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Sharma S, Morisetti M, Gandhi N, Chennapragada SS, Cotelingam JD, Ramadas P. Detecting Multiple Driver Mutations in a Patient with Essential Thrombocythemia. Am J Case Rep 2024; 25:e942030. [PMID: 38310350 PMCID: PMC10858393 DOI: 10.12659/ajcr.942030] [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: 08/03/2023] [Revised: 12/27/2023] [Accepted: 11/28/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Three driver mutations have been identified in patients with essential thrombocythemia - JAK2 V617F, CALR, and MPL. Out of these, JAK2 V617F is mostly common. These mutations are thought to be mutually exclusive; therefore, the initial workup may not include the identification of all mutations separately. CASE REPORT We present a case of a 55-year-old woman who was referred to the hematology clinic for an elevated platelet count noted when she was hospitalized for a renal stone. The patient was asymptomatic. A workup was initiated for essential thrombocythemia, and she was tested for JAK2 V617F mutation using an allele-specific polymerase chain reaction (AS-PCR) test in peripheral blood, which came back positive. The variant allele frequency was 2%. She underwent a bone marrow biopsy, and next-generation sequencing (NGS) showed a CALR mutation. A 52 bp deletion-type mutation was detected in the CALR gene on exon 9, with a variant allele frequency of 7%. The NGS did not detect JAK2 mutation due to its low sensitivity. She was started on aspirin alone as she was less than 60 years old and had no history of thrombotic events. The patient has been following up with the hematology clinic for the last 2 years and has not had any thrombotic events. CONCLUSIONS We propose that in patients with a low JAK2 V617 allele variant, testing for other driver mutations should be performed. In our patient, JAK2 mutation could be clonal hematopoiesis of indeterminate potential; therefore, the dominant mutation (CALR) would determine the disease phenotype.
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Affiliation(s)
- Shivani Sharma
- Department of Internal Medicine, Louisiana State University Health, Shreveport, LA, USA
| | - Manasa Morisetti
- Department of Pathology, Louisiana State University Health, Shreveport, LA, USA
| | - Nitesh Gandhi
- Department of Internal Medicine, Louisiana State University Health, Shreveport, LA, USA
| | - Suma Sri Chennapragada
- Department of Hematology and Oncology, Louisiana State University Health, Shreveport, LA, USA
| | - James D. Cotelingam
- Department of Pathology, Louisiana State University Health, Shreveport, LA, USA
| | - Poornima Ramadas
- Department of Hematology and Oncology, Louisiana State University Health, Shreveport, LA, USA
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2
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Feng FX, Farsi N, Dai M, Cuevas-Ocampo AK, Veillon DM, Cotelingam JD. Histiocytic Disorder Mimicking a Brain Tumor: A Report of 2 Rare Cases. Am J Case Rep 2022; 23:e935885. [PMID: 35971309 PMCID: PMC9393051 DOI: 10.12659/ajcr.935885] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Case series
Patients: Male, 65-year-old • Female, 61-year-old
Final Diagnosis: Langerhans cell histiocytosis • Rosai-Dorfman disease
Symptoms: The patient with LHD presented with increasing memory loss, confusion, and depression • the patient with RDD presented with dizziness and confusion for three weeks and headaches for one day
Medication: —
Clinical Procedure: —
Specialty: Pathology
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Affiliation(s)
| | - Negin Farsi
- Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, USA, LA
| | - Min Dai
- Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, USA, LA
| | - Areli K. Cuevas-Ocampo
- Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, USA, LA
| | - Diana M. Veillon
- Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, USA, LA
| | - James D. Cotelingam
- Department of Pathology and Translational Pathobiology, Louisiana State University Health-Shreveport, Shreveport, USA, LA
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3
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Ozluk E, Patel S, Coppola D, Ghali G, Cotelingam JD, Kevil CG, Shackelford RE. Cystathionine Gamma-Lyase Is Increased in Testicular Seminomas, Embryonal, and Yolk Sac Tumors. Anticancer Res 2021; 41:4211-4214. [PMID: 34475040 DOI: 10.21873/anticanres.15225] [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: 05/07/2021] [Revised: 07/06/2021] [Accepted: 07/09/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Testicular cancer constitutes 1.0% of male cancer and typically carries a good prognosis. As far as we are aware, the role for hydrogen sulfide in testicular cancer and the level of hydrogen sulfide-synthesizing enzyme have never been addressed. Here we examined cystathionine gamma-lyase (CSE) expression in several germ-cell testicular tumors. MATERIALS AND METHODS Tissue microarrays were employed to examine CSE expression in 32 benign testicular samples, 88 testicular seminomas, 34 embryonal carcinomas, 4 mature teratomas, and 16 yolk sac tumors, and CSE expression was compared to that seen in benign testicular tissue. RESULTS Compared to benign testicular tissue, CSE expression was increased in all three types of testicular neoplasm but not in mature teratomas. Highest CSE expression was identified in embryonal carcinomas, which often show a relatively aggressive clinical course. CONCLUSION For the first time, we show that CSE is increased in several common testicular germ-cell tumor types.
