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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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2
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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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Onaka T, Ohshima K, Kinoshita I, Miyakawa N, Shirae A, Kato-Ogura A, Otsuka Y, Iwai F, Yonezawa A. Post-transplant lymphoproliferative disease of two different histological types. Ann Hematol 2024:10.1007/s00277-024-05722-y. [PMID: 38609728 DOI: 10.1007/s00277-024-05722-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Affiliation(s)
- Takashi Onaka
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan.
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Izumi Kinoshita
- Department of Pathology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Naoto Miyakawa
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan
| | - Atsuto Shirae
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan
| | - Aiko Kato-Ogura
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan
| | - Yasuyuki Otsuka
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan
| | - Fumie Iwai
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, Japan
| | - Akihito Yonezawa
- Department of Hematology, Kokura Memorial Hospital, 3-2-1, Asano, Kokura-kita, Fukuoka, Kitakyushu, 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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5
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Takizawa J, Suzuki R, Izutsu K, Kiguchi T, Asaoku H, Saburi Y, Masunari T, Utsunomiya A, Takeuchi K, Nakamura N, Ohshima K, Gruber M, Jäger U, Aoki S, Suzumiya J. Characteristics of chronic lymphocytic leukemia in Japan: Comprehensive analysis of the CLLRSG-01 study. Int J Hematol 2024:10.1007/s12185-024-03741-z. [PMID: 38492198 DOI: 10.1007/s12185-024-03741-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
Chronic lymphocytic leukemia (CLL) is rare in Japan. We conducted the nationwide, prospective observational study CLLRSG-01 to clarify the current state of CLL in Japan and to make accurate international comparisons by preparing naturally air-dried smears like those used in other countries. Of the 201 untreated patients enrolled and evaluated, 119 were diagnosed with CLL and 82 with non-CLL mature B-cell neoplasms, based on the WHO classification. Of the 119 CLL patients, 90 were classified as typical and 29 as atypical according to FAB classification morphology, with the proportion of atypical CLL consistent with reports from other countries. Immunophenotypic analyses by flow cytometry showed that 55% of Japanese CLL patients had a Matutes score of 4 or higher, which is lower than the rate of about 90% in Europeans. Mutated IGHV was identified in 80% of Japanese CLL patients, which is a higher rate than in Western patients. The most frequent IGHV gene was VH3-30 (15%), followed by VH3-23 (12%) and VH4-34 (10%). VH1-69, the most common gene in Western countries, was identified in only one patient. These results indicate that the pattern of immunophenotypes and IGHV gene usage in Japanese CLL patients differs from that in Western patients.
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Affiliation(s)
- Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan.
| | - Ritsuro Suzuki
- Shimane University Hospital, Cancer Center, Izumo, Japan
- Department of Hematology and Oncology, Shimane University School of Medicine, Izumo, Japan
| | - Koji Izutsu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Toru Kiguchi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
- Division of Diabetes, Endocrinology and Hematology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hideki Asaoku
- Department of Hematology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Yoshio Saburi
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Taro Masunari
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University, Isehara, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, Kurume, Japan
| | - Michaela Gruber
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Ulrich Jäger
- Department of Internal Medicine 1, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Sadao Aoki
- Pathophysiology, Niigata University of Pharmacy and Applied Life Sciences, Niigata, Japan
| | - Junji Suzumiya
- Shimane University Hospital, Cancer Center, Izumo, Japan
- Department of Hematology, Koga Community Hospital, Shizuoka, Japan
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Kinoshita S, Ishii M, Ando J, Kimura T, Yamaguchi T, Harada S, Takahashi F, Nakashima K, Nakazawa Y, Yamazaki S, Ohshima K, Takahashi K, Nakauchi H, Ando M. Rejuvenated iPSC-derived GD2-directed CART Cells Harbor Robust Cytotoxicity Against Small Cell Lung Cancer. Cancer Res Commun 2024; 4:723-737. [PMID: 38380966 PMCID: PMC10926899 DOI: 10.1158/2767-9764.crc-23-0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/21/2023] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
Small cell lung cancer (SCLC) is exceptionally aggressive, with limited treatment options. Disialoganglioside (GD2) is highly expressed on SCLC and is considered a good target for chimeric antigen receptor (CAR) T cells (CART). Although GD2-directed CARTs (GD2-CART) exhibit cytotoxicity against various GD2-expressing tumors, they lack significant cytotoxicity against SCLC. To enhance cytotoxicity of GD2-CARTs against SCLC, we introduced GD2-CAR into induced pluripotent stem cells (iPSC)-derived rejuvenated cytotoxic T lymphocytes (GD2-CARrejT). GD2-CARrejTs acted much more strongly against SCLC cells than did GD2-CARTs both in vitro and in vivo. Single-cell RNA sequencing elucidated that levels of expression of TIGIT were significantly lower and levels of expression of genes associated with cytotoxicity were significantly higher in GD2-CARrejTs than those in GD2-CARTs. Dual blockade of TIGIT and programmed death-1 (PD-1) increased the cytotoxicity of GD2-CARTs to some extent, suggesting that low TIGIT and PD-1 expression by GD2-CARrejTs is a major factor required for robust cytotoxicity against SCLC. Not only for robust cytotoxicity but also for availability as "off-the-shelf" T-cell therapy, iPSC-derived GD2-CARrejTs are a promising novel treatment for SCLC. SIGNIFICANCE This research introduces iPSC-derived rejuvenated GD2-CARTs (GD2-CARrejT) as a novel approach to combat SCLC. Compared with conventional GD2-CARTs, GD2-CARrejTs with reduced TIGIT and PD-1 expression demonstrate robust cytotoxicity against SCLC and would be a promising therapy for SCLC.
