1
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Marques-Piubelli ML, Lyapichev KA, Fnu A, Adrada B, Stewart J, Hunt KK, Clemens MW, Iyer S, Wu Y, El Hussein S, Xu J, Ok CY, Li S, M Pierson D, Ferrufino-Schmidt MC, Nahmod KA, Yoga A, Hunsicker L, Evans MG, Resetkova E, Qiu L, Khanlari M, Garces SA, Bueso-Ramos CE, Medeiros LJ, Miranda RN. The Spectrum of Non-neoplastic Changes Associated With Breast Implants: Histopathology, Imaging, and Clinical Significance. Am J Surg Pathol 2024:00000478-990000000-00306. [PMID: 38451836 DOI: 10.1097/pas.0000000000002198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Breast implant-associated anaplastic large cell lymphoma has been recognized as a distinct entity in the World Health Organization classification of hematolymphoid neoplasms. These neoplasms are causally related to textured implants that were used worldwide until recently. Consequently, there is an increased demand for processing periprosthetic capsules, adding new challenges for surgeons, clinicians, and pathologists. In the literature, the focus has been on breast implant-associated anaplastic large cell lymphoma; however, benign complications related to the placement of breast implants occur in up to 20% to 30% of patients. Imaging studies are helpful in assessing patients with breast implants for evidence of implant rupture, changes in tissues surrounding the implants, or regional lymphadenopathy related to breast implants, but pathologic examination is often required. In this review, we couple our experience with a review of the literature to describe a range of benign lesions associated with breast implants that can be associated with different clinical presentations or pathogenesis and that may require different diagnostic approaches. We illustrate the spectrum of the most common of these benign disorders, highlighting their clinical, imaging, gross, and microscopic features. Finally, we propose a systematic approach for the diagnosis and handling of breast implant specimens in general.
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Affiliation(s)
| | - Kirill A Lyapichev
- Department of Pathology, University of Texas Medical Branch, Galveston, TX
| | | | | | | | | | | | - Swaminathan Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston
| | | | - Siba El Hussein
- Department of Pathology, The University of Vermont Larner College of Medicine, Burlington, VT
| | - Jie Xu
- Department of Hematopathology
| | | | | | - Diane M Pierson
- Department of Pathology, Kings Daughters Medical Center, Ashland, KY
| | | | | | - Arthy Yoga
- Houston Methodist, Breast Surgical Oncology, Houston, TX
| | - Lisa Hunsicker
- Revalla Plastic Surgery and Medical Esthetics, Denver, CO
| | | | | | - Lianqun Qiu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
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2
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Khanlari M, Wang W, Liu YC, Wang L, Rubnitz JE, Dixon S, Orr BA, Anelo OM, Cheng Z, Balagopal V, Klco JM. Concurrent peripheral T-cell lymphoma and T-cell lymphoblastic leukemia/lymphoma with identical STIL:: TAL1 fusion events. Haematologica 2024; 109:994-999. [PMID: 37767572 PMCID: PMC10905091 DOI: 10.3324/haematol.2023.283585] [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] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN.
| | - Wei Wang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Yen-Chun Liu
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Lu Wang
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffrey E Rubnitz
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Stephanie Dixon
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Brent A Orr
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Obianuju M Anelo
- Department of Pathology, University of Tennessee Health Science Center, TN
| | - Zhongshan Cheng
- Center for Applied Bioinformatics, St. Jude Children's Research Hospital, Memphis, TN
| | - Vidya Balagopal
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffery M Klco
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
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3
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Barajas JM, Umeda M, Contreras L, Khanlari M, Westover T, Walsh MP, Xiong E, Yang C, Otero B, Arribas-Layton M, Abdelhamed S, Song G, Ma X, Thomas Rd ME, Ma J, Klco JM. UBTF tandem duplications in pediatric myelodysplastic syndrome and acute myeloid leukemia: implications for clinical screening and diagnosis. Haematologica 2024. [PMID: 38426285 DOI: 10.3324/haematol.2023.284683] [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: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
Recent genomic studies in adult and pediatric acute myeloid leukemia (AML) demonstrated recurrent in-frame tandem duplications (TD) in exon 13 of upstream binding transcription factor (UBTF). These alterations, which account for ~4.3% of AMLs in childhood and about 3% in adult AMLs under 60, are subtype-defining and associated with poor outcomes. Here, we provide a comprehensive investigation into the clinicopathological features of UBTF-TD myeloid neoplasms in childhood, including 89 unique pediatric AML and 6 myelodysplastic syndrome (MDS) cases harboring a tandem duplication in exon 13 of UBTF. We demonstrate that UBTF-TD myeloid tumors are associated with dysplastic features, low bone marrow blast infiltration, and low white blood cell count. Furthermore, using bulk and single-cell analyses, we confirm that UBTF-TD is an early and clonal event associated with a distinct transcriptional profile, whereas the acquisition of FLT3 or WT1 mutations is associated with more stem celllike programs. Lastly, we report rare duplications within exon 9 of UBTF that phenocopy exon 13 duplications, expanding the spectrum of UBTF alterations in pediatric myeloid tumors. Collectively, we comprehensively characterize pediatric AML and MDS with UBTF-TD and highlight key clinical and pathologic features that distinguish this new entity from other molecular subtypes of AML.