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Affiliation(s)
- Ekin Ozluk
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, LA, U.S.A
| | - Staven Patel
- Head and Neck Oncologic/Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA, U.S.A
| | - Domenico Coppola
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - Ghali Ghali
- Head and Neck Oncologic/Microvascular Reconstructive Surgery, Department of Oral and Maxillofacial/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, LA, U.S.A
| | - James D Cotelingam
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, LA, U.S.A
| | - Christopher G Kevil
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, LA, U.S.A
| | - Rodney E Shackelford
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center Shreveport, Shreveport, LA, U.S.A.;
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Kwatra KS, Paul PAM, Calton N, John JM, Cotelingam JD. Systemic and primary cutaneous anaplastic large cell lymphoma: Clinical features, morphological spectrum, and immunohistochemical profile. South Asian J Cancer 2020; 6:129-131. [PMID: 28975123 PMCID: PMC5615884 DOI: 10.4103/2278-330x.214575] [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] [Indexed: 11/28/2022] Open
Abstract
Background: T-cell lymphomas with anaplastic morphology typically comprise of anaplastic lymphoma kinase positive, anaplastic large cell lymphoma (ALK+ ALCL), ALK-negative ALCL (ALK- ALCL), and primary cutaneous ALCL (PC-ALCL). However, other entities such as diffuse large B-cell lymphoma, peripheral T-cell lymphoma, Hodgkin lymphoma, and undifferentiated carcinoma can also show similar anaplastic features. Aims: To study the clinical features and histological spectrum of ALCL and emphasize the role of immunohistochemistry (IHC) in their diagnosis and categorization. Setting and Design: Eight cases of ALCL diagnosed over a period of 4 years were selected for the study. Materials and Methods: Histopathological review and IHC was performed on all cases. Two ALK+ ALCL cases were tested by fluorescent in situ hybridization (FISH) for t(2;5)(p23;q35). Results: There were four cases of ALK+ ALCL and two each of ALK- ALCL and PC-ALCL. Histologically, all the subtypes showed pleomorphic and “hallmark” cells with strong CD30 expression and variable loss of T-cell antigens. One case of PC-ALCL was leukocyte common antigen (LCA) negative. Epithelial membrane antigen was positive in all the six systemic ALCL cases. Two cases tested for t(2;5)(p23;q35) by FISH were positive. Conclusions: Diagnosis of ALCL is based on recognizing the key morphological features, especially the presence of “hallmark” cells. IHC is essential for confirmation of diagnosis and excluding other malignancies with anaplastic morphology. The inclusion of CD30 in the initial IHC panel will help identify LCA negative cases and avoid misdiagnosis.
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Affiliation(s)
| | - Preethi A M Paul
- Department of Pathology, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Nalini Calton
- Department of Pathology, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Joseph M John
- Department of Clinical Hematology, Hemato-Oncology and Bone Marrow (Stem Cell) Transplant Unit, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - James D Cotelingam
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA
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5
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Abstract
Significance StatementUnilateral Eagle Syndrome is relatively rare and highlights important concepts in anatomy and pathophysiology. Bilateral Eagle Syndrome is exponentially more rare and has only been mentioned several times in the literature. Understanding the impact this can have on the human body and the severity of symptoms and sequelae is valuable for several types of specialists that treat this disorder.
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Affiliation(s)
- Dominik S Dabrowski
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center in Shreveport, LA, USA
| | - Ghali E Ghali
- Department of Oral and Maxillofacial Surgery, LSU Health Sciences Center in Shreveport, LA, USA
| | - James D Cotelingam
- Department of Pathology and Translational Pathobiology, LSU Health Sciences Center in Shreveport, LA, USA
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6
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Ansari J, Naqash AR, Munker R, El-Osta H, Master S, Cotelingam JD, Griffiths E, Greer AH, Yin H, Peddi P, Shackelford RE. Histiocytic sarcoma as a secondary malignancy: pathobiology, diagnosis, and treatment. Eur J Haematol 2016; 97:9-16. [PMID: 26990812 DOI: 10.1111/ejh.12755] [Citation(s) in RCA: 42] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 12/13/2022]
Abstract
Histiocytic sarcoma (HS) is an extremely rare non-Langerhans cell disorder with an aggressive course and limited treatment options. Recent advances in molecular/genetic sequencing have suggested a common clonal origin between various hematolymphoid disorders and cases of secondary HS. Deriving conclusions from previously reported cases of HS arising secondarily to certain hematolymphoid disorders, here we have tried to provide insight into the mechanisms influencing this evolution. We also discuss a clinical case of a 72-year-old man with a diagnosis of chronic myeloid leukemia (CML), presenting subsequently with a heterogeneous liver mass positive with a diagnosis of HS. The liver mass showed a retained BCR-ABL1 translocation suggesting clonality between the CML and HS. As seen in our case and other reported cases of HS derived secondarily, the concurrent expression of immunoglobulin heavy (IGH)-/light-chain rearrangements or cytogenetic markers common to the primary malignancy suggests an evolutionary mechanism involving lineage switching that could potentially be influenced by genetic or epigenetic cues which may occur at the level of a progenitor or the malignant cell itself.
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Affiliation(s)
- Junaid Ansari
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | - Abdul Rafeh Naqash
- University of Buffalo, Buffalo, NY, USA.,Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Reinhold Munker
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | - Hazem El-Osta
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | - Samip Master
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | | | | | - Adam H Greer
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | - Hong Yin
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
| | - Prakash Peddi
- Feist-Weiller Cancer Center, LSU Health, Shreveport, LA, USA
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7
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Ansari J, Ravipati HP, Munker R, Cotelingam JD, Shackelford RE, Prouty LA. Treatment-related MDS/AML in a patient after treatment for large-cell neuroendocrine lung cancer. J Community Support Oncol 2016; 13:411-4. [PMID: 26863022 DOI: 10.12788/jcso.0189] [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] [Subscribe] [Scholar Register] [Accepted: 05/11/2015] [Indexed: 11/20/2022]
Abstract
Secondary leukemia is a common late complication after exposure to cancer therapies such as chemotherapy and radiotherapy. With the increase in the overall survival of cancer patients over the past 3 decades, treatment-related malignant neoplasms have increased in incidence. Secondary leukemias due to breast cancer and Hodgkin lymphoma have been studied in detail, but to our knowledge only a few case studies have reported secondary leukemias with previous lung cancer.¹⁻⁴ Lung cancer is the leading cause of cancer death in the United States.⁵ Since the overall survival (OS) as well as the progression-free survival (PFS) of lung cancer has improved, secondary malignancies, which are usually aggressive and have a poor prognosis, have become a common occurrence among survivors. The use of concurrent chemo-radiotherapy could increase the risk for secondary cancers. Here we report the case of a patient who developed treatment-related acute myelogenous leukemia (t-AML) with a likely prior myelodysplasia (t-MDS) after receiving combined chemo-radiotherapy for lung cancer.
