamoto Medical Center, Japan
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Hashizume N, Aiko T, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Sakamoto S, Tsuruhisa S, Nakahara H, Muta H, Miyoshi H, Naito Y, Yamamoto H, Oda Y, Tanaka Y, Yagi M. Benign mesenteric lipomatous tumor in a child: a case report and literature review. Surg Case Rep 2020; 6:243. [PMID: 32997268 PMCID: PMC7527397 DOI: 10.1186/s40792-020-01020-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Lipomatous tumors are the most common type of soft-tissue tumors. Benign lipomatous tumors are lipomas and lipoblastoma. We herein report a case of benign mesenteric lipomatous tumor and the largest collection of known benign mesenteric lipomatous tumors in children in the literature. CASE PRESENTATION A 3-year-old girl presented with repeated dull abdominal pain and left abdominal mass swelling. On a physical examination, the child had a soft, moderately distended left abdomen that was not tender when palpated. Computed tomography and magnetic resonance imaging demonstrated a large fatty mass within the mesentery, measuring approximately 8 × 6 cm. The mass extended from the right upper quadrant to the lower pole of the kidneys. Laparotomy with resection of the mesenteric tumor was performed under general anesthesia. A well-capsuled tumor was a soft, yellow mass and found loosely attached to the mesenterium of the ileum. A histopathological examination demonstrated the lobular proliferation of mature adipocytes. Atypical lipoblasts were not seen. These features are compatible with benign lipomatous tumor, such as lipoma or lipoblastoma with maturation. CONCLUSION In conclusion, benign mesenteric lipomatous tumors tend to be large in size over 10 cm in longitudinal length. However, resection is well tolerated in the vast majority of cases with benign post-operative courses.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Takato Aiko
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroko Muta
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Higashku umade 3-1-1, Fukuoka, 812-8582, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Higashku umade 3-1-1, Fukuoka, 812-8582, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.,Division of Medical Safety Management, Kurume University Hospital, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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38
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Sato S, Nakahara M, Kato K, Moriyama T, Utsumi S, Sasaki K, Shima T, Miyoshi H, Yamamoto H, Furue M. Plasmablastic lymphoma occurring in the vicinity of enterocutaneous fistula in Crohn's disease. J Dermatol 2020; 47:e442-e443. [PMID: 32885864 DOI: 10.1111/1346-8138.15600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Seisho Sato
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Division of Skin Surface Sensing, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makiko Nakahara
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tomohiko Moriyama
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sae Utsumi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kensuke Sasaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Shima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masutaka Furue
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yoshida N, Miyoshi H, Arakawa F, Nakashima K, Kawamoto K, Seto M, Ohshima K. Cytokine-related genes play critical roles in extrafollicular growth of follicular lymphoma cells. Hematol Oncol 2020; 38:673-679. [PMID: 32835439 DOI: 10.1002/hon.2795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/05/2020] [Accepted: 08/21/2020] [Indexed: 01/11/2023]
Abstract
Follicular lymphoma (FL) is a germinal center-derived B-cell lymphoma that is known to proliferate in the intrafollicular region. However, lymphoma cells can be identified in the extrafollicular regions, which are related to disease dissemination. We purified the intrafollicular and extrafollicular regions of FL cells by laser microdissection and conducted microarray analysis in order to characterize the gene expression profiles of FL cells from both regions. BCL2 and genes of germinal B-cell markers clearly separated intrafollicular and extrafollicular regions of reactive follicular hyperplasia, suggesting the adequacy of the current analysis. In FL cases, cytokine-related genes were significantly enriched in extrafollicular regions compared with those in the intrafollicular regions. In intrafollicular regions of FL, cell-cycle-related genes were enriched. We found that the FL cells in the extrafollicular region more strongly expressed IL3RA and CXCL12 than those of intrafollicular regions. The cytokines might be also derived from stroma cells in the extrafollicular regions, which may initiate activation and migration of the tumor cells to this region. Our results suggest that FL cell interaction with surrounding stroma cells plays an important role in the pathophysiology of FL and that such interactions should be a good target for therapy.