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Affiliation(s)
- Juan M Barajas
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Masayuki Umeda
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Lisett Contreras
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Tamara Westover
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Michael P Walsh
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Emily Xiong
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | | | | | | | - Sherif Abdelhamed
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Guangchun Song
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Xiaotu Ma
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN
| | - Melvin E Thomas Rd
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jing Ma
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffery M Klco
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN.
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4
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Zhou T, Curry CV, Khanlari M, Shi M, Cui W, Peker D, Chen W, Wang E, Gao J, Shen Q, Xie W, Jelloul FZ, King RL, Yuan J, Wang X, Zhao C, Obiorah IE, Courville EL, Nomura E, Cherian S, Xu ML, Burack WR, Liu HX, Jabbour EJ, Takahashi K, Wang W, Wang SA, Khoury JD, Medeiros LJ, Hu S. Genetics and pathologic landscape of lineage switch of acute leukemia during therapy. Blood Cancer J 2024; 14:19. [PMID: 38272888 PMCID: PMC10810851 DOI: 10.1038/s41408-024-00983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Affiliation(s)
- Ting Zhou
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Choladda V Curry
- Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Min Shi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Wei Cui
- Department of Pathology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Deniz Peker
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Weina Chen
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qi Shen
- Department of Pathology, AdventHealth-Orlando, Orlando, FL, USA
| | - Wei Xie
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Fatima Z Jelloul
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rebecca L King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ji Yuan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xiaoqiong Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chen Zhao
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ifeyinwa E Obiorah
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Elizabeth L Courville
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Eric Nomura
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Sindhu Cherian
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Mina L Xu
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - W Richard Burack
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Hong-Xing Liu
- Molecular Medicine Center, Beijing Lu Daopei lnstitute of Hematology, Beijing, China
| | - Elias J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Koichi Takahashi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, Omaha, NE, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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5
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Qiu L, Lin P, Khanlari M, Xu J, Cohen EN, Garces S, Miranda RN, Wang W, Fang H, Bueso-Ramos CE, Medeiros LJ, Li S. The Clinicopathologic Features and Molecular Signatures of Blastoid High-Grade B Cell Lymphoma, Not Otherwise Specified. Mod Pathol 2023; 36:100349. [PMID: 37820764 DOI: 10.1016/j.modpat.2023.100349] [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: 05/24/2023] [Revised: 09/11/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
A small subset of high-grade B-cell lymphoma (HGBL) with blastoid morphology remains poorly understood. We assessed 55 cases of blastoid HGBL, not otherwise specified (NOS) and compared their clinicopathologic characteristics with those of 81 non-blastoid HGBL-NOS and 62 blastoid HGBL with MYC and BCL2, with or without BCL6 rearrangements (double/triple-hit lymphoma [D/THL]). Patients with blastoid HGBL-NOS showed similar clinicopathologic features to patients with blastoid D/THLs and non-blastoid HGBL-NOS, except more frequently with a history of low-grade B-cell lymphoma, bone marrow involvement, and BCL2 rearrangement (P < .05) compared to the latter. MYC rearrangement (MYC-R), detected in 40% of blastoid HGBL-NOS, was associated with aggressive clinicopathologic features and poorer overall survival, even worse than that of blastoid D/THL (P < .05). Transcriptome profiling revealed a distinct gene expression pattern with differentially expressed genes enriched in MYC and P53-targeted genes in MYC-R blastoid HGBL-NOS. Fifty-two percent of blastoid HGBL-NOS had a double hit-like signature, similar to non-blastoid HGBL-NOS (P = .73). The overall survival of the blastoid HGBL-NOS group was similar to that of the blastoid D/THL group but appeared poorer than that of its non-blastoid counterparts (P = .07). Taken together, blastoid HGBL-NOS is an aggressive B-cell lymphoma that shares overlapping clinicopathologic and genetic features with non-blastoid HGBL-NOS. MYC-R in patients with blastoid HGBL-NOS identifies a highly aggressive subgroup with distinct aggressive clinicopathologic features, unique molecular signatures, and a dismal clinical outcome.