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Affiliation(s)
- Shintaro Kinoshita
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Midori Ishii
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Jun Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
- Division of Cell Therapy and Blood Transfusion Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Takaharu Kimura
- Laboratory of Stem Cell Therapy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tomoyuki Yamaguchi
- Laboratory of Regenerative Medicine, Tokyo University of Pharmacy and Life Science, Tokyo, Japan
| | - Sakiko Harada
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Fumiyuki Takahashi
- Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazutaka Nakashima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinsyu University School of Medicine, Nagano, Japan
| | - Satoshi Yamazaki
- Laboratory of Stem Cell Therapy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiromitsu Nakauchi
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California
- Stem Cell Therapy Laboratory, Advanced Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, 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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8
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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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9
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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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10
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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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11
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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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12
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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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13
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Shimada K, Ohmachi K, Machida R, Ota S, Itamura H, Tsujimura H, Takayama N, Shimada T, Kurosawa M, Tabayashi T, Shimoyama T, Ohshima K, Miyazaki K, Maruyama D, Kinoshita T, Ando K, Hotta T, Tsukasaki K, Nagai H. Secondary central nervous system involvement in patients with diffuse large B-cell lymphoma treated with rituximab combined CHOP therapy - a supplementary analysis of JCOG0601. Ann Hematol 2024:10.1007/s00277-024-05620-3. [PMID: 38280061 DOI: 10.1007/s00277-024-05620-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 01/08/2024] [Indexed: 01/29/2024]
Abstract
Secondary central nervous system involvement (sCNSi) in diffuse large B-cell lymphoma (DLBCL) is fatal. However, its features in patients with sCNSi who are categorized as lower risk by international prognostic index (IPI) or CNS-IPI are not yet fully understood. In the present analysis, we evaluated DLBCL patients who developed sCNSi at their first progression and who participated in JCOG0601, most of whom were lower risk by IPI. Of 409 patients, 21 (5.1%) developed sCNSi during a median follow-up of 4.9 years. Five-year cumulative incidence of sCNSi were 5.1%; and 4.0%, 5.3%, and 11.5% at low, intermediate, and high risk of CNS-IPI, respectively. The most common locations of extranodal lesions at the time of registration in patients with sCNSi were the stomach (n = 4), paranasal cavity (n = 3), and bone marrow (n = 2). In univariable analysis, paranasal cavity lesion was a high-risk factor for sCNSi (subdistribution hazard ratio, 4.34 [95% confidence interval 1.28-14.73]). Median overall survival after sCNSi was 1.3 years, with a 2-year overall survival rate of 39.3%. The incidence of sCNSi in DLBCL patients at lower risk of CNS-IPI was low, as previously reported, but paranasal cavity lesion might indicate high risk for organ involvement. CLINICAL TRIAL REGISTRATION: JCOG0601 was registered in the UMIN Clinical Trials Registry (UMIN000000929, date of registration; December 04, 2007) and the Japan Registry of Clinical Trials (jRCTs031180139, date of registration; February 20, 2019).
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Affiliation(s)
- Kazuyuki Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, Aichi, 466-8550, Japan.
| | - Ken Ohmachi
- Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Ryunosuke Machida
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Hidekazu Itamura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hideki Tsujimura
- Department of Hematology-Oncology, Chiba Cancer Center, Chiba, Japan
| | - Nobuyuki Takayama
- Department of Hematology, Faculty of Medicine, Kyorin University, Mitaka, Japan
| | - Takaki Shimada
- Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mitsutoshi Kurosawa
- Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Takayuki Tabayashi
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Tatsu Shimoyama
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Dai Maruyama
- Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomohiro Kinoshita
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tomomitsu Hotta
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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14
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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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15
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Furukawa Y, Ishii M, Ando J, Ikeda K, Igarashi KJ, Kinoshita S, Azusawa Y, Toyota T, Honda T, Nakanishi M, Ohshima K, Masuda A, Yoshida E, Kitade M, Porteus M, Terao Y, Nakauchi H, Ando M. iPSC-derived hypoimmunogenic tissue resident memory T cells mediate robust anti-tumor activity against cervical cancer. Cell Rep Med 2023; 4:101327. [PMID: 38091985 PMCID: PMC10772465 DOI: 10.1016/j.xcrm.2023.101327] [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: 02/10/2023] [Revised: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 12/22/2023]
Abstract
Functionally rejuvenated human papilloma virus-specific cytotoxic T lymphocytes (HPV-rejTs) generated from induced pluripotent stem cells robustly suppress cervical cancer. However, autologous rejT generation is time consuming, leading to difficulty in treating patients with advanced cancer. Although use of allogeneic HPV-rejTs can obviate this, the major obstacle is rejection by the patient immune system. To overcome this, we develop HLA-A24&-E dual integrated HPV-rejTs after erasing HLA class I antigens. These rejTs effectively suppress recipient immune rejection while maintaining more robust cytotoxicity than original cytotoxic T lymphocytes. Single-cell RNA sequencing performed to gain deeper insights reveal that HPV-rejTs are highly enriched with tissue resident memory T cells, which enhance cytotoxicity against cervical cancer through TGFβR signaling, with increased CD103 expression. Genes associated with the immunological synapse also are upregulated, suggesting that these features promote stronger activation of T cell receptor (TCR) and increased TCR-mediated target cell death. We believe that our work will contribute to feasible "off-the-shelf" T cell therapy with robust anti-cervical cancer effects.
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Affiliation(s)
- Yoshiki Furukawa
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Midori Ishii
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Jun Ando
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Division of Cell Therapy & Blood Transfusion Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kazuya Ikeda
- Department of Pediatrics, School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA
| | - Kyomi J Igarashi
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, 265 Campus Drive, Stanford, CA 94305, USA
| | - Shintaro Kinoshita
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yoko Azusawa
- Division of Cell Therapy & Blood Transfusion Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tokuko Toyota
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Tadahiro Honda
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Mahito Nakanishi
- TOKIWA-Bio, Inc., Tsukuba Center Inc. (TCI), Building G, 2-1-6 Sengen, Tsukuba, Ibaraki 305-0047, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka 830-0011, Japan
| | - Ayako Masuda
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Emiko Yoshida
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Mari Kitade
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Matthew Porteus
- Department of Pediatrics, School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, USA
| | - Yasuhisa Terao
- Department of Obstetrics and Gynecology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Hiromitsu Nakauchi
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, 265 Campus Drive, Stanford, CA 94305, USA.
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
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16
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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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17
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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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18
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Kawada JI, Ito Y, Ohshima K, Yamada M, Kataoka S, Muramatsu H, Sawada A, Wada T, Imadome KI, Arai A, Iwatsuki K, Ohga S, Kimura H. Updated guidelines for chronic active Epstein-Barr virus disease. Int J Hematol 2023; 118:568-576. [PMID: 37728704 PMCID: PMC10615970 DOI: 10.1007/s12185-023-03660-5] [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: 04/28/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
Abstract
Chronic active Epstein-Barr virus disease (CAEBV), formerly named chronic active Epstein-Barr virus infection, is characterized by systemic inflammation and clonal proliferation of Epstein-Barr virus (EBV)-infected T or NK cells. As CAEBV is a potentially life-threatening illness, appropriate diagnosis and therapeutic interventions are necessary for favorable clinical outcomes. Substantial evidence regarding the pathogenesis and treatment of CAEBV has been accumulated since previous guidelines for the diagnosis of CAEBV were proposed. To reflect this evidence, we updated the guidelines for the diagnosis and treatment of CAEBV to improve clinical management of the disease. The details of the updated guidelines are presented in this report. Diagnosis of CAEBV now requires confirmation of a high copy number of EBV genome and EBV-infected T or NK cells. An EBV DNA load ≥ 10,000 IU/mL in whole blood is proposed as the diagnostic cutoff value for CAEBV in this updated guideline. A standard treatment approach for CAEBV has not been established, and hematopoietic stem cell transplantation (HSCT) is considered the only curative treatment. Chemotherapy can be administered to control disease activity before HSCT.
