1
|
Belaloui K, Malifarge E, Bohm J, Bossard C, Dienstmann R, Garcia S, Geppert C, Gogenur I, Hartmann A, Hatzibougias D, Landolfi S, Mishaeli M, Paez D, Patel P, Rodriguez-Justo M, Szafranska J, van den Eynde M, Zavadova E, Turcan S, Hermitte F. Immunoscore feasibility study in routine postsurgical pathologic review for early-stage colon cancer (CC) cases risk-assessment. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.031] [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: 11/14/2022] Open
|
2
|
Isabelle M, Dorney J, Lewis A, Lloyd GR, Old O, Shepherd N, Rodriguez-Justo M, Barr H, Lau K, Bell I, Ohrel S, Thomas G, Stone N, Kendall C. Multi-centre Raman spectral mapping of oesophageal cancer tissues: a study to assess system transferability. Faraday Discuss 2018; 187:87-103. [PMID: 27048868 DOI: 10.1039/c5fd00183h] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The potential for Raman spectroscopy to provide early and improved diagnosis on a wide range of tissue and biopsy samples in situ is well documented. The standard histopathology diagnostic methods of reviewing H&E and/or immunohistochemical (IHC) stained tissue sections provides valuable clinical information, but requires both logistics (review, analysis and interpretation by an expert) and costly processing and reagents. Vibrational spectroscopy offers a complimentary diagnostic tool providing specific and multiplexed information relating to molecular structure and composition, but is not yet used to a significant extent in a clinical setting. One of the challenges for clinical implementation is that each Raman spectrometer system will have different characteristics and therefore spectra are not readily compatible between systems. This is essential for clinical implementation where classification models are used to compare measured biochemical or tissue spectra against a library training dataset. In this study, we demonstrate the development and validation of a classification model to discriminate between adenocarcinoma (AC) and non-cancerous intraepithelial metaplasia (IM) oesophageal tissue samples, measured on three different Raman instruments across three different locations. Spectra were corrected using system transfer spectral correction algorithms including wavenumber shift (offset) correction, instrument response correction and baseline removal. The results from this study indicate that the combined correction methods do minimize the instrument and sample quality variations within and between the instrument sites. However, more tissue samples of varying pathology states and greater tissue area coverage (per sample) are needed to properly assess the ability of Raman spectroscopy and system transferability algorithms over multiple instrument sites.
Collapse
Affiliation(s)
- M Isabelle
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| | - J Dorney
- Biomedical Spectroscopy, School of Physics, University of Exeter, UK
| | - A Lewis
- Department of Cell and Developmental Biology, University College London, London, UK
| | - G R Lloyd
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| | - O Old
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| | - N Shepherd
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| | - M Rodriguez-Justo
- Department of Cell and Developmental Biology, University College London, London, UK
| | - H Barr
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| | - K Lau
- Spectroscopy Products Division, Renishaw plc, Wotton-Under-Edge, Gloucestershire, UK
| | - I Bell
- Spectroscopy Products Division, Renishaw plc, Wotton-Under-Edge, Gloucestershire, UK
| | - S Ohrel
- Spectroscopy Products Division, Renishaw plc, Wotton-Under-Edge, Gloucestershire, UK
| | - G Thomas
- Department of Cell and Developmental Biology, University College London, London, UK
| | - N Stone
- Biomedical Spectroscopy, School of Physics, University of Exeter, UK
| | - C Kendall
- Biophotonics Research Unit and Pathology Department, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
| |
Collapse
|
3
|
Chand M, Keller DS, Joshi HM, Devoto L, Rodriguez-Justo M, Cohen R. Feasibility of fluorescence lymph node imaging in colon cancer: FLICC. Tech Coloproctol 2018; 22:271-277. [PMID: 29551004 DOI: 10.1007/s10151-018-1773-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [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] [Received: 11/13/2017] [Accepted: 03/14/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND In colon cancer, appropriate tumour excision and associated lymphadenectomy directly impact recurrence and survival outcomes. Currently, there is no standard for mesenteric lymphadenectomy, with a lymph node yield of 12 acting as a surrogate quality marker. Our goal was to determine the safety and feasibility of indocyanine green (ICG) fluorescence imaging to demonstrate lymphatic drainage in colon cancer in a dose-escalation study. METHODS A prospective pilot study of colon cancer patients undergoing curative laparoscopic resection was performed. At surgery, peritumoural subserosal ICG injection was done to demonstrate lymphatic drainage of the tumour. A specialized fluorescence system excited the ICG and assessed lymphatics in real time. The primary outcome was the feasibility of ICG fluorescent lymphangiography for lymphatic drainage in colon cancer. Secondary outcomes were the optimal protocol for dose, injection site, and ICG lymphatic mapping timing. RESULTS Ten consecutive patients were evaluated (six males, mean age 69.5 years). In all, lymphatic channels were seen around the tumour to a varying extent. Eight (80%) had drainage to the sentinel node. In all cases where the lymphatic map was seen, there was no further spread 10 min after injection. In 2 patients (20%), additional lymph nodes located outside of the proposed resection margins were demonstrated. In both cases the resection was extended to include the nodes and in both patients these nodes were positive on histopathology. Factors contributing to reduced lymphatic visualization were inadequate ICG concentrations, excess India ink blocking drainage, and inflammation from tattoo placement. CONCLUSIONS ICG can be safely injected into the peritumoural subserosal and demonstrate lymphatic drainage in colon cancer. This proof of concept and proposed standards for the procedure can lead to future studies to optimize the application of image-guided precision surgery in colon cancer. Furthermore, this technique may be of value in indicating the need for more extended lymphadenectomy.