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Affiliation(s)
- Lianqun Qiu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Evan N Cohen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sofia Garces
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hong Fang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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6
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Barajas JM, Umeda M, Contreras L, Khanlari M, Westover T, Walsh MP, Xiong E, Yang C, Otero B, Arribas-Layton M, Abdelhamed S, Song G, Ma X, Thomas ME, Ma J, Klco JM. UBTF Tandem Duplications in Pediatric MDS and AML: Implications for Clinical Screening and Diagnosis. medRxiv 2023:2023.11.13.23298320. [PMID: 38014207 PMCID: PMC10680889 DOI: 10.1101/2023.11.13.23298320] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Recent genomic studies in adult and pediatric acute myeloid leukemia (AML) demonstrated recurrent in-frame tandem duplications (TD) in exon 13 of upstream binding transcription factor (UBTF). These alterations, which account for ~4.3% of AMLs in childhood and up to 3% in adult AMLs under 60, are subtype-defining and associated with poor outcomes. Here, we provide a comprehensive investigation into the clinicopathological features of UBTF-TD myeloid neoplasms in childhood, including 89 unique pediatric AML and 6 myelodysplastic syndrome (MDS) cases harboring a tandem duplication in exon 13 of UBTF. We demonstrate that UBTF-TD myeloid tumors are associated with dysplastic features, low bone marrow blast infiltration, and low white blood cell count. Furthermore, using bulk and single-cell analyses, we confirm that UBTF-TD is an early and clonal event associated with a distinct transcriptional profile, whereas the acquisition of FLT3 or WT1 mutations is associated with more stem cell-like programs. Lastly, we report rare duplications within exon 9 of UBTF that phenocopy exon 13 duplications, expanding the spectrum of UBTF alterations in pediatric myeloid tumors. Collectively, we comprehensively characterize pediatric AML and MDS with UBTF-TD and highlight key clinical and pathologic features that distinguish this new entity from other molecular subtypes of AML.
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Affiliation(s)
- Juan M. Barajas
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Masayuki Umeda
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Lisett Contreras
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Mahsa Khanlari
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Tamara Westover
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Michael P. Walsh
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Emily Xiong
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | | | | | | | - Sherif Abdelhamed
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Guangchun Song
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Xiaotu Ma
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Melvin E. Thomas
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Jing Ma
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Jeffery M. Klco
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
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7
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Khanlari M, Wang L, Bolen CY, Otanez FSB, Furtado LV, Key L, Irwin L, Wang W, Klco JM. CBFA2T3::GLIS2-positive acute leukemia with RAM and mixed T/megakaryocytic phenotype. EJHaem 2023; 4:765-769. [PMID: 37601875 PMCID: PMC10435670 DOI: 10.1002/jha2.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023]
Abstract
Herein, we present a rare case of acute myeloid leukemia (AML) with CBFA2T3-rearrangement and the expression of megakaryocytic and lymphoid markers, highlighting the need for a high suspicion index in differential diagnosis and applying adequate workup to avoid misdiagnosing this entity. CBFA2T3::GLIS2-positive AML is primarily found in infants with non-down syndrome acute megakaryoblastic leukemia (non-DSAMKL). Flow cytometry immunophenotyping plays an important role in recognizing the unique immunophenotype of bright CD56 expression with dim/negative expression of HLA-DR, CD38, and CD45 termed the RAM immunophenotype in this entity. Still, CBFA2T3::GLIS2-positive acute leukemia with T/megakaryocytic markers could be misdiagnosed as T-lymphoblastic leukemia/lymphoma, early T-cell precursor acute lymphoblastic leukemia/lymphoma, NK lymphoblastic leukemia, AML with minimal differentiation, or AML with myelodysplasia-related changes.