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Affiliation(s)
- Jun-Ichi Kawada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Yoshinori Ito
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Masaki Yamada
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Shinsuke Kataoka
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Sawada
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Taizo Wada
- Department of Pediatrics, Kanazawa University, Kanazawa, Japan
| | - Ken-Ichi Imadome
- Department of Advanced Medicine for Viral Infections, National Center for Child Health and Development, Tokyo, Japan
| | - Ayako Arai
- Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Kimura
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Sakamoto K, Baba S, Okumura Y, Momose S, Ono S, Tonooka A, Ichinohasama R, Takakuwa E, Nakasone H, Ohshima K, Takeuchi K. Comparison and Development of Immunohistochemical Diagnostic Criteria for Blastic Plasmacytoid Dendritic Cell Neoplasm. Mod Pathol 2023; 36:100253. [PMID: 37380058 DOI: 10.1016/j.modpat.2023.100253] [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: 03/09/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 06/30/2023]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological malignancy derived from the precursors of plasmacytoid dendritic cells. Diagnostic criteria for BPDCN have not been fully established. BPDCN is often diagnosed without other BPDCN markers than the 3 conventional markers (CD4, CD56, and CD123) in practice and case reports, although acute myeloid leukemia/myeloid sarcoma (AML/MS), which is always considered in the differential diagnosis of BPDCN, can express them. We reviewed published case reports on BPDCN and found that the diagnosis was made without any other BPDCN markers than the conventional markers in two-thirds of the cases. Next, 4 representative existing diagnostic criteria were applied to 284 cases of our cohort of BPDCN and mimics. The results differed in 20% (56/284) of the cases. The criterion based on the 3 conventional markers alone had a low concordance rate (80%-82%) with the other 3 criteria, which were almost concordant with each other. However, newly found minor limitations in these criteria prompted us to devise new diagnostic criterion for BPDCN composed of TCF4, CD123, TCL1, and lysozyme. We also revealed that CD123-positive AML/MS patients had a significantly poorer outcome than those with BPDCN and that 12% (24/205) of the cases were non-BPDCN even if all 3 conventional markers were positive, thus clarifying the risk of diagnosing BPDCN without more specific markers. In addition, histopathological features, such as the reticular pattern, which is not seen in BPDCN and suggests AML/MS, were also identified.
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Affiliation(s)
- Kana Sakamoto
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuka Okumura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Shuji Momose
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Sawako Ono
- Department of Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Akiko Tonooka
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Komagome Hospital, Tokyo, Japan
| | - Ryo Ichinohasama
- Division of Hematopathology, Tohoku University Hospital, Sendai, Japan
| | - Emi Takakuwa
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Nakasone
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Clinical Pathology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
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20
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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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21
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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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22
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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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23
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Furuta T, Moritsubo M, Muta H, Shimamoto H, Ohshima K, Sugita Y. Pediatric and elderly polymorphous low-grade neuroepithelial tumor of the young: Typical and unusual case reports and literature review. Neuropathology 2023; 43:319-325. [PMID: 36545913 DOI: 10.1111/neup.12889] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 08/03/2023]
Abstract
Polymorphous low-grade neuroepithelial tumor of the young (PLNTY), one of the pediatric-type diffuse low-grade gliomas, is characterized by a diffuse infiltrating pattern of oligodendroglioma-like tumor cells showing CD34 positivity and harbors mitogen-activated protein kinase (MAPK) alteration, such as vRAF murine sarcoma viral oncogene homolog B1 (BRAF) p.V600E or fibroblast growth factor fusion genetically. It occurs mainly in pediatric and adolescents with seizures due to the dominant location of the temporal lobe. However, there have been a few cases of PLNTY in adult patients, suggesting the wide range of this tumor spectrum. Here, we describe two cases of PLNTY, one in a 14-year-old female and the other in a 66-year-old female. The pediatric tumor showed typical clinical course and histopathology with BRAF p.V600E mutation, whereas the elderly tumor was unusual because of non-epileptic onset clinically and ependymal differentiation histopathologically harboring KIAA1549-BRAF fusion. There might be unusual but possible PLNTY, as in our elderly case. We also compared typical pediatric and unusual elderly tumors by reviewing the literature.
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Affiliation(s)
- Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroko Muta
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Yasuo Sugita
- Department of Neuropathology, St. Mary's Hospital, Fukuoka, Japan
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24
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Shimizu S, Inamura E, Sugai T, Kawashima K, Tsuji T, Ohshima K, Eguchi H, Fujita Y. Primary cutaneous Langerhans cell sarcoma without evident Birbeck granules: the importance of CD207/langerin positivity. Eur J Dermatol 2023; 33:311-312. [PMID: 37594347 DOI: 10.1684/ejd.2023.4487] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Satoko Shimizu
- Department of Dermatology, Sapporo City General Hospital, Japan
| | - Emi Inamura
- Department of Dermatology, Sapporo City General Hospital, Japan
| | - Tatsuro Sugai
- Department of Dermatology, Sapporo City General Hospital, Japan
| | | | - Takahiro Tsuji
- Department of Pathology, Sapporo City General Hospital, Japan
| | | | | | - Yasuyuki Fujita
- Department of Dermatology, Sapporo City General Hospital, Japan
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25
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Hirai Y, Asada H, Hamada T, Kawada JI, Kimura H, Arai A, Ohshima K, Ohga S, Iwatsuki K. Diagnostic and disease severity determination criteria for hydroa vacciniforme lymphoproliferative disorders and severe mosquito bite allergy. J Dermatol 2023. [PMID: 37249004 DOI: 10.1111/1346-8138.16842] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/31/2023]
Abstract
Hydroa vacciniforme lymphoproliferative disorder (HV-LPD) and severe mosquito bite allergy (SMBA) are both cutaneous forms of Epstein-Barr virus (EBV)-associated T/natural killer (NK) cell LPDs and are closely related to chronic active EBV disease (CAEBV) and EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH). HV-LPD is further divided into classic HV, a benign subtype mediated by EBV-positive γδT cells, and systemic HV, another life-threatening subtype mainly associated with EBV-positive αβT or γδT cells. The vast majority of patients with SMBA have increased numbers of EBV-infected NK cells in the blood. Clinical symptoms of HV-LPD and SMBA often overlap in the same patient and may progress to more serious disease conditions equivalent to the systemic form of CAEBV. To define the disease spectrum of HV-LPD and SMBA, we propose the diagnostic criteria and the determination criteria for disease severity. The proposed diagnostic criteria are consistent with those for CAEBV and EBV-HLH in the guidelines for the management for CAEBV and related disorders 2023.