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Affiliation(s)
- Junaid Ansari
- Feist Weiller Cancer Center, LSU Health, Shreveport, Louisiana, USA.
| | - Hari P Ravipati
- Feist Weiller Cancer Center, LSU Health, Shreveport, Louisiana, USA
| | - Reinhold Munker
- Feist Weiller Cancer Center, LSU Health, Shreveport, Louisiana, USA
| | | | | | - Leonard A Prouty
- Departments of Pathology and Pediatrics, LSU Health, Shreveport, Louisiana, USA
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8
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Munker R, Shi R, Nair B, Devarakonda S, Cotelingam JD, McLarty J, Mills GM, Glass J. The Shreveport Myeloma Experience: Survival, Risk Factors and Other Malignancies in the Age of Stem Cell Transplantation. Acta Haematol 2015; 135:146-55. [PMID: 26588024 DOI: 10.1159/000440970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 05/18/2015] [Accepted: 09/06/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND The overall prognosis of multiple myeloma has improved significantly over the last 15 years. We wondered whether the overall improvement would also be seen in unselected patients in an academic center in Northwest Louisiana with a high proportion of minority patients, and if second malignant neoplasms are relevant for our patients. MATERIALS AND METHODS Between 1998 and 2009, 215 patients were treated for multiple myeloma at our center and had complete follow-up until May 2013. RESULTS The mean survival of patients with multiple myeloma increased from 3.25 to 5.34 years, which is comparable to patients treated at larger centers. No prognostic difference was observed in the subgroups of myeloma patients. Among 215 patients followed for the development of secondary cancers, 16 already had a preexisting or concomitant malignancy (7.4%) and 10 developed secondary cancers. Our data indicate a significant background of histologically unrelated cancers and a cumulative incidence of new cancers of about 20% after 10 years of follow-up. Based on SEER data, preexisting or secondary cancers were not statistically increased in our population. CONCLUSIONS The use of autologous transplantation and the introduction of new agents resulted in a significant improvement in the prognosis of multiple myeloma. Other cancers are not statistically increased before or after multiple myeloma is diagnosed and are not prognostically relevant.
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9
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Koshy N, Ong MG, Nordberg ML, Turturro F, Cotelingam JD. Oligosecretory biclonal multiple myeloma. J La State Med Soc 2013; 165:215-218. [PMID: 24133785] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Among the plasma cell dyscrasias, non-secretory myeloma is one of the rarest. This diagnosis is based on the absence of monoclonal proteins in the serum and urine. When serum free light chains are trace and the kappa: lambda ratio normal, clonality may however be established by PCR. We present a case of an oligosecretory myeloma confirmed by PCR, which would have hitherto been classified as non-secretory.
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Affiliation(s)
- Nebu Koshy
- Feist-Weiller Cancer Center Louisiana State University Health Sciences Center, Shreveport, USA
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10
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Bao JR, Anga A, Gu X, Zhang S, Cotelingam JD. An infant with recurrent maculopapular rashes, anemia, lymphadenopathy, and hepatosplenomegaly. J La State Med Soc 2011; 163:140-143. [PMID: 21827060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Jianxiong R Bao
- Department of Pathology, Louisiana State University, Health Sciences Center, Shreveport, USA
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11
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Jacob S, Mohapatra D, Nordberg ML, Cotelingam JD, Upadhyay S, Japa D. Enteropathy-associated T-cell lymphoma in a patient without a prior diagnosis of celiac disease: a diagnostic conundrum. Indian J Cancer 2011; 48:124-5. [PMID: 21330761 DOI: 10.4103/0019-509x.76640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Ong MG, Veillon DM, Cotelingam JD. Microcytosis in a 43-Year-Old Man. Lab Med 2010. [DOI: 10.1309/lmt0uahxxryyclnm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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13
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Gill MT, Cotelingam JD, Lowery-Nordberg M, Nathan CAO. Tracheal Non-Hodgkin's Lymphoma Masquerading as Benign Granulation Tissue: A Report of Two Cases. Ann Otol Rhinol Laryngol 2010; 119:431-5. [DOI: 10.1177/000348941011900701] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary tracheal non-Hodgkin's lymphoma (NHL) is rare, with fewer than 30 cases reported to date. We review the clinical presentation, evaluation, and treatment of 2 cases of tracheal NHL mimicking granulation tissue. The first patient was a 67-year-old man with myelodysplastic syndrome and Crohn's disease who had a recurring lesion of the proximal trachea causing significant airway obstruction. The second patient was a 47-year-old man with a history of multiple intubations who presented with dyspnea and stridor due to circumferential tracheal stenosis. In both cases, bronchoscopy revealed abundant granulation tissue, and the initial biopsy results indicated benign disease. However, after requests from the diagnostic team to rule out lymphoma, additional immunohistochemical stains and polymerase chain reaction testing confirmed NHL. Radiotherapy was initiated. The first patient responded well and remains disease-free after 4 years. The second patient died of airway obstruction due to severe distal tracheal stenosis. Recurrent granulation tissue should raise the suspicion of malignancy and prompt further tissue evaluation for evidence of lymphoma. Steroids for airway compromise may cause progression to mature stenosis as prednisone is used in the treatment of lymphoma. Localized disease involving the central airways may be treated successfully with limited chemotherapy and radiotherapy.