Collapse
Affiliation(s)
- M Chand
- Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK.
| | - D S Keller
- Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK
| | - H M Joshi
- Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, London, UK
| | - L Devoto
- Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, GENIE Centre, University College London, Charles Bell House, 43 Foley Street, London, W1W 7TS, UK
| | - M Rodriguez-Justo
- Department of Pathology, University College London Hospitals, NHS Foundation Trusts, London, UK
| | - R Cohen
- Department of Surgery and Interventional Sciences, University College London Hospitals, NHS Foundation Trusts, London, UK
| |
Collapse
|
4
|
Huggett MT, Culver E, Kumar M, Hurst J, Rodriguez-Justo M, Chapman M, Johnson G, Pereira S, Chapman R, Webster GJ, Barnes E. Type 1 autoimmune pancreatitis and IgG4-related sclerosing cholangitis is associated with extrapancreatic organ failure, malignancy, and mortality in a prospective UK cohort. Am J Gastroenterol 2014; 109:1675-1683. [PMID: 25155229 PMCID: PMC4552254 DOI: 10.1038/ajg.2014.223] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 07/25/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Type I autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-related SC) are now recognized as components of a multisystem IgG4-related disease (IgG4-RD). We aimed to define the clinical course and long-term outcomes in patients with AIP/IgG4-SC recruited from two large UK tertiary referral centers. METHODS Data were collected from 115 patients identified between 2004 and 2013, and all were followed up prospectively from diagnosis for a median of 33 months (range 1-107), and evaluated for response to therapy, the development of multiorgan involvement, and malignancy. Comparisons were made with national UK statistics. RESULTS Although there was an initial response to steroids in 97%, relapse occurred in 50% of patients. IgG4-SC was an important predictor of relapse (P<0.01). Malignancy occurred in 11% shortly before or after the diagnosis of IgG4-RD, including three hepatopancreaticobiliary cancers. The risk of any cancer at diagnosis or during follow-up when compared with matched national statistics was increased (odds ratio=2.25, CI=1.12-3.94, P=0.02). Organ dysfunction occurred within the pancreas, liver, kidney, lung, and brain. Mortality occurred in 10% of patients during follow-up. The risk of death was increased compared with matched national statistics (odds ratio=2.07, CI=1.07-3.55, P=0.02). CONCLUSIONS Our findings suggest that AIP and IgG4-SC are associated with significant morbidity and mortality owing to extrapancreatic organ failure and malignancy. Detailed clinical evaluation for evidence of organ dysfunction and associated malignancy is required both at first presentation and during long-term follow-up.