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Affiliation(s)
- Yoji Hirai
- Department of Dermatology, Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideo Asada
- Department of Dermatology, Nara Medical University School of Medicine, Nara, Japan
| | - Toshihisa Hamada
- Department of Dermatology, International University of Health and Welfare, Narita, Japan
| | - Jun-Ichi Kawada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroshi Kimura
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ayako Arai
- Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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26
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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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27
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Miyazaki K, Sakai R, Iwaki N, Yamamoto G, Murayama K, Nishikori M, Sunami K, Yoshida I, Yano H, Takahashi N, Okamoto A, Munemoto S, Sawazaki A, Suehiro Y, Fukuhara N, Wake A, Arai A, Masaki Y, Toyama K, Yokoyama A, Tsunemine H, Hasegawa Y, Matsumoto K, Yamada T, Nishimura Y, Tamaru S, Asano N, Miyawaki K, Izutsu K, Kinoshita T, Suzuki R, Ohshima K, Kato K, Katayama N, Yamaguchi M. Five-year follow-up of a phase II study of DA-EPOCH-R with high-dose MTX in CD5-positive DLBCL. Cancer Sci 2023. [PMID: 36929591 DOI: 10.1111/cas.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/16/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ayako Arai
- St. Marianna University, Kawasaki, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
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28
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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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29
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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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30
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Imaizumi Y, Iwanaga M, Nosaka K, Ishitsuka K, Ishizawa K, Ito S, Amano M, Ishida T, Uike N, Utsunomiya A, Ohshima K, Tanaka J, Tokura Y, Tobinai K, Watanabe T, Uchimaru K, Tsukasaki K. Validation of the iATL-PI prognostic index in therapeutic decision-making for patients with smoldering and chronic ATL: a multicenter study. Int J Hematol 2023; 117:206-215. [PMID: 36308678 DOI: 10.1007/s12185-022-03473-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 07/19/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 02/03/2023]
Abstract
Adult T cell leukemia-lymphoma (ATL) is clinically heterogeneous and is classified into four subtypes: acute, lymphoma, chronic, and smoldering. Recently, a new prognostic index based on the value of soluble interleukin-2 receptor, denoted the "iATL-PI," has been proposed for patients with smoldering and chronic ATL. To evaluate the effectiveness of the iATL-PI, we re-analyzed our previously published data on 176 patients with smoldering or chronic ATL (76 smoldering, 100 chronic) diagnosed between 2010 and 2011, as well data from the subsequent follow-up study on prognosis between 2016 and 2017. The proportions for the low-, intermediate-, and high-risk iATL-PI groups at the time of ATL diagnosis were 44.7%, 48.7%, and 5% for smoldering ATL; 6.3%, 71.9%, and 21.9% for favorable chronic ATL; and 5.9%, 27.9%, and 66.2% for unfavorable chronic ATL, respectively. The survival of patients with smoldering or chronic ATL as a whole was significantly stratified according to the three iATL-PI groups. Most patients with unfavorable chronic ATL in the low iATL-PI risk group had indolent clinical courses. Our results showed that iATL may become a useful tool to predict the prognosis of smoldering and chronic ATL, which have diverse clinical courses.
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Affiliation(s)
- Yoshitaka Imaizumi
- Department of Hematology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Masako Iwanaga
- Department of Clinical Epidemiology, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Kisato Nosaka
- Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan
| | - Kenji Ishitsuka
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima, Japan
| | - Kenichi Ishizawa
- Department of Third Internal Medicine, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shigeki Ito
- Department of Hematology and Oncology, Iwate Medical University, Iwate, Japan
| | - Masahiro Amano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Takashi Ishida
- Department of Immunology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naokuni Uike
- Department of Hospice Care, St. Mary's Hospital, Kurume, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Woman's Medical University, Tokyo, Japan
| | - Yoshiki Tokura
- Department of Dermatology and Skin Oncology, Allergic Disease Research Center, Chutoen General Medical Center, Kakegawa, Japan
| | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Toshiki Watanabe
- Department of Practical Management of Medical Information, Graduate School of Medicine, St. Marianna University, Kanagawa, Japan
| | - Kaoru Uchimaru
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, International Medical Center, Saitama Medical University, Saitama, Japan
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31
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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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32
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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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33
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Kuhara A, Sumi A, Chikasue T, Kawaguchi A, Tanoue S, Nagata S, Koganemaru M, Abe T, Kashihara M, Mitsuoka M, Ishii H, Ohshima K, Leung ANC, Fujimoto K. Utility of non-contrast-enhanced magnetic resonance imaging in predicting preoperative clinical stage and prognosis in patients with thymic epithelial tumor. Jpn J Radiol 2023; 41:302-311. [PMID: 36374474 PMCID: PMC9974725 DOI: 10.1007/s11604-022-01358-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to find useful imaging features on non-contrast-enhanced magnetic resonance imaging (MRI) that can divide patients with thymic epithelial tumor (TET) into clinical stage I-II and III-IV groups under assumption that contrast media are contraindicated. MATERIALS AND METHODS This retrospective study included 106 patients (median age, 60 years; range, 27-82 years; 62 women) with surgically resected TET who underwent MRI between August 1986 and July 2015. All cases were classified according to the 2015 WHO classification and staged using the eighth edition of the TNM system. Two radiologists independently evaluated 14 categories of MRI findings; the findings in patients with stage I-II were compared with those of patients with stage III-IV using a logistic regression model. Disease-specific survival associated with significant findings was calculated using the Kaplan-Meier method. RESULTS Univariate analysis showed that stage III-IV patients were more likely to have tumors with an irregular contour, heterogeneity on T1WI, low-signal intensity on T2WI, irregular border with lung, findings of great vessel invasion (GVI) (hereafter, GVI sign), pericardial thickening/nodule, and lymphadenopathy (all, P < 0.01). On multivariable analysis, only two findings, irregular border between tumor and lung (odds ratio [OR], 272.8; 95% CI 26.6-2794.1; P < 0.001) and positive GVI sign (OR, 49.3; 95% CI 4.5-539.8; P = 0.001) remained statistically significant. Patients with one or both features had significantly worse survival (log-rank test, P < 0.001). CONCLUSION For patients with TET who are unable to receive contrast for preoperative staging, the two image findings of an irregular border between tumor and lung and the positive GVI sign on non-contrast-enhanced MRI could be helpful in determining stage III-IV disease which is associated with a worse survival.