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Affiliation(s)
- Mahsa Khanlari
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Lu Wang
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Christine Y Bolen
- Department of OncologyNovant Health Presbyterian Medical CenterCharlotteNorth CarolinaUSA
| | | | - Larissa V. Furtado
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Laura Key
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Lisa Irwin
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Wei Wang
- Department of HematopathologyMD Anderson Cancer CenterHoustonTexasUSA
| | - Jeffery M. Klco
- Department of PathologySt. Jude Children's Research HospitalMemphisTennesseeUSA
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8
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Khanlari M, Mo H, Kim DH, Sakhdari A, Young KH, Jain P, Wang M, Li S, Kanagal-Shamanna R, Miranda RN, Vega F, Medeiros LJ, Ok CY. Blastoid and Pleomorphic Mantle Cell Lymphoma Demonstrate Distinct Clinicopathologic and Genetic Features. Am J Surg Pathol 2023:00000478-990000000-00177. [PMID: 37288826 PMCID: PMC10348620 DOI: 10.1097/pas.0000000000002068] [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] [Indexed: 06/09/2023]
Abstract
The blastoid (B) and pleomorphic (P) variants of mantle cell lymphoma (MCL) are associated with aggressive clinical behavior. In this study, we collected 102 cases of B-MCL and P-MCL from untreated patients. We reviewed clinical data, analyzed morphologic features using an image analysis tool (ImageJ) and we assessed mutational and gene expression profiles. The chromatin pattern of lymphoma cells was assessed quantitatively by the pixel value. Cases of B-MCL showed a greater median pixel value with lower variation compared with P-MCL, indicating a homogeneously euchromatin-rich pattern in B-MCL. In addition, the Feret diameter of the nuclei was significantly smaller (median 6.92 vs. 8.49 µm per nucleus, P<0.001) and had a lesser degree of variation in B-MCL compared with P-MCL, indicating that B-MCL cells have smaller cells with a more monomorphic appearance. B-MCL showed a significantly higher median Ki-67 proliferation rate (60% vs. 40%, P=0.003), and affected patients had poorer overall survival compared with those with P-MCL (median overall survival: 3.1 vs. 8.8 y, respectively, P=0.038). NOTCH1 mutation was significantly more frequent in B-MCL compared with P-MCL (33% and 0%, respectively, P=0.004). Gene expression profiling showed 14 genes overexpressed in B-MCL cases and gene set enrichment assay for the overexpressed genes showed significant enrichment in the cell cycle and mitotic transition pathways. We also report a subset of MCL cases that has blastoid chromatin but a higher degree of pleomorphism in nuclear size and shape, designated here as hybrid MCL. Hybrid MCL cases had a similar Ki-67 proliferation rate, mutation profile, and clinical outcome to B-MCL and distinct from P-MCL. In summary, these data suggest biological differences between B-MCL and P-MCL cases justifying their separate designation when possible.
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Affiliation(s)
| | - Huan Mo
- Departments of Hematopathology
| | | | | | - Ken H Young
- Division of Hematopathology, Department of Pathology, Duke University School of Medicine, Durham, NC
| | - Preetesh Jain
- Lymphoma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Wang
- Lymphoma, The University of Texas MD Anderson Cancer Center, Houston, TX
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9
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Qiu L, Xu J, Lin P, Cohen EN, Tang G, Wang SA, Khanlari M, Wang W, Khoury JD, Konoplev S, Yin CC, Jorgensen JL, Vega F, Medeiros LJ, Li S. Unique pathologic features and gene expression signatures distinguish blastoid high-grade B-cell lymphoma from B-acute lymphoblastic leukemia/lymphoma. Haematologica 2023; 108:895-899. [PMID: 36325892 PMCID: PMC9973484 DOI: 10.3324/haematol.2022.281646] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Lianqun Qiu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Evan N Cohen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Sergej Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Jeffrey L Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston.
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10
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Ryland GL, Umeda M, Holmfeldt L, Lehmann S, Herlin MK, Ma J, Khanlari M, Rubnitz JE, Ries RE, Kosasih HJ, Ekert PG, Goh HN, Tiong IS, Grimmond SM, Haferlach C, Day RB, Ley TJ, Meshinchi S, Ma X, Blombery P, Klco JM. Description of a novel subtype of acute myeloid leukemia defined by recurrent CBFB insertions. Blood 2023; 141:800-805. [PMID: 36179268 PMCID: PMC10273080 DOI: 10.1182/blood.2022017874] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Georgina L. Ryland
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Centre for Cancer Research, University of Melbourne, Parkville, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Masayuki Umeda
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Linda Holmfeldt
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- The Beijer Laboratory, Uppsala, Sweden
| | - Sören Lehmann
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Morten Krogh Herlin
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jing Ma
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Mahsa Khanlari
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
| | - Jeffrey E. Rubnitz
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - Rhonda E. Ries
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Paul G. Ekert
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
| | - Hwee Ngee Goh
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ing S. Tiong
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Sean M. Grimmond
- Centre for Cancer Research, University of Melbourne, Parkville, VIC, Australia
| | | | - Ryan B. Day
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Timothy J. Ley
- Division of Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Soheil Meshinchi
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Xiaotu Ma
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN
| | - Piers Blombery
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Jeffery M. Klco
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN
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11
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Li S, Qiu L, Xu J, Lin P, Ok CY, Tang G, McDonnell TJ, James You M, Khanlari M, Miranda RN, Medeiros LJ. High-grade B-cell lymphoma (HGBL)-NOS is clinicopathologically and genetically more similar to DLBCL/HGBL-DH than DLBCL. Leukemia 2023; 37:422-432. [PMID: 36513804 DOI: 10.1038/s41375-022-01778-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022]
Abstract
High-grade B-cell lymphoma, not otherwise specified (HGBL-NOS) is rare and data focused on these neoplasms is lacking. We studied the clinicopathologic and genetic features of 136 HGBL-NOS patients and compared them to patients with DLBCL/HGBL-DH (n = 224, defined by 5th Edition WHO) and DLBCL (n = 217). HGBL-NOS patients had clinical features similar to DLBCL/HGBL-DH patients. MYC rearrangement (MYC-R) was present in 43% of HGBL-NOS. With induction regimen similar to DLBCL/HGBL-DH patients, HGBL-NOS patients had a median overall survival (OS) of 28.9 months, similar to DLBCL/HGBL-DH (p = 0.48) but inferior to DLBCL patients (p = 0.03). R-EPOCH induction was associated with improved OS compared with R-CHOP. MYC-R, history of lymphoma, and high IPI were independent adverse prognostic factors in HGBL-NOS patients. Whole transcriptome profiling performed on a subset of HGBL-NOS cases showed a profile more similar to DLBCL/HGBL-DH than to DLBCL; 53% of HGBL-NOS had a DH-like signature (DH-like-Sig) and were enriched for MYC-R. DH-like-Sig+ HGBL-NOS patients had a poorer OS than DH-like-Sig-negative patients (p = 0.04). In conclusion, HGBL-NOS has clinicopathologic features and a gene expression profile more similar to DLBCL/HGBL-DH than to DLBCL. Cases of HGBL-NOS frequently carry MYC-R and have a DH-like-Sig+. R-EPOCH induction in HGBL-NOS appears associated with improved OS compared with standard R-CHOP.