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Affiliation(s)
- Noriaki Yoshida
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Keisuke Kawamoto
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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40
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Yanagida E, Miyoshi H, Takeuchi M, Yoshida N, Nakashima K, Yamada K, Umeno T, Shimasaki Y, Furuta T, Seto M, Ohshima K. Clinicopathological analysis of immunohistochemical expression of CD47 and SIRPα in adult T-cell leukemia/lymphoma. Hematol Oncol 2020; 38:680-688. [PMID: 32569413 DOI: 10.1002/hon.2768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/04/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022]
Abstract
The interaction of CD47 and signal-regulatory protein alpha (SIRPα) induces "don't eat me signal", leading suppression of phagocytosis. This signal can affect the clinical course of malignant disease. Although CD47 and SIRPα expression are associated with clinicopathological features in several neoplasms, the investigation for adult T-cell leukemia/lymphoma (ATLL) has not been well-documented. This study aimed to declare the association between CD47 and SIRPα expression and clinicopathological features in ATLL. We performed immunostaining on 73 biopsy samples and found that CD47 is primarily expressed in tumor cells, while SIRPα is expressed in non-neoplastic stromal cells. CD47 positive cases showed significantly higher FoxP3 (P = .0232) and lower CCR4 (P = .0214). SIRPα positive cases presented significantly better overall survival than SIRPα negative cases (P = .0132). SIRPα positive cases showed significantly HLA class I (P = .0062), HLA class II (P = .0133), microenvironment PD-L1 (miPD-L1) (P = .0032), and FoxP3 (P = .0229) positivity. In univariate analysis, SIRPα expression was significantly related to prognosis (Hazard ratio [HR] 0.470; 95% confidence interval [CI] 0.253-0.870; P = .0167], although multivariate analysis did not show SIPRα as an independent prognostic factor. The expression of SIRPα on stromal cells reflects activated immune surveillance mechanism in tumor microenvironment and induce good prognosis in ATLL. More detailed studies for gene expression or genomic abnormalities will disclose clinical and biological significance of the CD47 and SIRPα in ATLL.
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Affiliation(s)
- Eriko Yanagida
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Noriaki Yoshida
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan.,Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takeshi Umeno
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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Moritsubo M, Miyoshi H, Matsuda K, Yoshida N, Nakashima K, Yanagida E, Yamada K, Takeuchi M, Suzuki T, Muta H, Umeno T, Furuta T, Seto M, Ohshima K. TACC3 expression as a prognostic factor in aggressive types of adult T-cell leukemia/lymphoma patients. Int J Lab Hematol 2020; 42:842-848. [PMID: 32744749 DOI: 10.1111/ijlh.13289] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Adult T-cell leukemia/lymphoma (ATLL) is a malignant peripheral T-cell neoplasm associated with human T-cell leukemia virus type-1 (HTLV-1). The acute and lymphoma subtypes are regarded as aggressive ATLLs, and the overall survival (OS) of patients remains poor. Transforming acidic coiled-coil-containing protein 3 (TACC3) regulates microtubules, which are associated with cancer-related proteins overexpressed in various cancers. Such a relationship has not been reported in hematopoietic tumors, including ATLL. METHODS We examined tissue microarrays of histological samples from 92 cases of aggressive ATLL and assessed clinical features, including TACC3 protein expression levels. RESULTS Compared with TACC3-low, TACC3-high ATLL patients were significantly older (P < .001), with a tendency toward pleomorphic variant over other morphological classifications (P = .019). TACC3-high patients (median survival time [MST] 10.6 months, confidence interval [CI] [6.27-15.6]) had poorer OS compared to TACC3-low patients (MST 20 months, CI [9.43-38.5]) (P = .0168). Moreover, multivariate analysis on TACC3 expression levels suggests that TACC3-high is an independent significant prognostic factor (HR, 1.700; 95% CI, 1.037-2.753; P = .0355). CONCLUSION Certain drugs that inhibit TACC3-overexpressing neoplastic cells are used clinically. Further studies might highlight a key role for TACC3 in the oncogenesis and progression of ATLL.