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Affiliation(s)
- Matthew T. Gill
- Departments of Otolaryngology–Head and Neck Surgery, Shreveport, Louisiana
| | | | - Mary Lowery-Nordberg
- Departments of Pathology, Shreveport, Louisiana
- Louisiana State University Health Sciences Center, and Feist-Weiller Cancer Center, Shreveport, Louisiana
| | - Cherie-Ann O. Nathan
- Departments of Otolaryngology–Head and Neck Surgery, Shreveport, Louisiana
- Louisiana State University Health Sciences Center, and Feist-Weiller Cancer Center, Shreveport, Louisiana
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14
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Ong MC, Veillon DM, Nordberg ML, Cotelingam JD. Karyopyknotic cytoplasmic inclusions in neutrophils. J La State Med Soc 2010; 162:228-230. [PMID: 20882817] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Karyopyknotic cytoplasmic inclusions in neutrophils (KPCI) have been previously called "Howell-Jolly" like inclusions and identified in immunosuppressed patients with human immunodeficiency virus (HIV) and in patients with various malignancies who have undergone chemotherapy. Attempts to characterize these inclusions have included the Grocott's methenamine silver (GMS), periodic acid Schiff (PAS), Gram, and Feulgen stains. Previous authors have concluded that these inclusions are of deoxyribonucleic acid (DNA) origin. We present a case describing an additional method to confirm this observation and to document previously undescribed curvilinear forms.
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Affiliation(s)
- Menchu C Ong
- Louisiana State University Health Sciences Center Department of Pathology, Shreveport, USA
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15
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Zhang S, Abreo F, Lowery-Nordberg M, Veillon DM, Cotelingam JD. The role of fluorescence in situ hybridization and polymerase chain reaction in the diagnosis and classification of lymphoproliferative disorders on fine-needle aspiration. Cancer Cytopathol 2010; 118:105-12. [PMID: 20340097 DOI: 10.1002/cncy.20070] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) has been used in the evaluation of lymphadenopathy for a long time and is highly reliable in the identification of metastatic malignancies. However, the role of FNA in the assessment of new lymphoproliferative disorders continues to be a subject of debate. The objective of the current study was to evaluate the role of molecular cytogenetic studies in FNA diagnoses of lymphoproliferative disorders. METHODS A retrospective, computer-based search for lymph node FNAs from 2006 to 2007 was performed. Cases with either fluorescence in situ hybridization (FISH) and/or polymerase chain reaction (PCR) studies were subjected to further analysis. RESULTS In total, 243 lymph node FNAs were performed during the period, including 104 that were positive/suspicious for metastatic malignancies, 16 that were positive/suspicious for lymphomas, 15 that demonstrated atypical lymphoid proliferation, 73 that were reactive, 14 that were deemed granulomas, and 21 that were determined to be nondiagnostic. Molecular analysis included combined FISH/PCR in 4 cases, FISH only in 7 cases, and PCR only in 4 cases. By using multiplex PCR, 6 cases with atypical/negative flow cytometry results were diagnosed as 4 B-cell lymphomas, 1 T-cell lymphoma, and 1 reactive lymph node; and 4 cases that had atypical T cells determined by flow cytometry were diagnosed as reactive. One CD10-negative follicular lymphoma and 2 cases with suspicious flow cytometry results were positive for t(14;18)(q32;q21) by FISH. Forty-five cases had follow-up histology with 3 false-negative findings and no false-positive results. CONCLUSIONS In this study, multiplex PCR studies for immunoglobulin heavy-chain or T-cell receptor gene rearrangements were useful for demonstrating clonality, and FISH studies were able to detect translocations or gene rearrangements that allowed for the subclassification of B-cell non-Hodgkin lymphomas.
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Affiliation(s)
- Songlin Zhang
- Department of Pathology, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 71130, USA.
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16
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Song K, Cotelingam JD, Lowery-Nordberg M, Sun W. Characterization of the lymphoid stroma in Warthin's tumor of salivary gland by immunohistochemistry, heavy chain gene and Bcl-2 gene rearrangement. Am J Transl Res 2009; 1:352-357. [PMID: 19956447 PMCID: PMC2780035] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2009] [Accepted: 04/01/2009] [Indexed: 05/28/2023]
Abstract
Warthin's tumor is rarely associated with malignant lymphoma. Only 18 cases were reported in the literature so far. In most cases the latter is a low grade process, including Marginal zone/Mucosa associated lymphoid tissue (MALT) type lymphoma, follicular lymphoma, and rarely diffuse large cell lymphoma which may arise de novo or secondary to low grade lymphoma. This study was conducted to determine the prevalence of occult B cell monoclones and genetic alterations in Warthin's tumor. Fourteen cases of Warthin's tumor were stained with antibodies to CD3, CD20, kappa and lambda light chains. On six cases of randomly selected Warthin's tumor, polymerase chain reaction (PCR) of IgH gene rearrangement (IgH-GR) was performed on genomic DNA extracted from formalin-fixed paraffin embedded tissue. One case of primary salivary gland indolent B-cell lymphoma and 3 cases of sialadenitis were analyzed by the same methods for comparison. In all Warthin's tumor and sialadenitis cases most of lymphoid stroma was B cell phenotype and concentrated in germinal centers. T cells were mostly located between germinal centers. No light chain restriction was demonstrable by kappa and lambda immunostains. Molecular genetic studies failed to show IgH-GR by FISH and showed polyclonal by IgH PCR. In contrast, the lymphoma case showed a diffuse proliferation of small B cells with light chain restriction and a minor component of reactive T cells. FISH showed IgH-GR and bcl-2 gene translocation with monoclonality by IgH PCR. Our study concludes that the lymphoid stroma of Warthin's tumor is reactive.