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Affiliation(s)
- Asako Kuhara
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Akiko Sumi
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Tomonori Chikasue
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Atsushi Kawaguchi
- Education and Research Center for Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Masamichi Koganemaru
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011 Japan
| | - Masaki Kashihara
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masahiro Mitsuoka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Ann N. C. Leung
- Department of Radiology, Stanford University, Stanford, CA USA
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, 67 Asahi-Machi, Fukuoka, Kurume, 830-0011, Japan.
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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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Kosako H, Yamashita Y, Tanaka K, Mishima H, Iwamoto R, Kinoshita A, Murata SI, Ohshima K, Yoshiura KI, Sonoki T, Tamura S. Intestinal Mucosa-Associated Lymphoid Tissue Lymphoma Transforming into Diffuse Large B-Cell Lymphoma in a Young Adult Patient with Neurofibromatosis Type 1: A Case Report. Medicina (B Aires) 2022; 58:medicina58121830. [PMID: 36557032 PMCID: PMC9782547 DOI: 10.3390/medicina58121830] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Neurofibromatosis type 1 (NF1) is a hereditary cancer syndrome characterized by multiple café-au-lait macules on the skin. Lymphoproliferative malignancies associated with NF1 are limited, although the most common are brain tumors. Case presentation: A 22-year-old woman with NF1 was admitted due to abdominal pain and bloody diarrhea. Her laboratory data exhibited macrocytic anemia and elevated IgA levels. Image studies showed diffuse increased wall thickening in the transverse and descending colon without lymphadenopathy and hepatosplenomegaly. A colonoscopy revealed a hemorrhagic ulcerated mass. Pathological analysis of the tumor tissues confirmed IgA-expressing mucosa-associated lymphoid tissue (MALT) lymphoma with histological transformation. Moreover, whole-exome sequencing in tumor tissues and peripheral blood mononuclear cells identified a somatic frameshift mutation of the A20 gene, which represents the loss of function. The patient responded well to R-CHOP chemotherapy, but the disease relapsed after 1 year, resulting in a lethal outcome. Conclusions: MALT lymphoma in children and young adults is extremely rare and is possibly caused by acquired genetic changes. This case suggests a novel association between hereditary cancer syndrome and early-onset MALT lymphoma.
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Affiliation(s)
- Hideki Kosako
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan
| | - Yusuke Yamashita
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan
| | - Ken Tanaka
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan
- Department of Pathology, Kurume University School of Medicine, Fukuoka 8300011, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 8528523, Japan
| | - Ryuta Iwamoto
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama 6418509, Japan
| | - Akira Kinoshita
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 8528523, Japan
| | - Shin-ichi Murata
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama 6418509, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Fukuoka 8300011, Japan
| | - Koh-ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 8528523, Japan
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan
| | - Shinobu Tamura
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 6418509, Japan
- Department of Emergency and Intensive Care Medicine, Wakayama Medical University, Wakayama 6418509, Japan
- Correspondence: ; Tel.: +81-73-441-0665; Fax: +81-73-441-0653
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Nato Y, Nagaharu K, Inoue K, Yabu K, Sawaki A, Shiotani T, Kageyama Y, Tanaka K, Ohshima K, Miyashita H. An experience with ibrutinib monotherapy for Richter's syndrome isolated in the central nervous system. J Clin Exp Hematop 2022; 62:238-241. [PMID: 36436931 PMCID: PMC9898719 DOI: 10.3960/jslrt.22017] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Richter's syndrome (RS) of the central nervous system (CNS) is known to have an extremely poor prognosis. Ibrutinib has been reported to have some activity in patients with RS, despite its poor prognosis. Although ibrutinib crosses the blood-brain barrier, its efficacy in RS patients with CNS involvement remains unknown. Here, we report a case of RS isolated in the CNS that was confirmed to be clonally related to chronic lymphocytic leukemia (CLL) by immunoglobulin heavy chain gene analysis. Although the median survival of patients with RS clonally related to CLL was significantly shorter than that of patients with RS clonally unrelated to CLL, the patient received ibrutinib monotherapy without experiencing any significant adverse events, and the disease remained stable with ibrutinib until 6 weeks later. Following whole-brain radiation therapy (40 Gy in 20 fractions) with dexamethasone, the patient has survived for five months after diagnosis. Thus, ibrutinib may be a safe and effective therapeutic option for patients with RS and CNS involvement.
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Affiliation(s)
- Yuma Nato
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Keiki Nagaharu
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Kanako Inoue
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kodai Yabu
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Akihiko Sawaki
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Takuya Shiotani
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Yuki Kageyama
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Miyashita
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
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Hosoi H, Tanaka K, Sakaki A, Kosako H, Iwamoto R, Matsumoto A, Arakawa F, Yamoto T, Murata S, Mushino T, Murata SI, Nakao N, Ohshima K, Sonoki T. Rituximab Monotherapy for Grade 2-3 Lymphomatoid Granulomatosis with Central Nervous System Involvement in a Patient Receiving Methotrexate for Rheumatoid Arthritis. Intern Med 2022. [PMID: 36418093 PMCID: PMC10372291 DOI: 10.2169/internalmedicine.0636-22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Lymphomatoid granulomatosis (LYG) is a rare lymphoproliferative disorder (LPD). The optimal management strategy of methotrexate (MTX) related-LPD with central nervous system (CNS) involvement and histological features of LYG remains unclear. We herein report a case of grade 2-3 LYG in a rheumatoid arthritis patient, in which an intracranial mass accompanied by hemorrhaging and pulmonary and skin lesions developed. The patient received successful rituximab monotherapy. The tumor cells in the skin and brain showed monoclonal and oligoclonal proliferation, respectively. Our case suggests that rituximab monotherapy may be effective against MTX-LPD with CNS involvement, especially in cases with LYG histology.