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Affiliation(s)
- Mayuko Moritsubo
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Kotaro Matsuda
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan.,Department of Orthopedic surgery, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Noriaki Yoshida
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan.,Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Hiroshima, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Eriko Yanagida
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Takaharu Suzuki
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Hiroko Muta
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Takeshi Umeno
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of medicine, Kurume, Fukuoka, Japan
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42
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Kanno H, Miyoshi H, Yoshida N, Sudo T, Nakashima K, Takeuchi M, Nomura Y, Seto M, Hisaka T, Tanaka H, Okuda K, Akagi Y, Ohshima K. Differences in the immunosurveillance pattern associated with DNA mismatch repair status between right-sided and left-sided colorectal cancer. Cancer Sci 2020; 111:3032-3044. [PMID: 32449240 PMCID: PMC7419035 DOI: 10.1111/cas.14495] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/28/2020] [Accepted: 05/13/2020] [Indexed: 12/25/2022] Open
Abstract
Tumor location and immunity play important roles in the progression of colorectal cancer (CRC). This study aimed to investigate the differences in the immunosurveillance pattern between right‐ and left‐sided CRC and analyze their association with clinicopathologic features, including mismatch repair (MMR) status. We included surgically resected stage II/III CRC cases and evaluated the immunohistochemical findings of HLA class I, HLA class II, programmed cell death‐ligand 1 (PD‐L1), PD‐1, CTLA‐4, CD3, CD4, CD8, TIA‐1, T‐bet, GATA3, RORγT, Foxp3, and CD163. A total of 117 patients were included in the analyses; of these, 30 and 87 had right‐ and left‐sided cancer, respectively. Tumor immunity varied according to the tumor location in the overall cohort. Analysis of the tumors excluding those with DNA mismatch repair (MMR) deficiency also revealed that tumor immunity differed according to the tumor location. In right‐sided colon cancer (CC), high expression of Foxp3 (P = .0055) and TIA‐1 (P = .0396) were associated with significantly better disease‐free survival (DFS). High CD8 (P = .0808) and CD3 (P = .0863) expression tended to have better DFS. Furthermore, in left‐sided CRC, only high PD‐L1 expression in the stroma (P = .0426) was associated with better DFS. In multivariate analysis, high Foxp3 expression in right‐sided CC was an independent prognostic factor for DFS (hazard ratio, 7.6445; 95% confidence interval, 1.2091‐150.35; P = .0284). In conclusion, the immunosurveillance pattern differs between right‐ and left‐sided CRC, even after adjusting for MMR deficiency.
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Affiliation(s)
- Hiroki Kanno
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Naohiro Yoshida
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yoriko Nomura
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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43
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Yasuda T, Sanada M, Nishijima D, Kanamori T, Iijima Y, Hattori H, Saito A, Miyoshi H, Ishikawa Y, Asou N, Usuki K, Hirabayashi S, Kato M, Ri M, Handa H, Ishida T, Shibayama H, Abe M, Iriyama C, Karube K, Nishikori M, Ohshima K, Kataoka K, Yoshida K, Shiraishi Y, Goto H, Adachi S, Kobayashi R, Kiyoi H, Miyazaki Y, Ogawa S, Kurahashi H, Yokoyama H, Manabe A, Iida S, Tomita A, Horibe K. Clinical utility of target capture-based panel sequencing in hematological malignancies: A multicenter feasibility study. Cancer Sci 2020; 111:3367-3378. [PMID: 32619037 PMCID: PMC7469806 DOI: 10.1111/cas.14552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 01/22/2023] Open
Abstract
Although next‐generation sequencing‐based panel testing is well practiced in the field of cancer medicine for the identification of target molecules in solid tumors, the clinical utility and clinical issues surrounding panel testing in hematological malignancies have yet to be fully evaluated. We conducted a multicenter prospective clinical sequencing study to verify the feasibility of a panel test for hematological tumors, including acute myeloid leukemia, acute lymphoblastic leukemia, multiple myeloma, and diffuse large B‐cell lymphoma. Out of 96 eligible patients, 79 patients (82%) showed potentially actionable findings, based on the clinical sequencing assays. We identified that genetic alterations with a strong clinical significance were found at a higher frequency in terms of diagnosis (n = 60; 63%) and prognosis (n = 61; 64%) than in terms of therapy (n = 8; 8%). Three patients who harbored a germline mutation in either DDX41 (n = 2) or BRCA2 (n = 1) were provided with genetic counseling. At 6 mo after sequencing, clinical actions based on the diagnostic (n = 5) or prognostic (n = 3) findings were reported, but no patients were enrolled in a clinical trial or received targeted therapies based on the sequencing results. These results suggest that panel testing for hematological malignancies would be feasible given the availability of useful diagnostic and prognostic information. This study is registered with the UMIN Clinical Trial Registry (UMIN000029879, multiple myeloma; UMIN000031343, adult acute myeloid leukemia; UMIN000033144, diffuse large B‐cell lymphoma; and UMIN000034243, childhood leukemia).