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Affiliation(s)
- Kunchang Song
- Department of Pathology, New York University School of MedicineNew York, NY, USA
| | - James D. Cotelingam
- Department of Pathology, Louisiana State University Health Science CenterShreveport, LA, USA
| | - Mary Lowery-Nordberg
- Department of Pathology, Louisiana State University Health Science CenterShreveport, LA, USA
| | - Wei Sun
- Department of Pathology, New York University School of MedicineNew York, NY, USA
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17
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Bao F, Munker R, Lowery C, Martin S, Shi R, Veillon DM, Cotelingam JD, Nordberg ML. Comparison of FISH and quantitative RT-PCR for the diagnosis and follow-up of BCR-ABL-positive leukemias. Mol Diagn Ther 2007; 11:239-45. [PMID: 17705578 DOI: 10.1007/bf03256245] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND For Philadelphia chromosome positive (Ph+) leukemias (chronic myelogenous leukemia [CML], acute lymphoblastic leukemia [ALL], and rare other leukemias), both allogeneic transplantation and treatment with tyrosine kinase inhibitors offer chances of molecular remission (the molecular marker being consistently undetectable). Molecular remission is defined as a reduction in the quantification of BCR-ABL transcripts to an undetectable level by molecular diagnostic methods, and is considered as a surrogate marker for cure or long-term disease control. The molecular diagnostic methods including fluorescence in situ hybridization (FISH) and quantitative reverse transcription-polymerase chain reaction (QRT-PCR) are more sensitive than classical cytogenetic analysis for the detection of BCR-ABL positive cells. QRT-PCR, due to its superior sensitivity, is considered the gold standard for the follow-up of Ph+ leukemias treated with imatinib. AIM The objective of our study was to compare the diagnostic and clinical usefulness of FISH and QRT-PCR at different timepoints for Ph+ leukemias. PATIENTS AND METHODS We investigated 23 unselected patients with Ph+ CML (n = 21) or Ph+ ALL (n = 2) at 77 different timepoints in a comparative study with both FISH and QRT-PCR using commercially available reagents in a routine laboratory. RESULTS Our study demonstrated a good correlation of QRT-PCR with FISH in detecting the BCR-ABL fusion gene among patients with CML or ALL (coefficient of correlation = 0.77493, p < 0.0001, using Spearman's correlation procedure). All newly diagnosed or untreated cases were positive with both methods. Lower coefficients of correlation were found when FISH and QRT-PCR were correlated with the white blood cell count (WBC). An overall concordance of FISH and QRT-PCR (being either negative or positive in both tests) was found in 65 cases (84.4%) and a discrepancy identified in 12 cases (15.6%). CONCLUSIONS We confirm that QRT-PCR allows precise measurement of low levels of BCR-ABL transcripts and can serve as a sensitive indicator for minimal residual disease. In addition, we demonstrate in most cases a good correlation of QRT-PCR with FISH in detecting the BCR-ABL fusion gene among patients with CML or Ph+ ALL. FISH is not suitable for monitoring minimal residual disease.
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Affiliation(s)
- Fei Bao
- Department of Pathology, Louisiana State University, Shreveport, Louisiana, USA
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Wei XE, Bao F, Veillon DM, Heldmann M, Cotelingam JD. Pathology case of the month. A mediastinal mass. Castleman's disease, hyaline-vascular type. J La State Med Soc 2006; 158:222-4, 226. [PMID: 17144214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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19
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Shackelford RE, Veillon DM, Heldmann M, Elmajian DA, Gonzalez E, Cotelingam JD. Pathology case of the month. Thirty-year-old man with a right adrenal mass. Adrenocortical carcinoma with lung and right renal hilar metastases. J La State Med Soc 2006; 158:172-5. [PMID: 17022359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Rodney E Shackelford
- Louisiana State University Health Sciences Center-Shreveport, Department of Pathology, USA
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Mazzella FM, Smith D, Horn P, Cotelingam JD, Rector JT, Shrit MA, Pesce A, Schumacher HR. Prognostic significance of pronormoblasts in erythrocyte predominant myelodysplastic patients. Am J Hematol 2006; 81:484-91. [PMID: 16755568 DOI: 10.1002/ajh.20563] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Recent studies of acute erythroleukemias have reaffirmed DiGuglielmo's syndrome (M6a, myeloblast-predominant) and disease (M6b, pronormoblast-predominant). M6c (mixed myeloblast/pronormoblast) has also been described. However, MDS is still defined according to the percentage of myeloblasts (% myeloblasts) without including the pronormoblast count. A 20-year retrospective study was performed to identify cases demonstrating >or=50% erythrocytic component and <30% calculated blasts (FAB exclusion criteria) without underlying cause (96 cases). Pronormoblast and myeloblast counts and other variables were analyzed as possible explanatory variables of the variations in survival. Considered alone, increasing % myeloblasts and/or percentage of pronormoblasts (% pronormoblasts) were significant predictors of decreasing survival. When all variables were considered as a multivariate group, the best fitting statistical model for predicting survival was a function of age, % pronormoblasts, IPSS cytopenias, platelet count, and percentage erythrocytic component. Of these, % pronormoblasts was by far the most significant. Nonappearance of % myeloblasts in this model is indicative of high correlations of this count with other variables.
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Affiliation(s)
- Fermina M Mazzella
- Department of Pathology and Laboratory Medicine, Medical College of Georgia, Augusta, USA.
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Puttaswamy S, Bagby J, Zhang RD, Veillon DM, Heldmann M, Cotelingam JD. An adult male presenting with an umbilical nodule. J La State Med Soc 2006; 158:122-5. [PMID: 16886831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Shekar Puttaswamy
- Louisiana State University Health Sciences Center-Shreveport, Department of Pathology, USA
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22
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Bhardwaj H, Veillon DM, Heldmann M, Simoneaux WJ, Elmajian DA, Cotelingam JD. Pathology case of the month. Young woman with abdominal pain and a right upper quadrant mass. Papillary renal cell carcinoma, type 2. J La State Med Soc 2006; 158:60-4; quiz 64, 111. [PMID: 16774031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- Hemant Bhardwaj
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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23
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Bilello SJ, Bao F, Veillon DM, Muldoon R, Cotelingam JD. Pathology case of the month. Elderly man with pancytopenia. Bone marrow granulomas secondary to amiodarone. J La State Med Soc 2006; 158:10-2. [PMID: 16602478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Affiliation(s)
- Seth J Bilello
- Department of Pathology, Louisiana State University Health Sciences Center-Shreveport, USA
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Veillon DM, Cotelingam JD. Pathologic Studies Useful for the Diagnosis and Monitoring of Plasma Cell Dyscrasias. Contributions to Nephrology 2006; 153:25-43. [PMID: 17075222 DOI: 10.1159/000096759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The pathologic diagnosis of multiple myeloma and other plasma cell dyscrasias includes histopathologic examination of a bone marrow aspirate and biopsy and clinical laboratory tests to assess end organ damage and other prognostic information. Plasma cell dyscrasias are characteristically classified and staged based on the results of these pathologic studies in conjunction with other clinical and radiologic parameters. New staging systems such as the International Staging System (ISS) use readily available laboratory tests to stratify prognostic subgroups. The continued introduction of new laboratory assays will help improve our understanding of plasma cell dyscrasias and the therapeutic management of these patients.