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Affiliation(s)
- Hiroki Hosoi
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Ken Tanaka
- Department of Hematology/Oncology, Wakayama Medical University, Japan
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Ayaka Sakaki
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Hideki Kosako
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Ryuta Iwamoto
- Department of Human Pathology, Wakayama Medical University, Japan
| | - Ai Matsumoto
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Fumiko Arakawa
- Department of Pathology, Kurume University School of Medicine, Japan
| | | | - Shogo Murata
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Toshiki Mushino
- Department of Hematology/Oncology, Wakayama Medical University, Japan
| | - Shin-Ichi Murata
- Department of Human Pathology, Wakayama Medical University, Japan
| | - Naoyuki Nakao
- Department of Neurosurgery, Wakayama Medical University, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Takashi Sonoki
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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Ishii K, Kamachi K, Okamoto S, Katsuya H, Fujita M, Nagaie T, Nishioka A, Yoshimura M, Ureshino H, Kubota Y, Ando T, Watanabe T, Takeuchi M, Kai K, Ohshima K, Kimura S. Diffuse Large B-cell Lymphoma Involving an Abundant Infiltration of T Follicular Helper Cells: A Case Report. Intern Med 2022; 62:1335-1340. [PMID: 36130892 DOI: 10.2169/internalmedicine.0521-22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 76-year-old man presented with skin plaque and splenic nodules, and diffuse large B-cell lymphoma (DLBCL) with infiltration of T-cells was suspected based on the skin lesions. The disease showed indolent clinical behavior for three months, when systemic lymphadenopathy rapidly evolved. An inguinal lymph node biopsy revealed DLBCL with abundant infiltration of T follicular helper (TFH) cells. A polymerase chain reaction-based analysis of immunoglobulin variable heavy chain showed that the skin, splenic nodules, and inguinal lymph node shared the same clone. This case indicates that the dysregulated infiltration of TFH cells in the tumor microenvironment accelerates the lymphomagenesis and progression of DLBCL.
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Affiliation(s)
- Keitaro Ishii
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Kazuharu Kamachi
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Japan
| | - Sho Okamoto
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Hiroo Katsuya
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Mai Fujita
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Toshiaki Nagaie
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Atsujiro Nishioka
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Mariko Yoshimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Hiroshi Ureshino
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Japan
| | - Yasushi Kubota
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
- Department of Transfusion Medicine and Cell Therapy, Saitama Medical Center, Saitama Medical University, Japan
| | - Toshihiko Ando
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
| | - Tatsuro Watanabe
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Keita Kai
- Department of Pathology, Saga University Hospital, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan
- Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Japan
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Matsuda K, Sugita Y, Furuta T, Moritsubo M, Ohshima K, Morioka M, Takahashi K, Higaki K, Kakita A. Elevated expression of transforming acidic coiled-coil-containing protein 3 (TACC3) reflects aggressiveness of primary central nervous system lymphomas. Pathol Int 2022; 72:437-443. [PMID: 35959857 DOI: 10.1111/pin.13264] [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: 03/06/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
Transforming acidic coiled-coil-containing protein 3 (TACC3) plays an important role in centrosome/microtubule dynamics. Deregulation of centrosomes/microtubules causes mitotic spindle defects, leading to tumorigenesis. However, the correlation between TACC3 and primary central nervous system lymphomas (PCNSLs) is unknown. The present study investigated the association between the immunohistochemical expression of TACC3, p53, and Ki-67, and the clinical factors in 40 PCNSLs. We evaluated the staining of TACC3 based on the histoscore (H-score) that contains a semiquantitative evaluation of both the intensity of staining, and the percentage of positive cells. Expression level of each component was classified as low or high according to the median H-score value. Patients with PCNSLs were divided into groups depending on TACC3 expression levels (no expression and low expression, 18; high expression, 22). Disease-free survival and overall survival of patients with high TACC3 expression were significantly shorter (p < 0.01 and p < 0.05, respectively). These results suggest that elevated expression of TACC3 could reflects aggressiveness of primary central nervous system lymphomas.
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Affiliation(s)
- Kotaro Matsuda
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yasuo Sugita
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Neuropathology, Neurology Center, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenji Takahashi
- Department of Neurosurgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Koichi Higaki
- Department of Pathology, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Fukuoka, Japan
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40
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Tanahashi H, Yamaguchi K, Koura T, Kambara T, Yamada K, Sakamoto S, Horimasu Y, Masuda T, Miyamoto S, Nakashima T, Iwamoto H, Fukushima N, Fujitaka K, Hamada H, Ichinohe T, Ohshima K, Hattori N. Primary Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma with the High Expression of IgG4. Intern Med 2022; 61:1043-1048. [PMID: 34544945 PMCID: PMC9038459 DOI: 10.2169/internalmedicine.7436-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This is the first report describing primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma with the high expression of IgG4. The histological findings were compatible with the diagnostic criteria for MALT lymphoma and IgG4-related respiratory disease (IgG4-RRD). An unfixed sample for Southern blotting was not obtained since computed tomography findings showed multiple lung cysts, which is rare in patients with MALT lymphoma. However, polymerase chain reaction using paraffin sections showed the clonality of the immunoglobulin heavy chain variable region gene rearrangement, confirming a diagnosis of MALT lymphoma. This is an instructive case in which primary pulmonary MALT lymphoma was histologically compatible with IgG4-RRD.
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Affiliation(s)
- Hiroki Tanahashi
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Kakuhiro Yamaguchi
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Tomoko Koura
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Takahiro Kambara
- Department of Pathology, Hiroshima University Graduate School of Biomedical and Health Science, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Shinjiro Sakamoto
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Yasushi Horimasu
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Takeshi Masuda
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Shintaro Miyamoto
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Taku Nakashima
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Hiroshi Iwamoto
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | | | - Kazunori Fujitaka
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Hironobu Hamada
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
| | - Tatsuo Ichinohe
- Department of Hematology, Hiroshima University Hospital, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Japan
| | - Noboru Hattori
- Department of Respiratory Medicine, Hiroshima University Hospital, Japan
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Yoshida-Sakai N, Oe K, Kimura Y, Ureshino H, Nomiyama K, Hashiguchi M, Jojima H, Imamura Y, Ohshima K, Okamura T. Coexistence of gastric and pulmonary MALT lymphoma and a clonally related, disseminated large B cell lymphoma with conspicuous angiotropism. Ann Hematol 2022; 101:1383-1385. [PMID: 35194669 DOI: 10.1007/s00277-022-04752-8] [Citation(s) in RCA: 1] [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] [Received: 06/22/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Nao Yoshida-Sakai
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan.