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Affiliation(s)
- Takahiko Yasuda
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masashi Sanada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Dai Nishijima
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Takashi Kanamori
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Science, Nagoya, Japan
| | - Yuka Iijima
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyoshi Hattori
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Akiko Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norio Asou
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Shinsuke Hirabayashi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Science, Nagoya, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School, Tokushima, Japan
| | - Chisako Iriyama
- Department of Hematology, Fujita Health University, Toyoake, Japan
| | - Kennosuke Karube
- Department of Pathology and Cell Biology, Graduate School of Medicine and Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Momoko Nishikori
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Kataoka
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Kenichi Yoshida
- Department of Pathology and Tumor biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuichi Shiraishi
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Hiroaki Goto
- Division of Hemato-Oncology and Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Souichi Adachi
- Department of Human Health Science, Kyoto University, Kyoto, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto, Japan.,Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan
| | - Hisayuki Yokoyama
- Department of Hematology, National Hospital Organization, Sendai Medical Center, Sendai, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Science, Nagoya, Japan
| | - Akihiro Tomita
- Department of Hematology, Fujita Health University, Toyoake, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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44
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Miyoshi H, Sakata-Yanagimoto M, Shimono J, Yoshida N, Hattori K, Arakawa F, Yanagida E, Takeuchi M, Yamada K, Suzuki T, Moritsubo M, Furuta T, Chiba S, Ohshima K. RHOA mutation in follicular T-cell lymphoma: Clinicopathological analysis of 16 cases. Pathol Int 2020; 70:653-660. [PMID: 32648273 DOI: 10.1111/pin.12981] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 12/18/2022]
Abstract
Follicular T-cell lymphoma (FTCL) is considered to originate from follicular helper T-cell (Tfh) cells. Angioimmunoblastic T-cell lymphoma (AITL) and peripheral T-cell lymphomas with the Tfh phenotype, derived from Tfh cells, often harbor RHOA G17V mutation. We investigated whether RHOA mutations affect the clinicopathological features of FTCL. We performed deep sequencing and Sanger sequencing for RHOA exon 2 in 16 cases of FTCL. Nine cases showed RHOA mutations, including eight with c.G50T, p.Gly17Val and one with c.G50A, p.Gly17Glu, c.A52G, p.Lys18Glu, c.T102C, p.Tyr34Tyr and c.G145T, p.Asp49Tyr. Compared to the RHOA mutation-negative group, the RHOA mutation-positive group had a higher tendency for B-immunoblasts (P = 0.06), the AITL component (P = 0.09), and higher positive rate for CD10 (P = 0.09) and BCL6 (P = 0.09), and a significantly higher positive rate for CXCL13 (P = 0.04). Although not statistically significant, the RHOA mutation-positive group showed higher values for almost all characteristic AITL features. There was no significant difference in overall survival between RHOA mutation-positive and -negative groups. The RHOA mutation may play an important role in clinicopathological characteristics and lymphomagenesis of FTCL. A more detailed investigation is needed to highlight the importance of RHOA mutations in FTCL.