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Affiliation(s)
- Shaoying Li
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States.
| | - Lianqun Qiu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Jie Xu
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Pei Lin
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Chi Young Ok
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Guilin Tang
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Timothy J McDonnell
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - M James You
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Mahsa Khanlari
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Roberto N Miranda
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - L Jeffrey Medeiros
- Department of Hematopathology, UT MD Anderson Cancer Center, Houston, TX, United States
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12
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Abstract
Follicular lymphoma (FL) is the most common indolent B-cell lymphoma and originates from germinal center B-cells (centrocytes and centroblasts) of the lymphoid follicle. Tumorigenesis is believed to initiate early in precursor B-cells in the bone marrow (BM) that acquire the t(14;18)(q32;q21). These cells later migrate to lymph nodes to continue their maturation through the germinal center reaction, at which time they acquire additional genetic and epigeneticabnormalities that promote lymphomagenesis. FLs are heterogeneous in terms of their clinicopathologic features. Most FLs are indolent and clinically characterized by peripheral lymphadenopathy with involvement of the spleen, BM, and peripheral blood in a substantial subset of patients, sometimes accompanied by constitutional symptoms and laboratory abnormalities. Diagnosis is established by the histopathologic identification of a B-cell proliferation usually distributed in an at least partially follicular pattern, typically, but not always, in a lymph node biopsy. The B-cell proliferation is biologically of germinal center cell origin, thus shows an expression of germinal center-associated antigens as detected by immunophenotyping. Although many cases of FLs are typical and histopathologic features are straightforward, the biologic and histopathologic variability of FL is wide, and an accurate diagnosis of FL over this disease spectrum requires knowledge of morphologic variants that can mimic other lymphomas, and rarely non-hematologic malignancies, clinically unique variants, and pitfalls in the interpretation of ancillary studies. The overall survival for most patients is prolonged, but relapses are frequent. The treatment landscape in FL now includes the application of immunotherapy and targeted therapy in addition to chemotherapy.
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Affiliation(s)
- Mahsa Khanlari
- Department of Pathology and Hematopathology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Corresponding Author: Mahsa Khanlari, MD, Department of Pathology and Hematopathology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA Tel: +1-901-595-0394, Fax: +1-901-595-3100, E-mail:
| | - Jennifer R. Chapman
- Department of Pathology, Division of Hematopathology, University of Miami, Sylvester Comprehensive Cancer Center, and Jackson Memorial Hospitals, Miami, FL, USA
- Corresponding Author: Jennifer R. Chapman, MD, Department of Pathology, University of Miami Hospital, 4th floor, room 4076, 1400 NW 12th Ave., Miami, FL 33138, USA Tel: +1-305-689-1332, E-mail:
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13
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Khanlari M, Wang X, Loghavi S, Wang SA, Li S, Thakral B, Bueso-Ramos CE, Yin CC, Kanagal-Shamanna R, Khoury JD, Patel KP, Popat UR, Medeiros LJ, Konoplev S. Value and pitfalls of assessing bone marrow morphologic findings to predict response in patients with myelofibrosis who undergo hematopoietic stem cell transplantation. Ann Diagn Pathol 2021; 56:151860. [PMID: 34823075 DOI: 10.1016/j.anndiagpath.2021.151860] [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: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative option for patients with myelofibrosis (MF). Bone marrow (BM) morphologic evaluation of myelofibrosis following allo-HSCT is known to be challenging in this context because resolution of morphologic changes is a gradual process. PATIENTS AND METHODS We compared BM samples of patients with myelofibrosis who underwent first allo-HSCT and achieved molecular remission by day 100 with BM samples of patients who continued to have persistent molecular evidence of disease following allo-HSCT. RESULTS The study group included 29 patients: 17 primary MF, 7 post-polycythemia vera (PV) MF, and 5 post-essential thrombocythemia (ET) MF. In this cohort there were 18 JAK2 p.V617F, 8 CALR; 1 MPL, and 2 patients had concurrent JAK2 p.V617F and MPL mutations. The control group included 5 patients with primary MF, one with post-PV MF, one with post-ET MF (5 JAK2 p.V617F; 2 CALR). Following allo-HSCT, both groups showed reduction in BM cellularity and number of megakaryocytes. The study cohort also less commonly had dense megakaryocyte clusters and endosteal located megakaryocytes and showed less fibrosis. There was no statistical difference in BM cellularity, presence of erythroid islands, degree of osteosclerosis, or megakaryocyte number, size, nuclear lobation, presence of clusters or intrasinusoidal location. CONCLUSIONS Following allo-HSCT at 100 days, morphologic evaluation of BM in patients with MF cannot reliably predict persistence versus clearance of molecular evidence of MF. Disappearance of BM MF, dense megakaryocyte clusters, and endosteal localization of megakaryocytes are suggestive of disease response.