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Affiliation(s)
- Diana M Veillon
- Department of Pathology, Louisiana State University, Health Sciences Center, Shreveport, LA 71103, USA.
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25
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Shackelford RE, Bhalodia AR, Cotelingam JD, Veillon DM, Lowery-Nordberg M. Increased transferrin receptor expression following 11q23 deletion as a mechanism of malignant progression in chronic lymphocytic leukemia. Med Hypotheses 2006; 66:509-12. [PMID: 16326028 DOI: 10.1016/j.mehy.2005.08.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 08/09/2005] [Accepted: 08/18/2005] [Indexed: 12/24/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is a common adult leukemia characterized by the accumulation of mature neoplastic B-lymphocytes. Typically, CLL follows an indolent course, with most patients surviving for many years. However, 10-20% of CLL patients carry 11q23 chromosomal deletions and often exhibit a more severe disease course, with earlier onset of symptoms, shortened lymphocyte doubling time, poor response to therapy, and shortened survival. The molecular basis for 11q23 deletions resulting in a poor prognosis is currently poorly understood. The tumor suppressor gene, ataxia-telangiectasia mutated (ATM, 11q22.3-23.1), is considered a likely candidate gene whose loss could result in the poor prognosis associated with 11q23 deletion and is mutated in a significant percentage of CLL cases. Recently, recombinant ATM expression in ATM-deficient cells was found to decrease transferrin receptor (TfR) expression, suggesting that deletion of the chromosomal region carrying ATM results in increased TfR expression. TfR imports iron into cells, an event necessary for DNA synthesis and cell growth. Additionally, rapidly growing malignant cells, including lymphomas and CLL, often express high TfR levels. Based on this, we propose that one molecular mechanism by which 11q23 deletions confer a poor prognosis in CLL is via increased TfR expression secondary to ATM loss, resulting in the increased cellular iron import, and hence increased capacity for malignant growth. Our hypothesis may also partially explain why gallium, an atomically iron-like toxic metal that binds to transferrin and the TfR is incorporated into cells and was previously demonstrated to have anti-tumor activity in patients with lymphomas refractory to other chemotherapeutic treatments.
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Affiliation(s)
- Rodney E Shackelford
- Louisiana State University at Shreveport, Department of Pathology, 1501 Kings Hwy, P.O. Box 33932, Shreveport, LA 711030-3932, USA.
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Rodriguez JR, Heldmann M, Veillon DM, Carrico J, Elmajian DA, Cotelingam JD. Pathology case of the month. A man with an abdominal wall lesion. Squamous cell carcinoma of the urinary bladder associated with exstrophy of the urinary bladder. J La State Med Soc 2005; 157:294-7; quiz 298. [PMID: 16579341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
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Sakhalkar VS, Roberts K, Hawthorne LM, McCaskill DM, Veillon DM, Caldito GC, Cotelingam JD. Allosensitization in Patients Receiving Multiple Blood Transfusions. Ann N Y Acad Sci 2005; 1054:495-9. [PMID: 16339705 DOI: 10.1196/annals.1345.072] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Extended antigen (C, E, K) matching decreased the incidence of alloantibody (alloAB) and autoantibody (autoAB) formation, in addition to eliminating transfusion reactions in the multiply transfused sickle cell disease patients. AlloAB formation possibly transforms the immune system into a hyperactive state leading to further and earlier alloAB and autoAB formation. However, additional CEK matching results in marked overuse of Rh-negative packed red blood cell (pRBC) units, 30 minutes' extra time of a skilled technologist, and 153 dollars extra CEK reagent cost per unit to find CEK-matched pRBCs for every transfusion for these multiply transfused patients.
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Affiliation(s)
- V S Sakhalkar
- Department of Pediatrics, Louisiana State University Health Science Center at Shreveport, Feist-Weiller Cancer Center, 1501 Kings Hwy., P.O. Box 33932, Shreveport, LA 71130-3932, USA.
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Wei EX, Dancer YJ, Veillon DM, Linscott AJ, Dowden K, Fowler M, Cotelingam JD. Fever, chills, and weakness in a 61-year-old man. J La State Med Soc 2005; 157:245-9; quiz 250. [PMID: 16374968] [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] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
A 61-year-old man presented to the emergency department of a community hospital with a 2-week history of fever, chills, and sudden extreme weakness of his right arm and lower extremities. He also had a cough, shortness of breath, nausea, abdominal pain, diarrhea, and myalgia. Though initially alert and cooperative, he quickly became unresponsive. In addition, he had hyponatremia, renal insufficiency, and compromised cardiopulmonary function. He was admitted to the intensive care unit for suspected bacterial infection and was started on broad-spectrum antibiotics. Chest radiograph revealed miliary infiltrates consistent with infectious emboli or metastatic carcinoma. Despite intensive resuscitation, the patient died 36 hours after admission. At autopsy multiple nodular lesions were observed on gross examination of the lungs, perihilar and paratracheal lymph nodes, and liver. Microscopic sections of the lung (Figure 1) and brain (Figures 2 and 3) are shown.