| | - Kensuke Oe
- Department of Cardiology, St. Mary's Hospital, Kurume, Japan
| | - Yoshizo Kimura
- Department of Pathology, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Ureshino
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keita Nomiyama
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan
| | - Michitoshi Hashiguchi
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan
| | - Hiroto Jojima
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan
| | - Yutaka Imamura
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Takashi Okamura
- Department of Hematology, St. Mary's Hospital, 422, Tsubuku-honmachi, Kurume, Fukuoka, 830-8543, Japan
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Kawano N, Saito N, Yoshida S, Kitanaka A, Shide K, Marutsuka K, Ohshima K, Shimoda K. Immunohistopathological Analysis of Extramedullary Hematopoiesis and Angiogenesis of Spleen in a Case of Primary Myelofibrosis with Huge Splenomegaly. TOHOKU J EXP MED 2022; 256:119-125. [PMID: 35173090 DOI: 10.1620/tjem.256.119] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Although splenomegaly is one of the important signs of primary myelofibrosis, the differential diagnosis varies from malignant disorders to benign disorders, including malignant lymphoma and sarcoidosis. The patient was a 67-year-old male who developed anemia and huge splenomegaly. The laboratory findings include human T-cell leukemia virus type 1 (HTLV-1) antibody, elevated soluble interleukin-2 receptor, hypocellular bone marrow, and uptake in the spleen on positron emission tomography/computed tomography scan. Additionally, we performed laparoscopic splenectomy to alleviate the clinical symptoms and to rule out malignant lymphoma. Histological findings revealed extramedullary hematopoiesis, characterized by the presence of erythroid islands and clusters of dysplastic megakaryocytes with increased reticulin fibrosis. Immunohistochemical staining revealed the presence of von Willebrand factor, dysplastic megakaryocytes, myeloperoxidase, myeloid-predominant proliferations, and CD34 immature myeloid cells. Furthermore, regarding the angiogenesis in the spleen, the endothelial cells of the capillaries and those of the sinusoidal vascular system that were reactive for CD34 and CD8, respectively, were also detected. Consequently, the histological findings revealed both extramedullary hematopoiesis and angiogenesis in spleen. Based on the histological findings and the identification of Janus activating kinase 2 (JAK-2) mutation, the patient was diagnosed with primary myelofibrosis. Splenectomy reduces blood transfusion requirements after surgery. The patient was carefully followed-up without further treatments. Thus, primary myelofibrosis is the crucial differential diagnosis of huge splenomegaly.
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Affiliation(s)
- Noriaki Kawano
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
| | - Noriyuki Saito
- Department of Hematology, Saiseikai Fukuoka General Hospital
| | - Shuro Yoshida
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital
| | - Akira Kitanaka
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
| | - Kotaro Shide
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
| | | | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine
| | - Kazuya Shimoda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
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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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44
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Harada S, Ando M, Ando J, Ishii M, Yamaguchi T, Yamazaki S, Toyota T, Ohara K, Ohtaka M, Nakanishi M, Shin C, Ota Y, Nakashima K, Ohshima K, Imai C, Nakazawa Y, Nakauchi H, Komatsu N. Dual-antigen targeted iPSC-derived chimeric antigen receptor-T cell therapy for refractory lymphoma. Mol Ther 2022; 30:534-549. [PMID: 34628050 PMCID: PMC8821952 DOI: 10.1016/j.ymthe.2021.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 01/03/2021] [Revised: 07/04/2021] [Accepted: 09/30/2021] [Indexed: 02/04/2023] Open
Abstract
We generated dual-antigen receptor (DR) T cells from induced pluripotent stem cells (iPSCs) to mitigate tumor antigen escape. These cells were engineered to express a chimeric antigen receptor (CAR) for the antigen cell surface latent membrane protein 1 (LMP1; LMP1-CAR) and a T cell receptor directed to cell surface latent membrane protein 2 (LMP2), in association with human leucocyte antigen A24, to treat therapy-refractory Epstein-Barr virus-associated lymphomas. We introduced LMP1-CAR into iPSCs derived from LMP2-specific cytotoxic T lymphocytes (CTLs) to generate rejuvenated CTLs (rejTs) active against LMP1 and LMP2, or DRrejTs. All DRrejT-treated mice survived >100 days. Furthermore, DRrejTs rejected follow-up inocula of lymphoma cells, demonstrating that DRrejTs persisted long-term. We also demonstrated that DRrejTs targeting CD19 and LMP2 antigens exhibited a robust tumor suppressive effect and conferred a clear survival advantage. Co-operative antitumor effect and in vivo persistence, with unlimited availability of DRrejT therapy, will provide powerful and sustainable T cell immunotherapy.
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Affiliation(s)
- Sakiko Harada
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan; Division of Stem Cell Therapy, Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan.
| | - Jun Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Midori Ishii
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Tomoyuki Yamaguchi
- Division of Stem Cell Therapy, Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Satoshi Yamazaki
- Division of Stem Cell Biology, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan; Laboratory of Stem Cell Therapy Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
| | - Tokuko Toyota
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Kazuo Ohara
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Manami Ohtaka
- TOKIWA-Bio, Inc., Tsukuba Center, Ibaraki 305-0047, Japan
| | | | - Chansu Shin
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Yasunori Ota
- Department of Pathology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan
| | - Kazutaka Nakashima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka 830-0011, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka 830-0011, Japan
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinsyu University School of Medicine, Nagano 390-0802, Japan
| | - Hiromitsu Nakauchi
- Division of Stem Cell Therapy, Distinguished Professor Unit, The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA 94305-5461, USA.
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
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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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46
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Higuchi M, Senoo T, Morita C, Furugo I, Hamada T, Ohshima K. Lymphoplasmacytic lymphoma with IgG-κ paraproteinemia presenting as a hepatic bulky mass. J Clin Exp Hematop 2022; 62:273-278. [PMID: 36575005 DOI: 10.3960/jslrt.22037] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Lymphoplasmacytic lymphoma (LPL) usually involves bone marrow (BM) and sometimes lymph nodes and spleen. LPL presenting as a hepatic mass lesion is extremely rare, with only one case reported in the English literature. A 70-year-old Japanese female presented to us with a right hypochondriac mass with tenderness. Computed tomography (CT) revealed a 14 cm-sized bulky hepatic mass. Laboratory findings showed a normal white blood cell count of 4.1×109/L with 4% plasmacytoid lymphocytes; normocytic anemia, Hb 9.4 g/dL; high soluble IL-2 receptor level, 2,290 U/mL; and elevated IgG, 10,306 mg/dL. Furthermore, IgG-κ monoclonal protein was detected. 18F-fluorodeoxyglucose-positron emission tomography/CT revealed abnormal uptake in the liver mass; left supraclavicular, parasternal, abdominal, and left inguinal lymph nodes; and bilateral lung bases. Magnetic resonance imaging showed no bone lesions. BM aspiration and liver biopsy showed predominant infiltration of small lymphocytes admixed with plasmacytoid lymphocytes and plasma cells. In the liver specimen, lymphoepithelial lesions were not observed. The small lymphocytes were positive for CD20, CD79a, and bcl-2, and negative for CD5, CD10, cyclin D1, and IRTA1; plasma cells in BM were positive for CD19, CD45, IgG, and κ-chain, and negative for CD20, and CD56. MYD88 L265P mutation, reported in approximately 40% of non-IgM LPL cases, was not detected in the liver specimen and BM cells. The frequency is lower than that of typical IgM LPL. These findings led us to a diagnosis of LPL with IgG-κ paraproteinemia. The patient underwent four courses of R-CHOP and two courses of Bendamustine-R. Partial remission was achieved.