Collapse
Affiliation(s)
- Matthew T. Huggett
- UCL Institute for Liver and Digestive Health, University College London, London, UK
,Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - E.L. Culver
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
,NDM Oxford University, Oxford Martin School, Oxford University, Oxford, UK
| | - M. Kumar
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - J.M. Hurst
- Institute of Emerging Diseases, Oxford Martin School, Oxford University, Oxford, UK
| | | | - M.H. Chapman
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - G.J. Johnson
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - S.P. Pereira
- UCL Institute for Liver and Digestive Health, University College London, London, UK
,Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - R.W. Chapman
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
,NDM Oxford University, Oxford Martin School, Oxford University, Oxford, UK
| | - George J.M. Webster
- Department of Gastroenterology and Hepatology, University College Hospital, London, UK
| | - E. Barnes
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
,NDM Oxford University, Oxford Martin School, Oxford University, Oxford, UK
,Oxford NIHR BRC, Oxford University, Oxford, UK
| |
Collapse
|
5
|
Chowdhury R, Ganeshan B, Irshad S, Lawler K, Eisenblätter M, Milewicz H, Rodriguez-Justo M, Miles K, Ellis P, Groves A, Punwani S, Ng T. The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis. BJR Case Rep 2014. [DOI: 10.1259/bjrcr.20140065] [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: 11/05/2022] Open
|
6
|
Chowdhury R, Ganeshan B, Irshad S, Lawler K, Eisenblätter M, Milewicz H, Rodriguez-Justo M, Miles K, Ellis P, Groves A, Punwani S, Ng T. The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis. Br J Radiol 2014; 87:20140065. [PMID: 24597512 PMCID: PMC4075563 DOI: 10.1259/bjr.20140065] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 01/09/2014] [Accepted: 03/03/2014] [Indexed: 01/10/2023] Open
Abstract
Tumour heterogeneity has, in recent times, come to play a vital role in how we understand and treat cancers; however, the clinical translation of this has lagged behind advances in research. Although significant advancements in oncological management have been made, personalized care remains an elusive goal. Inter- and intratumour heterogeneity, particularly in the clinical setting, has been difficult to quantify and therefore to treat. The histological quantification of heterogeneity of tumours can be a logistical and clinical challenge. The ability to examine not just the whole tumour but also all the molecular variations of metastatic disease in a patient is obviously difficult with current histological techniques. Advances in imaging techniques and novel applications, alongside our understanding of tumour heterogeneity, have opened up a plethora of non-invasive biomarker potential to examine tumours, their heterogeneity and the clinical translation. This review will focus on how various imaging methods that allow for quantification of metastatic tumour heterogeneity, along with the potential of developing imaging, integrated with other in vitro diagnostic approaches such as genomics and exosome analyses, have the potential role as a non-invasive biomarker for guiding the treatment algorithm.
Collapse
Affiliation(s)
- R Chowdhury
- Richard Dimbleby Department of Cancer Research, Randall Division of Cell and Molecular Biophysics, King's College London, London, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Doshi A, Khosravi M, Marks DJB, Rodriguez-Justo M, Connolly JO, de Wolff JF. Back pain and acute kidney injury. Clin Med (Lond) 2013; 13:71-4. [PMID: 23472499 PMCID: PMC5873714 DOI: 10.7861/clinmedicine.13-1-71] [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: 11/27/2022]
Affiliation(s)
- A Doshi
- National Hospital for Neurology and Neurosurgery
| | | | - DJB Marks
- University College London Hospital, London
| | | | | | | |
Collapse
|
8
|
Dunn JM, Mackenzie GD, Banks MR, Mosse CA, Haidry R, Green S, Thorpe S, Rodriguez-Justo M, Winstanley A, Novelli MR, Bown SG, Lovat LB. A randomised controlled trial of ALA vs. Photofrin photodynamic therapy for high-grade dysplasia arising in Barrett's oesophagus. Lasers Med Sci 2012; 28:707-15. [PMID: 22699800 DOI: 10.1007/s10103-012-1132-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 05/31/2012] [Indexed: 02/06/2023]
Abstract
Photofrin photodynamic therapy (PDT) is a licenced treatment for Barrett's oesophagus (BE) with high-grade dysplasia (HGD) but causes strictures and photosensitivity and complete reversal of dysplasia (CR-HGD) by 50 % at 5 years. 5-Aminolaevulinic acid (ALA) is an alternative treatment with non-randomised data suggesting 85 % CR-HGD and a low risk of side effects. We aimed to compare efficacy and side effect profile between the drugs. A single-centre randomised controlled trial was conducted. Presence of HGD was confirmed on three occasions by two specialist GI pathologists. Stratification was by length of BE and extent of dysplasia. Standard protocols for ALA and Photofrin-PDT were followed. Endoscopic follow-up with 2-cm four-quadrant biopsy was at 6 weeks, 4 months, and then annually. All adverse event data were collected. Sixty four patients were randomised, 34 ALA and 30 Photofrin-PDT. Median follow-up is 24 months. On intention-to-treat analysis, CR-HGD was 16/34 (47 %) with ALA-PDT and 12/30 (40 %) with Photofrin-PDT. The overall cancer incidence was 14 % (9/64). On sub-group log-rank analysis, for BE ≤ 6 cm, CR-HGD was significantly higher with ALA-PDT than Photofrin-PDT (χ(2) =5.39, p=0.02). Strictures and skin photosensitivity were significantly more common after treatment with Photofrin-PDT than ALA-PDT (33 vs. 9 % and 43 vs. 6 %, respectively, p<0.05). The rate of buried glands with either drug was significantly higher post-PDT (48 % of patients) than pre-PDT (20 %). ALA-PDT has a better risk profile than Photofrin-PDT. In patients with BE length ≤ 6 cm, preliminary results show ALA-PDT is associated with significantly higher CR-HGD. In longer segments of BE, neither PDT drug is sufficiently efficacious to warrant routine use.