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Affiliation(s)
- Eric Xueying Wei
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Saccaro SJ, Veillon DM, Heldmann M, Hargon CG, Fried A, Mills GM, Cotelingam JD. Pathology case of the month. Young woman with arterial thrombosis. Heparin-induced thrombocytopenia and thrombosis (HITT). J La State Med Soc 2005; 157:130-4; quiz 134. [PMID: 16173311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Steven J Saccaro
- Department of Medicine and the Feist-Weiller Cancer Center at Louisiana State University Health Sciences Center, Shreveport, USA
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Latif S, Veillon DM, Matthews-Greer J, Cotelingam JD, Turbat-Herrera EA. Pathology case of the month. A 35-year-old woman with an abnormal pap smear. HR-HPV-DNA positive atypical aquamous cells of undetermined significance (ASCUS). J La State Med Soc 2005; 157:77-9. [PMID: 16022272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- Shahnila Latif
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
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32
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Wei EX, Flamholz RB, Lowery-Nordberg M, Veillon DM, Behm W, Heldmann M, Cotelingam JD. Pathology case of the month. A mediastinal mass. Malignant lymphoma, composite (nodular sclerosis Hodgkin lymphoma and diffuse large B-cell lymphoma). J La State Med Soc 2004; 156:294-7. [PMID: 15688668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Eric Xueying Wei
- Louisiana State University Health Sciences Center-Shreveport, Department of Pathology, USA
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33
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Desai KA, Cotter NM, Doucet L, Veillon DM, Cotelingam JD, Herrera GA, Heldmann M, Berney SM. Pathology case of the month. 39-year-old woman with abdominal pain and weight loss. Takayasu's arteritis (TA). J La State Med Soc 2004; 156:230-4; quiz 234. [PMID: 15554091] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
A 39-year-old white woman presented with a history of aortoiliac occlusive disease diagnosed in 1992 attributed to oral contraceptive use. Shortly thereafter, aortoiliac replacement was performed. Mild hyperlipidemia was diagnosed in 2001. At the current clinic visit, she presented to her primary care physician with a 3-month history of postprandial midepigastric abdominal pain relieved by vomiting and a 30-pound weight loss. Her evaluation included an esophagogastroduodenoscopy, a colonoscopy, and an abdominal ultrasound, all of which were within normal limits. Because of her medical history, the patient underwent an arteriogram, which revealed brachiocephalic stenosis (Figure 1), occlusion of the left subclavian artery (Figures 2a and 2b), and narrowing of the superior and inferior mesenteric arteries (not shown). Since she had discontinued her oral contraceptives in 1992 and her hyperlipidemia was mild, the rheumatology service was consulted to evaluate this patient. On physical examination, she had decreased left brachial and radial pulses and a right carotid bruit. Laboratory evaluation revealed a normal complete blood count, comprehensive metabolic panel, erythrocyte sedimentation rate, and C - reactive protein. Subsequent testing included a prothrombin time, activated partial thromboplastin time, protein S, protein C, reptilase time, antithrombin III, anticardiolipin antibody, antiphospholipid antibody, lupus anticoagulant, homocysteine, RPR, and a lipid profile. All test results were within normal limits. Due to the severity of her abdominal pain, the patient underwent superior mesenteric artery (SMA) bypass surgery. Sections from the aorta resected in 1992 are shown in Figures 3 and 4.
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Wellman G, Gonzalez E, Veillon DM, Barnum O, Cotelingam JD. Pathology case of the month. 41-year-old woman with abdominal discomfort and weight loss. J La State Med Soc 2004; 156:177-80. [PMID: 15366344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Greg Wellman
- Department of Pathology, Louisiana State University Health Sciences Center-Shreveport, USA
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Flamholz RB, Veillon DM, Jeroudi M, Sakhalkar VS, Nordberg ML, Cotelingam JD. Myeloblastic Proliferation in the Peripheral Blood of a Neonate With Down Syndrome. Lab Med 2004. [DOI: 10.1309/tdjq1kw8yjn5w2qj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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36
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Wei XE, Veillon DM, Flamholz RB, Heldmann M, Grafton WD, Fowler MR, Cotelingam JD. Pathology case of the month. Tumor of the pineal region. Pineoblastoma, recurrent. J La State Med Soc 2004; 156:125-7, 129. [PMID: 15233382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Xueying Eric Wei
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Latif S, Veillon DM, Flamholz RB, Henley J, Abreo F, Zibari G, Heldman M, Cotelingam JD. Pathology case of the month. Painful abdominal mass in a boy. Undifferentiated (embryonal) sarcoma of the liver. J La State Med Soc 2004; 156:69-71. [PMID: 15106863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Shahnila Latif
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Flamholz RB, Veillon DM, Nordberg ML, Cotelingam JD. Pathology case of the month. A recurrent vesicle on the plantar aspect of the foot. Primary cutaneous CD30- positive T-cell lymphoproliferative disorder, consistent with lymphomatoid papulosis. J La State Med Soc 2004; 156:15-8. [PMID: 15000207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Rachel B Flamholz
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Latif S, Veillon DM, Brown D, Kaltenbach J, Curry S, Linscott AJ, Oberle A, Cotelingam JD. Spurious Automated Platelet Count. Am J Clin Pathol 2003. [DOI: 10.1309/h2k6e59lyfe63gpb] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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40
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Heard C, Wellman G, Veillon D, Heldmann M, Cotelingam JD, Albores-Saavedra J. Pathology case of the month. Tumor of the cauda equina. Paraganglioma of the cauda equina. J La State Med Soc 2003; 155:298, 300-1. [PMID: 14750748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Cooper Heard
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Shukla D, Veillon DM, Abreo F, Cotelingam JD. Pathologic Quiz Case: A 55-Year-Old Woman With a History of Treated Hodgkin Disease and a Persistent Abdominal Mass. Arch Pathol Lab Med 2003; 127:1527-8. [PMID: 14567745 DOI: 10.5858/2003-127-1527-pqcayw] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Deepti Shukla
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport 71130-3932, USA.