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Affiliation(s)
- Mahsa Khanlari
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Pathology and the Hematological Malignancies Program, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xiaoqiong Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanam Loghavi
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Beenu Thakral
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos E Bueso-Ramos
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rashmi Kanagal-Shamanna
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur P Patel
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Uday R Popat
- Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergej Konoplev
- Departments of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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14
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Qiu L, Xu J, Tang G, Wang SA, Lin P, Ok CY, Garces S, Yin CC, Khanlari M, Vega F, Medeiros LJ, Li S. Mantle Cell Lymphoma with Chronic Lymphocytic Leukemia-Like Features: A Diagnostic Mimic and Pitfall. Hum Pathol 2021; 119:59-68. [PMID: 34767860 DOI: 10.1016/j.humpath.2021.11.001] [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] [Received: 10/07/2021] [Accepted: 11/03/2021] [Indexed: 11/04/2022]
Abstract
Mantle cell lymphoma (MCL) is a mature B-cell neoplasm characterized by t(11;14)(q13;q32) and cyclin D1 overexpression in >95% of cases. Classic MCL cases are composed of a monotonous population of small to medium-sized lymphocytes with irregular nuclear contours that are positive for cyclin D1 and SOX11, and negative for CD23 and CD200. By contrast, occasional MCL cases express CD23 and CD200 but lack of SOX11, and morphologically and immunophenotypically resemble chronic lymphocytic leukemia (CLL), termed as CLL-like MCL in this study. These neoplasms pose a diagnostic challenge and easy to be diagnosed as CLL in daily practice. We studied 14 cases of CLL-like MCL to define their clinicopathologic features and compared them with 33 traditional CLL cases. There were 8 men and 6 women with a median age of 62 years (range, 44-80). Compared with CLL, patients with CLL-like MCL have lower levels of peripheral blood and bone marrow involvement, and more frequently had mutated IGHV. Immunophenotypically, CLL-like MCL often showed moderate to bright expression of B-cell antigens and surface immunoglobulin light chain, dim and partial expression of CD23 and CD200, infrequent CD43 positivity, and lack of LEF1. The overall survival of patients with CLL-like MCL was similar to that of CLL patients. In conclusion, CD23+, CD200+, and SOX11-negative MCL closely resemble CLL, both clinically and pathologically, including a similar indolent clinical course. They may pose a diagnostic challenge. However, patients with CLL-like MCL also have distinctive immunophenotypic features that are useful to distinguish these neoplasms from CLL.
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Affiliation(s)
- Lianqun Qiu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Chi Young Ok
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sophia Garces
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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15
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DeSalvo J, Ban Y, Li L, Sun X, Jiang Z, Kerr DA, Khanlari M, Boulina M, Capecchi MR, Partanen JM, Chen L, Kondo T, Ornitz DM, Trent JC, Eid JE. ETV4 and ETV5 drive synovial sarcoma through cell cycle and DUX4 embryonic pathway control. J Clin Invest 2021; 131:141908. [PMID: 33983905 DOI: 10.1172/jci141908] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 05/11/2021] [Indexed: 12/21/2022] Open
Abstract
Synovial sarcoma is an aggressive malignancy with no effective treatments for patients with metastasis. The synovial sarcoma fusion SS18-SSX, which recruits the SWI/SNF-BAF chromatin remodeling and polycomb repressive complexes, results in epigenetic activation of FGF receptor (FGFR) signaling. In genetic FGFR-knockout models, culture, and xenograft synovial sarcoma models treated with the FGFR inhibitor BGJ398, we show that FGFR1, FGFR2, and FGFR3 were crucial for tumor growth. Transcriptome analyses of BGJ398-treated cells and histological and expression analyses of mouse and human synovial sarcoma tumors revealed prevalent expression of two ETS factors and FGFR targets, ETV4 and ETV5. We further demonstrate that ETV4 and ETV5 acted as drivers of synovial sarcoma growth, most likely through control of the cell cycle. Upon ETV4 and ETV5 knockdown, we observed a striking upregulation of DUX4 and its transcriptional targets that activate the zygotic genome and drive the atrophy program in facioscapulohumeral dystrophy patients. In addition to demonstrating the importance of inhibiting all three FGFRs, the current findings reveal potential nodes of attack for the cancer with the discovery of ETV4 and ETV5 as appropriate biomarkers and molecular targets, and activation of the embryonic DUX4 pathway as a promising approach to block synovial sarcoma tumors.