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Affiliation(s)
- Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | | | - Joji Shimono
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Noriaki Yoshida
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Keiichiro Hattori
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Fumiko Arakawa
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Eriko Yanagida
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Mai Takeuchi
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Kyohei Yamada
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Takaharu Suzuki
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Mayuko Moritsubo
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
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45
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Kazama R, Miyoshi H, Takeuchi M, Miyawaki K, Nakashima K, Yoshida N, Kawamoto K, Yanagida E, Yamada K, Umeno T, Suzuki T, Kato K, Takizawa J, Seto M, Akashi K, Ohshima K. Combination of CD47 and signal-regulatory protein-α constituting the "don't eat me signal" is a prognostic factor in diffuse large B-cell lymphoma. Cancer Sci 2020; 111:2608-2619. [PMID: 32342603 PMCID: PMC7385345 DOI: 10.1111/cas.14437] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 12/21/2022] Open
Abstract
The interaction between CD47 and signal‐regulatory protein‐α (SIRPα) inhibits phagocytosis, thus affecting the clinical outcomes of neoplastic diseases. Although CD47 upregulation is associated with poor prognosis in several malignancies, the effect of SIRPα expression and its coexpression with CD47 remains unclear. This study aimed to investigate the clinicopathologic effect of CD47 and SIRPα expression in diffuse large B‐cell lymphoma (DLBCL). Immunostaining of 120 biopsy samples showed that CD47 is primarily expressed in tumor cells, whereas SIRPα is expressed in nonneoplastic stromal cells, mostly macrophages. CD47high cases showed higher MYC protein expression and lower MYC translocation. The SIRPαhigh cases presented significantly shorter overall survival (OS) and progression‐free survival (PFS) than SIRPαlow cases in the activated B‐cell (ABC) subtype of DLBCL (P = .04 and P = .02, respectively). Both CD47high and SIRPαhigh presented significantly shorter OS and PFS than other cases among all DLBCL patients (P = .01 and P = .004, respectively), and the ABC type (P = .04 and P = .008, respectively) but not the germinal center B‐cell type. Both CD47high and SIRPαhigh yielded a constant independent prognostic value for OS and PFS in multivariate analysis (hazard ratio [HR], 2.93; 95% confidence interval [CI], 1.20‐7.43; P = .02; and HR, 2.87; 95% CI, 1.42‐5.85; P = .003, respectively). To the best of our knowledge, this is the first study to report that combinatorial CD47 and SIRPα expression is a potential independent prognostic factor for DLBCL. Evaluation of CD47 and SIRPα expression could be useful before CD47 blockade therapy.
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Affiliation(s)
- Ryo Kazama
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.,Department of Internal Medicine, Sakai City Medical Center, Sakai, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kohta Miyawaki
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.,Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kazutaka Nakashima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Noriaki Yoshida
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.,Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
| | - Keisuke Kawamoto
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Eriko Yanagida
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takeshi Umeno
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takaharu Suzuki
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan.,Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Masao Seto
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
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46
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Kasai S, Itonaga H, Niino D, Miyoshi H, Kato T, Imanishi D, Fujioka M, Furumoto T, Sato S, Sawayama Y, Taguchi J, Imaizumi Y, Hata T, Yoshida S, Moriuchi Y, Ohshima K, Miyazaki Y. Programmed death 1 ligand (PD-L1) in solid cancers after allogeneic hematopoietic stem cell transplantation: a retrospective analysis by the Nagasaki Transplant Group. Int J Hematol 2020; 112:524-534. [PMID: 32588395 DOI: 10.1007/s12185-020-02926-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 11/30/2022]
Abstract
Programmed death 1 ligand (PD-L1) is an immunomodulatory molecule expressed by cancer cells, and it has been widely demonstrated to inhibit host antitumor responses. The aim of the present study was to identify clinicopathological features associated with PD-L1 expression in the secondary solid cancers of patients after allogeneic hematopoietic stem cell transplantation. In this database of 530 patients who received allo-HSCT between 1990 and 2017, 15 developed solid cancers with a median interval of 3487 days after transplantation. Three patients had 2 different solid cancers. Eighteen solid cancer cases were identified. A multivariate analysis showed that chronic graft-versus-host disease (GVHD) was associated with an increased risk of solid cancer. The presence of chronic GVHD was observed in 8 out of 18 cases at the diagnosis of secondary malignancies. PD-L1 expression levels in cancers were significantly higher in patients with active chronic GVHD than in those without chronic GVHD (P = 0.020). Five cases of cancer that developed in the involved organs of chronic GVHD showed 30% or higher PD-L1 positivity. The present results revealed distinct PD-L1 expression in the secondary solid cancers of post-transplant patients with chronic GVHD.