Collapse
Affiliation(s)
- J M Dunn
- National Medical Laser Centre, Division of Surgery and Interventional Science, University College London, 67-73 Riding House Street, London, W1W 7EJ, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Dunn JM, Banks MR, Oukrif D, Mackenzie GD, Thorpe S, Rodriguez-Justo M, Winstanley A, Bown SG, Novelli MR, Lovat LB. Radiofrequency ablation is effective for the treatment of high-grade dysplasia in Barrett's esophagus after failed photodynamic therapy. Endoscopy 2011; 43:627-30. [PMID: 21717379 DOI: 10.1055/s-0030-1256443] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Endoscopic radiofrequency ablation (RFA) is an effective treatment for high-grade dysplasia in Barrett's esophagus in ablation-naïve patients, but no studies have evaluated its use in patients in whom ablative therapy has previously failed. We describe 14 patients with residual high-grade dysplasia following aminolevulinic acid or Photofrin (porfimer sodium) photodynamic therapy (PDT). An overall complete reversal of dysplasia was achieved in 86 % with a combination of RFA and rescue endoscopic mucosal resection. The median total follow-up is 19 months. The rate of strictures was 7 % (1/14) and there was a low rate of buried glands (0.5 % follow-up biopsies). These data suggest RFA is both safe and effective for eradication of high-grade dysplasia in patients in whom PDT has failed.
Collapse
Affiliation(s)
- J M Dunn
- National Medical Laser Centre, Department of Surgery, University College London, London, UK
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Direkze S, Mansour M, Rodriguez-Justo M, Kibbler C, Gant V, Peggs KS. Candida kefyr fungal enteritis following autologous BMT. Bone Marrow Transplant 2011; 47:465-6. [DOI: 10.1038/bmt.2011.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
11
|
Rodriguez-Justo M, Huang Y, Ye H, Liu H, Chuang SS, Munson P, Prada-Puentes C, Kim I, Du MQ, Bacon CM. Cyclin D1-positive diffuse large B-cell lymphoma. Histopathology 2008; 52:900-3. [PMID: 18494615 DOI: 10.1111/j.1365-2559.2008.03042.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
MESH Headings
- Aged
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/metabolism
- Cell Nucleus/metabolism
- Cell Nucleus/pathology
- Chromosome Aberrations
- Cyclin D
- Cyclins/metabolism
- Cyclophosphamide/therapeutic use
- DNA, Neoplasm/analysis
- Diagnosis, Differential
- Doxorubicin/therapeutic use
- Fatal Outcome
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Mantle-Cell/diagnosis
- Prednisone/therapeutic use
- Rituximab
- Vincristine/therapeutic use
Collapse
|
12
|
Parfitt JR, Rodriguez-Justo M, Feakins R, Novelli MR. Gastrointestinal Kaposi's sarcoma: CD117 expression and the potential for misdiagnosis as gastrointestinal stromal tumour. Histopathology 2008; 52:816-23. [PMID: 18494611 DOI: 10.1111/j.1365-2559.2008.03034.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
AIMS Gastrointestinal Kaposi's sarcoma (KS) may mimic gastrointestinal stromal tumours (GISTs) histologically. Studies have shown that KS outside the gastrointestinal (GI) tract may express CD117, an antibody usually used to support a diagnosis of GIST. The aim was to evaluate the clinicopathological features of GI KS, including the expression of CD117 with and without antigen retrieval. METHODS AND RESULTS Fourteen GI KS were assessed histologically, 12 of which were also subjected to immunohistochemistry for CD34, human herpesvirus (HHV) 8, DOG1 and CD117. CD117 immunohistochemistry was performed with and without antigen retrieval. All cases showed an infiltrative spindle cell tumour. Lamina propria infiltration, lymphoplasmacytic inflammation, extravasated red blood cells and haemosiderin were typical histological features. In all cases tumour cells were positive for CD34 and HHV8, but negative for DOG1. CD117 was positive in four of 12 cases without antigen retrieval and 10 of 12 cases with antigen retrieval. CONCLUSIONS The microscopic distinction of GI KS from GIST can be difficult. Clues that raise the possibility of GI KS include young patient age, a history of immunosuppression, lamina propria infiltration, lymphoplasmacytic inflammation, extravasated red blood cells and haemosiderin deposition. Use of the immunomarkers CD117 (without antigen retrieval), HHV8 and DOG1 may aid in the distinction between GI KS and GIST.