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Affiliation(s)
- Joanna DeSalvo
- Department of Medicine, Division of Medical Oncology.,Sylvester Comprehensive Cancer Center, and
| | - Yuguang Ban
- Sylvester Comprehensive Cancer Center, and.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Luyuan Li
- Department of Medicine, Division of Medical Oncology.,Sylvester Comprehensive Cancer Center, and
| | | | - Zhijie Jiang
- University of Miami Center for Computational Science, Coral Gables, Florida, USA
| | | | | | - Maria Boulina
- Analytical Imaging Core Facility, Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mario R Capecchi
- Department of Human Genetics, Howard Hughes Medical Institute, University of Utah, Salt Lake City, Utah, USA
| | - Juha M Partanen
- Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Lin Chen
- Center of Bone Metabolism and Repair, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, China
| | - Tadashi Kondo
- Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan
| | - David M Ornitz
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jonathan C Trent
- Department of Medicine, Division of Medical Oncology.,Sylvester Comprehensive Cancer Center, and
| | - Josiane E Eid
- Department of Medicine, Division of Medical Oncology.,Sylvester Comprehensive Cancer Center, and
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16
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Khanlari M, Wang SA, Fowler NH, Tang G, Saluja K, Muzzafar T, Medeiros LJ, Thakral B. Concurrent TP53 Mutation and Deletion in Refractory Low-grade Follicular Lymphoma. Clin Lymphoma Myeloma Leuk 2021; 21:e626-e629. [PMID: 33867306 DOI: 10.1016/j.clml.2021.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Mahsa Khanlari
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Sa A Wang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Nathan H Fowler
- Department of Lymphoma and Myeloma Division of Cancer Medicine, MD Anderson Cancer Center, Houston, TX
| | - Guilin Tang
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | - Karan Saluja
- Department of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston, TX
| | - Tariq Muzzafar
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX
| | | | - Beenu Thakral
- Department of Hematopathology, MD Anderson Cancer Center, Houston, TX.
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17
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Hao S, Lu X, Gong Z, Bassett RL, Hu S, Konoplev SN, Tang G, Li S, Xu J, Khanlari M, Lee HC, Manasanch EE, Weber DM, Orlowski RZ, Medeiros LJ, Lin P. The survival impact of CKS1B gains or amplification is dependent on the background karyotype and TP53 deletion status in patients with myeloma. Mod Pathol 2021; 34:327-335. [PMID: 32908255 DOI: 10.1038/s41379-020-00669-7] [Citation(s) in RCA: 6] [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] [Received: 07/29/2019] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/09/2022]
Abstract
Gains or amplification (amp) of chromosome 1q21/CKS1B are reported to be a high-risk factor in myeloma. In this retrospective study, we analyzed the impact of CKS1B gain/amp on overall survival in the context of other genetic aberrations, such as TP53 deletion, FGFR3-IGH, IGH-MAF, MYEOV/CCND1-IGH, and RB1, as well as karyotype. The cohort included 132 myeloma patients with CKS1B gain/amp detected by fluorescence in-situ hybridization. There were 72 men and 60 women with a median age of 65 years (range 39-88 years). A normal, simple, or complex karyotype was observed in 39.5%, 5.4%, and 55% of patients, respectively. "Double hit," defined as CKS1B gain/amp coexisting with TP53 deletion, or "triple hit," defined as double hit plus t(4;14)FGFR3-IGH or t(14;16)IGH-MAF, were identified in 25 patients (18.9%) and five patients (3.8%), respectively. Double and triple hit were highly associated with a complex karyotype (p = 0.02). Ninety-nine patients (99/128, 77.3%) received stem cell transplantation. The median follow-up time was 48.2 months (range 2-104 months); 68 patients (51.5%) died, with a median overall survival of 58.8 months. Multivariate analysis (Cox model) showed that double hit with TP53 deletion (p = 0.0031), triple hit (p = 0.01), and complex karyotype (p = 0.0009) were each independently associated with poorer overall survival. Stem cell transplantation was associated with better overall survival, mainly in patients with a double or triple hit and complex karyotype (p = 0.003). These findings indicate that the inferior outcome of myeloma patients with CKS1B gain/amp is attributable to the high number of high-risk patients in this group. The prognostic impact of CKS1B gain/amp depends on the background karyotype and TP53 status.