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Affiliation(s)
- Sachie Kasai
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan.
| | - Daisuke Niino
- Department of Pathology, Sasebo City General Hospital, Sasebo, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Daisuke Imanishi
- Department of Hematology, Nagasaki Prefecture Gotochuoh Hospital, Goto, Japan
| | - Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Takafumi Furumoto
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | | | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | | | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4, Sakamoto, Nagasaki city, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
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47
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Komaki S, Sugita Y, Furuta T, Yamada K, Moritsubo M, Abe H, Akiba J, Miyagi N, Nakamura H, Miyoshi H, Ohshima K, Morioka M. Expression of GLUT1 in Pseudopalisaded and Perivascular Tumor Cells Is an Independent Prognostic Factor for Patients With Glioblastomas. J Neuropathol Exp Neurol 2020; 78:389-397. [PMID: 30990881 PMCID: PMC6467190 DOI: 10.1093/jnen/nly124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Glioblastomas are highly aggressive brain tumors with a particularly poor prognosis. Glucose transporter-1 (GLUT1/SLC2A1), a uniporter that is expressed by various carcinomas and may be involved in malignant neoplasm glycometabolism, may also be related to prognosis in glioblastomas. GLUT1 is essential to central nervous system glycometabolism. To clarify the exact role of GLUT1 in glioblastoma, we assessed the expression and localization of GLUT1 in patient samples by immunohistochemistry and in situ RNA hybridization. This revealed that GLUT1 was mainly expressed on perivascular and pseudopalisaded tumor cell membranes. All samples expressed GLUT1 to some degree, with 30.8% showing stronger staining. On the basis of these data, samples were divided into high and low expression groups, although SLC2A1 mRNA expression was also higher in the high GLUT1 expression group. Kaplan-Meier survival curves revealed that high GLUT1 expression associated with lower overall survival (log-rank test, p = 0.001) and worse patient prognoses (p = 0.001). Finally, MIB-1 staining was stronger in high GLUT1 expression samples (p = 0.0004), suggesting a link with proliferation. We therefore hypothesize that GLUT1 expression in glioblastomas may enhance glycolysis, affecting patient prognosis. Examination of GLUT1 in patients with glioblastomas may provide a new prognostic tool to improve outcome.