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Solanki SK, Latif S, Veillon DM, Nordberg ML, Saccaro SJ, Cotelingam JD, Berney SM. A Swollen Painful Knee In An Elderly Man With Recently Diagnosed Acute Myelogenous Leukemia. Lab Med 2003. [DOI: 10.1309/yru7l787avrktcvl] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Reddy P, Veillon DM, Nordberg ML, Flamholz RB, Cunningham M, Mansour RP, Cotelingam JD. Pathology case of the month. A cheek mass in a young woman. Subcutaneous panniculitis-like T-cell lymphoma. J La State Med Soc 2003; 155:232-4. [PMID: 14748482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Praveen Reddy
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Sun T, Nordberg ML, Cotelingam JD, Veillon DM, Ryder J. Fluorescence in situ hybridization: method of choice for a definitive diagnosis of mantle cell lymphoma. Am J Hematol 2003; 74:78-84. [PMID: 12949897 DOI: 10.1002/ajh.10356] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fluorescence in situ hybridization (FISH) using IGH/CCND1 probes was used to analyze 35 specimens including 27 paraffin sections, 3 bone marrow aspirates, and 5 peripheral blood smears. The 27 paraffin sections included 7 bone marrows, 10 lymph nodes, 3 spleens, 3 tonsils, 3 gastrointestinal biopsies, and 1 skin biopsy. Among these cases, 23 specimens were from 20 patients with mantle cell lymphoma (MCL) and 12 specimens were from 12 patients with non-MCL lymphomas/lymphoid hyperplasia. Specimens from all MCL patients showed positive results with FISH. In one patient, the archived paraffin sections were negative with FISH, but a fresh peripheral blood specimen showed a positive result. Negative results were obtained in all specimens from non-MCL cases. Flow cytometric analysis revealed that all cases of MCL showed CD19/CD5 staining, but the percentages of cells positive for CD23 and FMC-7 were variable, thus they cannot be depended upon for a definitive diagnosis of MCL. Immunohistochemical stains demonstrated positive staining for CD5 and CD20 and negative staining for CD23 in MCL cases but cyclin D1 was positive in only 10 of 13 MCL cases studied. Therefore, it appears that immunophenotyping alone is not sufficient to establish a definitive diagnosis of MCL. FISH should be routinely used when the diagnosis needs confirmation. FISH can be performed in a routine clinical laboratory, and it is applicable to archived material for retrospective studies. Other molecular cytogenetic techniques in comparison with FISH are discussed.
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Affiliation(s)
- Tsieh Sun
- Pathology and Laboratory Medicine Service, Veterans Affairs Medical Center, Denver, Colorado 80220, USA.
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Latif S, Veillon DM, Brown D, Kaltenbach J, Curry S, Linscott AJ, Oberle A, Cotelingam JD. Laboratory diagnosis of von Willebrand disorder. Current practice in the southern hemisphere. Am J Clin Pathol 2003; 120:882-5. [PMID: 14671977 DOI: 10.1309/8wva-nm7h-0dkt-gb9f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
A survey of 44 laboratories was conducted to evaluate current testing proficiency in the diagnosis of von Willebrand disorder (vWD) and to assess recent changes in test practices. Laboratories performed their usual panel of tests for vWD and interpreted results for the likelihood of vWD and potential subtype. Samples were as follows: normal plasma; borderline normal or abnormal levels of von Willebrand factor (vWF) and factor VIII; type 3 vWD; type 2A vWD; and 2 samples from a healthy person, processed after handling at 22 degrees C and 4 degrees C, respectively. Interassay and within-method coefficients of variation were similar for all assays (approximately 15%-25%). Most laboratories reported test values consistent with expected findings and made correct interpretations, although discrepant results for 5% to 10% of responses are of concern. For the sample stored at 4 degrees C, all laboratories detected low or borderline levels of vWF and factor VIII coagulant, and no laboratory identified this sample as from a healthy person. In contrast, for the sample stored at 22 degrees C, most laboratories reported normal results. Compared with previous results, performance of some assays has declined while that of others has increased. Laboratories generally are proficient in tests for vWD, and transport of samples at 4 degrees C before processing may lead to false identification of vWD, suggesting that NCCLS guidelines should be reviewed.
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Affiliation(s)
- Shahnila Latif
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Latif S, Veillon DM, Constantinescu M, Heldmann M, Cotelingam JD. Pathology case of the month. Spontaneous pneumothorax in a young woman. Usual interstitial pneumonia (UIP). J La State Med Soc 2003; 155:131-3. [PMID: 12873096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Shukla D, Veillon DM, Nordberg ML, Mansour RP, Constantinescu M, Cotelingam JD. Leukemia in a Patient With Multiple Myeloma. Lab Med 2003. [DOI: 10.1309/6tgxpav1kg7wy436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Shukla D, Veillon DM, Scott LK, Heldmann M, Lewis DF, Cotelingam JD. Pathology case of the month. Abdominal pain in pregnancy. HELLP syndrome with subcapsular hematoma of the liver. J La State Med Soc 2003; 155:77-9. [PMID: 12778989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Deepti Shukla
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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Abstract
Ideally, the bone marrow core biopsy should be reviewed with knowledge of the clinical history, complete blood count, and findings in the peripheral blood and bone marrow aspirate smears. However, for a variety of reasons, the pathologist may receive the core biopsy and aspirate clot section without all of this information. Although this approach is not optimal, a great deal of valuable information can be generated from these specimens. Over the past 20 years, there has been considerable progress in the fields of flow cytometric analysis, immunohistochemistry, and molecular diagnostic studies that can be performed on smears or extracted DNA from paraffin embedded tissue. These modalities have augmented and refined diagnostic criteria formerly ascertained by light microscopy, cytochemistry, and cytogenetics. This is particularly true of some myeloid and lymphoreticular neoplasms where a collaborative and multidisciplinary approach to the diagnosis has become necessary. Despite this growing complexity and dependence on newer methodologies, the traditional role of histopathology in evaluating the bone marrow biopsy remains as important as it has been in the past. In this review, we focus on contemporary practices and expectations for interpreting bone marrow biopsies and clot sections.
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Affiliation(s)
- James D Cotelingam
- Department of Pathology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71330, USA
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Veillon DM, Nordberg ML, Neupane P, Cotelingam JD. Spontaneous resolution of RARalpha rearrangement in bone marrow recovery with a predominance of CD117- and CD11B-negative promyelocytes. Am J Clin Pathol 2002; 118:965; author reply 966. [PMID: 12472288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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