Collapse
Affiliation(s)
- J R Parfitt
- Department of Pathology, London Health Sciences, London, Ontario, Canada
| | | | | | | |
Collapse
|
13
|
Rodriguez-Justo M, Chan G, McNicol AM. Simultaneous occurrence of adrenal cortical adenoma and ganglioneuroma. Histopathology 2006; 49:206-8. [PMID: 16879403 DOI: 10.1111/j.1365-2559.2006.02384.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
14
|
Abstract
The histological distinction between Hodgkin's disease (HD) and anaplastic large cell lymphoma (ALCL) may be difficult but is important as the two conditions have different clinical behaviours, prognoses and responses to therapy. Morphological appearances that have been emphasised as favouring the diagnosis of ALCL rather than HD include the identification of neoplastic cells permeating sinusoidal spaces. We document two cases of Hodgkin's disease with classical morphological and immunohistochemical features of nodular-sclerosis subtype (HDNS) but with striking sinusoidal involvement by neoplastic cells. In each case, the CD30 positive/CD15 positive immunophenotype of the neoplastic cells was characteristic of HD without expression of any of the other antigens normally associated with ALCL. HD is generally considered to be a morphological diagnosis and, in those laboratories in which it is not possible to use wide panels of antibodies for the confirmation of the diagnosis, the identification of sinusoidal infiltration by the neoplastic cells in HD may lead to the mistaken impression of ALCL.
Collapse
Affiliation(s)
- M Rodriguez-Justo
- Department of Pathology, Hospital Universitario de Getafe, Getafe-Madrid, Spain.
| | | | | |
Collapse
|
15
|
Lopez-Matas M, Rodriguez-Justo M, Morilla R, Catovsky D, Matutes E. Quantitative expression of CD23 and its ligand CD21 in chronic lymphocytic leukemia. Haematologica 2000; 85:1140-5. [PMID: 11064465] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cells from the great majority of patients with chronic lymphocytic leukemia (CLL) express CD23. A recent histologic study has shown that CD23 is expressed more strongly in the proliferating centers of the lymph nodes, where the large prolymphocytoid cells are located. The aim of our study was to quantify the expression of CD23 and CD21 in small and prolymphocytoid cells from patients with CLL and B-cell lymphomas, and correlate this expression with clinical parameters. DESIGN AND METHODS Using quantitative flow cyto-metry we analyzed the antigen density of CD23 and CD21 in: 1) 101 cases of chronic lymphocytic leukemia, 84 typical, 14 with increased prolymphocytes (CLL/PL) and 3 atypical, 2) 15 cases of CD23 positive B-cell lymphoma with circulating lymphoma cells and 3) 8 normal subjects. The results were correlated with morphology and clinical staging. RESULTS Cells from CLL and CLL/PL have a significantly higher number of CD23 molecules than normal and lymphoma B-cells (p<0.001 and p<0.001, respectively). Differences were not significant for CD21. CLL and CLL/PL cases had similar values of CD23 and CD21 molecules, but analysis at a single level showed that prolymphocytes in typical CLL and CLL/PL expressed significantly higher CD23 (p=0.001, p=0.006) and CD21 (p=0.001, p=0.001) than small lymphocytes. There was no correlation between CD23 or CD21 antigen density and clinical stages although there was a trend for a brighter CD23 in stage C patients. INTERPRETATION AND CONCLUSIONS Since interaction between CD23 and CD21 is important for B-cell activation, proliferation and tumor formation, findings that both molecules are upregulated in prolymphocytes suggest that this is the proliferating cell component in CLL and underline the association between progression and increased prolymphocytes in typical CLL and CLL/PL.
Collapse
MESH Headings
- Bone Marrow Cells/immunology
- Bone Marrow Cells/pathology
- Flow Cytometry
- Humans
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/pathology
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/pathology
- Receptors, Complement 3d/metabolism
- Receptors, IgE/metabolism
- Statistics, Nonparametric
Collapse
Affiliation(s)
- M Lopez-Matas
- Academic Department of Haematology and Cytogenetics, Royal Marsden NHS Trust, Institute of Cancer Research, London, UK
| | | | | | | | | |
Collapse
|