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Affiliation(s)
- Satoru Komaki
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yasuo Sugita
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takuya Furuta
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kyohei Yamada
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Mayuko Moritsubo
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hideyuki Abe
- Diagnostic Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Jun Akiba
- Diagnostic Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naohisa Miyagi
- Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hideo Nakamura
- Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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48
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Takeuchi M, Miyoshi H, Nakashima K, Kawamoto K, Yamada K, Yanagida E, Muta H, Moritsubo M, Umeno T, Suzuki T, Seto M, Ohshima K. Comprehensive immunohistochemical analysis of immune checkpoint molecules in adult T cell leukemia/lymphoma. Ann Hematol 2020; 99:1093-1098. [PMID: 32157421 DOI: 10.1007/s00277-020-03967-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/15/2020] [Indexed: 10/24/2022]
Abstract
Acute or lymphomatous type adult T cell leukemia/lymphoma (ATLL) is an aggressive hematopoietic malignancy with poor prognosis. We previously reported that programmed cell death ligand 1 (PD-L1) expression could predict ATLL outcomes. However, the roles of other immune checkpoint molecules remain largely unknown in ATLL. Our aim in this study was to explore the clinicopathological impacts of immune checkpoint molecules in ATLL. Immunohistochemistry was performed in 69 ATLL patients with antibodies against the following: PD-L1, programmed cell death ligand 2 (PD-L2), OX40, OX40 ligand (OX40L), CD137, CD137 ligand (CD137L), Galectin-9, T cell immunoglobulin mucin-3 (Tim-3), cytotoxic T lymphocyte associated protein-4 (CTLA-4), lymphocyte activating-3 (LAG-3), CD80, CD86, glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR), GITR ligand (GITRL), and programmed death-1 (PD-1). Immune checkpoint molecules were variably expressed on neoplastic and/or microenvironmental cells. Expression of PD-1, OX40L, Galectin-9, and PD-L1 was nearly mutually exclusive on neoplastic cells, suggesting that immune checkpoint pathways differ in patients. Microenvironmental expression of PD-L1, OX40L, and Tim-3 was significantly associated with better overall survival (log-rank test; P =0.0004, 0.0394, and 0.0279, respectively). Univariate and multivariate analyses with clinical prognostic factors identified microenvironmental expression of PD-L1 and OX40L, and age (> 70 years) as significant prognostic factors. This is the first comprehensive analysis of ATLL immune checkpoint molecules. Our results may provide information on new therapeutic strategies in ATLL.
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Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan.
| | - Kazutaka Nakashima
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Keisuke Kawamoto
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, 951-8520, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Eriko Yanagida
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroko Muta
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Takeshi Umeno
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Takaharu Suzuki
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan.,Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, 951-8520, Japan
| | - Masao Seto
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, Fukuoka, 830-0011, Japan
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49
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Nguyen TB, Sakata-Yanagimoto M, Fujisawa M, Nuhat ST, Miyoshi H, Nannya Y, Hashimoto K, Fukumoto K, Bernard OA, Kiyoki Y, Ishitsuka K, Momose H, Sukegawa S, Shinagawa A, Suyama T, Sato Y, Nishikii H, Obara N, Kusakabe M, Yanagimoto S, Ogawa S, Ohshima K, Chiba S. Dasatinib Is an Effective Treatment for Angioimmunoblastic T-cell Lymphoma. Cancer Res 2020; 80:1875-1884. [PMID: 32107212 DOI: 10.1158/0008-5472.can-19-2787] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/25/2019] [Accepted: 02/25/2020] [Indexed: 11/16/2022]
Abstract
Recurrent hotspot (p.Gly17Val) mutations in RHOA encoding a small GTPase, together with loss-of-function mutations in TET2 encoding an epigenetic regulator, are genetic hallmarks of angioimmunoblastic T-cell lymphoma (AITL). Mice expressing the p.Gly17Val RHOA mutant on a Tet2-null background succumbed to AITL-like T-cell lymphomas due to deregulated T-cell receptor (TCR) signaling. Using these mice to investigate therapeutics for AITL, we found that dasatinib, a multikinase inhibitor prolonged their survival through inhibition of hyperactivated TCR signaling. A phase I clinical trial study of dasatinib monotherapy in 5 patients with relapsed/refractory AITL was performed. Dasatinib was started at a dose of 100 mg/body once a day and continued until days 10-78 (median day 58). All the evaluable patients achieved partial responses. Our findings suggest that AITL is highly dependent on TCR signaling and that dasatinib could be a promising candidate drug for AITL treatment. SIGNIFICANCE: Deregulated T-cell receptor signaling is a critical molecular event in angioimmunoblastic T-cell lymphoma and can be targeted with dasatinib.