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Affiliation(s)
- Masakazu Higuchi
- Department of Hematology, Kyushu Railway Memorial Hospital, Kitakyushu, Japan
| | - Takemasa Senoo
- Department of Gastroenterology, Kyushu Railway Memorial Hospital, Kitakyushu, Japan
| | - Chie Morita
- Department of Hepatology, Kyushu Railway Memorial Hospital, Kitakyushu, Japan
| | - Isao Furugo
- Department of Internal Medicine, Kyushu Railway Memorial Hospital, Kitakyushu, Japan
| | - Tetsuo Hamada
- Department of Laboratory Medicine & Surgical Pathology, Kyushu Railway Memorial Hospital, Kitakyushu, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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47
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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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48
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Ishioka K, Oki K, Hirose S, Oguri T, Sasada S, Murata S, Tsuchiya Y, Shigematsu L, Narita H, Adachi T, Fuji Y, Nakamura M, Kitano S, Kato K, Ohshima K, Takahashi S. Autopsy of a patient with fatal Epstein-Barr virus-associated encephalitis after treatment with immune checkpoint inhibitors for advanced lung adenocarcinoma: A case report. Current Problems in Cancer: Case Reports 2021. [DOI: 10.1016/j.cpccr.2021.100108] [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: 11/28/2022] Open
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49
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Harada S, Ando J, Ando M, Nitta H, Inano T, Hirasawa Y, Furukawa Y, Kinoshita S, Kondo A, Ohshima K, Komatsu N. High-grade Primary Central Nervous System Lymphomatoid Granulomatosis: Successful Rituximab Monotherapy. Intern Med 2021; 60:3795-3799. [PMID: 34121006 PMCID: PMC8710380 DOI: 10.2169/internalmedicine.7232-21] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The primary central nervous system (CNS) presentation of lymphomatoid granulomatosis (LYG) is rare, and no standard therapy for LYG with primary CNS symptoms exists. CNS-LYG patients usually survive for only less than a year from diagnosis. This is the first report of high-grade primary CNS-LYG with monoclonality that was successfully treated with rituximab monotherapy, resulting in a durable remission for more than 1 year in a 66-year-old woman with pemphigus vulgaris who was also on immunosuppressive therapy.
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Affiliation(s)
- Sakiko Harada
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Jun Ando
- Department of Hematology, Juntendo University School of Medicine, Japan
- Department of Transfusion Medicine and Stem Cell Regulation, Juntendo University School of Medicine, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Hideaki Nitta
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Tadaaki Inano
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Yusuke Hirasawa
- Department of Dermatology, Juntendo University School of Medicine, Japan
| | - Yoshiki Furukawa
- Department of Hematology, Juntendo University School of Medicine, Japan
| | | | - Akihide Kondo
- Department of Neurosurgery, Juntendo University School of Medicine, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Japan
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50
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Iwamoto R, Tanoue S, Nagata S, Tabata K, Fukuoka J, Koganemaru M, Sumi A, Chikasue T, Abe T, Murakami D, Takamori S, Ishii H, Ohshima K, Ohta S, Izuhara K, Fujimoto K. T1 invasive lung adenocarcinoma: Thin-section CT solid score and histological periostin expression predict tumor recurrence. Mol Clin Oncol 2021; 15:228. [PMID: 34650799 PMCID: PMC8506662 DOI: 10.3892/mco.2021.2391] [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: 03/15/2021] [Accepted: 08/12/2021] [Indexed: 11/06/2022] Open
Abstract
Adenocarcinoma is the most common histological type of non-small cell lung cancer (NSCLC), and various biomarkers for predicting its prognosis after surgical resection have been suggested, particularly in early-stage lung adenocarcinoma. Periostin (also referred to as POSTN, PN or osteoblast-specific factor) is an extracellular matrix protein, the expression of which is associated with tumor invasiveness in patients with NSCLC. In the present study, the novel approach, in which the thin-section CT findings prior to surgical resection and periostin expression of resected specimens were analyzed in combination, was undertaken to assess whether the findings could be a biomarker for predicting the outcomes following resection of T1 invasive lung adenocarcinoma. A total of 73 patients who underwent surgical resection between January 2000 and December 2009 were enrolled. A total of seven parameters were assessed in the thin-section CT scans: i) Contour; ii) part-solid ground-glass nodule or solid nodule; iii) percentage of solid component (the CT solid score); iv) presence of air-bronchogram and/or bubble-like lucencies; v) number of involved vessels; vi) shape linear strands between the nodule and the visceral pleura; and vii) number of linear strands between the nodule and the visceral pleura. Two chest radiologists independently assessed the parameters. Periostin expression was evaluated on the basis of the strength and extent of staining. Univariate and multivariate analyses were subsequently performed using the Cox proportional hazards model. There was a substantial to almost perfect agreement between the two observers with regard to classification of the seven thin-section CT parameters (κ=0.64-0.85). In the univariate analysis, a CT solid score >80%, pathological lymphatic invasion, tumor and lymph node status and high periostin expression were significantly associated with recurrence (all P<0.05). Multivariate analysis demonstrated that a CT solid score >80% and high periostin expression were risk factors for recurrence (P=0.002 and P=0.011, respectively). The cumulative recurrence rates among the three groups (both negative, CT solid score >80% or high periostin expression, or both positive) were significantly different (log-rank test, P<0.001). Although the solid component is already known to be a major predictor of outcome in lung adenocarcinomas according to previous studies, the combined analysis of CT solid score and periostin expression might predict the likelihood of tumor recurrence more precisely.
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Affiliation(s)
- Ryoji Iwamoto
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Shuji Nagata
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Nagasaki Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Junya Fukuoka
- Department of Pathology, Nagasaki Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Masamichi Koganemaru
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Akiko Sumi
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Tomonori Chikasue
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Daigo Murakami
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Shinzo Takamori
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Hidenobu Ishii
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Shoichiro Ohta
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga 849-8501, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga 849-8501, Japan
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
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