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MESH Headings
- Aged
- Animals
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/therapeutic use
- DNA-Binding Proteins/genetics
- Dasatinib/administration & dosage
- Dasatinib/therapeutic use
- Dioxygenases
- Disease Models, Animal
- Drug Administration Schedule
- Female
- Humans
- Immunoblastic Lymphadenopathy/blood
- Immunoblastic Lymphadenopathy/drug therapy
- Immunoblastic Lymphadenopathy/genetics
- Interferon-gamma/blood
- Interleukins/blood
- Lymphoma, T-Cell/blood
- Lymphoma, T-Cell/drug therapy
- Lymphoma, T-Cell/genetics
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Mice, Transgenic
- Middle Aged
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins c-vav/genetics
- Receptors, Antigen, T-Cell/drug effects
- Receptors, Antigen, T-Cell/metabolism
- Tumor Necrosis Factor-alpha/blood
- rhoA GTP-Binding Protein/genetics
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Affiliation(s)
- Tran B Nguyen
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Mamiko Sakata-Yanagimoto
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Manabu Fujisawa
- Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Sharna Tanzima Nuhat
- Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, School of Medicine, Kurume University, Kurume, Fukuoka, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Koichi Hashimoto
- Tsukuba Clinical Research and Development Organization, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kota Fukumoto
- Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Olivier A Bernard
- INSERM U1170, Gustave Roussy, Université Paris-Saclay, Equipe Labellisée Ligue Nationale Contre le Cancer, Villejuif, France
| | - Yusuke Kiyoki
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Kantaro Ishitsuka
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Haruka Momose
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Shinichiro Sukegawa
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Atsushi Shinagawa
- Department of Hematology, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Takuya Suyama
- Department of Hematology, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Yuji Sato
- Department of Hematology, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan
| | - Hidekazu Nishikii
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Naoshi Obara
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Manabu Kusakabe
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Shintaro Yanagimoto
- Division for Health Service Promotion, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Fukuoka, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Life Science Center for Survival Dynamics, Tsukuba Advanced Research Alliance, University of Tsukuba, Tsukuba, Ibaraki, Japan
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50
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Yoshino T, Makiyama J, Imaizumi Y, Matsuo E, Kitanosono H, Nakashima J, Kato T, Miyoshi H, Ohshima K, Yoshida S, Miyazaki Y. [CD20-negative diffuse large B-cell lymphoma complicated by rheumatoid arthritis]. Rinsho Ketsueki 2020; 61:33-38. [PMID: 32023600 DOI: 10.11406/rinketsu.61.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CD20 antigen is an important marker for diagnosis of B-cell neoplasms that is highly expressed on the surface of neoplastic B lymphocytes. Patients with rheumatoid arthritis (RA) have an increased risk of developing malignant lymphoma, of which diffuse large B-cell lymphoma (DLBCL) is the most common type. We report an unusual case of CD20-negative DLBCL complicated by rheumatoid arthritis. An 81-year old female presented with a left-sided cervical tumor, enlarged tonsil, and polyarticular pain. Pathological findings of the left tonsil showed proliferation of large atypical cells with irregular shaped nuclei. Most large cells were negative for CD3 and CD20. Additionally, these cells were positive for CD79a, BCL2, and MUM1, and negative for CD10, CD138, BCL6, PAX5, EBV-ISH, HHV8, and ALK.. Therefore, she was diagnosed with CD20-negative DLBCL complicated with RA and received dose-modified CHOP that achieved partial remission. Because CD20-negative DLBCL is rare, the identification of the clinicopathological features of this disease is urgently required.
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Affiliation(s)
- Teruhiko Yoshino
- Department of Hematology, National Hospital Organization Nagasaki Medical Center
| | - Junya Makiyama
- Department of Hematology, National Hospital Organization Nagasaki Medical Center.,Clinical Research Center, National Hospital Organization Nagasaki Medical Center
| | | | - Emi Matsuo
- Department of Hematology, Japan Community Health care Organization Isahaya General Hospital
| | - Hideaki Kitanosono
- Department of Hematology, National Hospital Organization Nagasaki Medical Center
| | - Jun Nakashima
- Department of Hematology, National Hospital Organization Nagasaki Medical Center
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University
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