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Affiliation(s)
- Suyang Hao
- Department of Pathology and Genomic Medicine, The Houston Methodist Hospital, Houston, TX, USA
| | - Xinyan Lu
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zimu Gong
- Department of Internal Medicine, AMITA Health Saint Joseph Hospital, Chicago, IL, USA
| | - Roland L Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sergej N Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hans C Lee
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elisabet E Manasanch
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Donna M Weber
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Z Orlowski
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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18
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El Hussein S, Khoury JD, Lyapichev KA, Tashakori M, Khanlari M, Miranda RN, Kanagal-Shamanna R, Wang SA, Ahmed A, Mirza KM, Crane GM, Medeiros LJ, Loghavi S. Next-Generation Scholarship: Rebranding Hematopathology Using Twitter: The MD Anderson Experience. Mod Pathol 2021; 34:854-861. [PMID: 33219298 PMCID: PMC7678590 DOI: 10.1038/s41379-020-00715-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022]
Abstract
Hematopathologists are witnessing very exciting times, as a new era of unsurpassed technological advances is unfolding exponentially, enhancing our understanding of diseases at the genomic and molecular levels. In the evolving field of precision medicine, our contributions as hematopathologists to medical practice are of paramount importance. Social media platforms such as Twitter have helped facilitate and enrich our professional interactions and collaborations with others in our field and in other medical disciplines leading to a more holistic approach to patient care. These platforms also have created a novel means for instantaneous dissemination of new findings and recent publications, and are proving to be increasingly useful tools that can be harnessed to expand our knowledge and amplify our presence in the medical community. In this Editorial, we share our experience as hematopathologists with Twitter, and how we leveraged this platform to boost scholarly activities within and beyond our subspecialty, and as a powerful medium for worldwide dissemination of educational material and to promote our remote teaching activities during the COVID-19 pandemic.
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Affiliation(s)
- Siba El Hussein
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Joseph D. Khoury
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Kirill A. Lyapichev
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Mehrnoosh Tashakori
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Mahsa Khanlari
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Roberto N. Miranda
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Rashmi Kanagal-Shamanna
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sa A. Wang
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Aadil Ahmed
- grid.241054.60000 0004 4687 1637Department of Pathology and Laboratory Medicine, The University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Kamran M. Mirza
- grid.470420.50000 0004 0443 7488Department of Pathology and Laboratory Medicine, Loyola University Health System, Maywood, IL USA
| | - Genevieve M. Crane
- grid.239578.20000 0001 0675 4725Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH USA
| | - L. Jeffrey Medeiros
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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19
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Khanlari M, Tang G, Hao S, Gong Y, Li S, Miranda RN, Lin P, Iyer S, Yin CC, Xie W, Vega F, Medeiros LJ, Xu J. Anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma with MYC rearrangement. Br J Haematol 2020; 192:e17-e21. [PMID: 33216956 DOI: 10.1111/bjh.17169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Suyang Hao
- Department of Pathology and Genomic Medicine, Methodist Hospital, Houston, TX, USA
| | - Yun Gong
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cameron C Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Xie
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francisco Vega
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L J Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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20
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Khanlari M, Wang SA, Tang G, Saluja K, Medeiros LJ, Thakral B. CD45
‐negative follicular lymphoma: A rare diagnostic pitfall of a common entity. Cytometry 2020; 100:406-408. [DOI: 10.1002/cyto.b.21944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Mahsa Khanlari
- Department of HematopathologyMD Anderson Cancer Center Houston Texas USA
| | - Sa A. Wang
- Department of HematopathologyMD Anderson Cancer Center Houston Texas USA
| | - Guilin Tang
- Department of HematopathologyMD Anderson Cancer Center Houston Texas USA
| | - Karan Saluja
- Department of Pathology and Laboratory MedicineMcGovern Medical School, The University of Texas Health Science Center Houston Texas USA
| | | | - Beenu Thakral
- Department of HematopathologyMD Anderson Cancer Center Houston Texas USA
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21
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Shen J, Medeiros LJ, Li S, Wang SA, Lin P, Khanlari M, Iyer SP, Yin CC, Tang G, Jorgensen JL, Hu S, Miranda RN, Xu J. CD8 expression in anaplastic large cell lymphoma correlates with noncommon morphologic variants and T-cell antigen expression suggesting biological differences with CD8-negative anaplastic large cell lymphoma. Hum Pathol 2020; 98:1-9. [PMID: 32032618 DOI: 10.1016/j.humpath.2020.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/20/2019] [Revised: 01/14/2020] [Accepted: 01/28/2020] [Indexed: 02/07/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm characterized by uniformly strong CD30 expression and common absence of T-cell markers. Most ALCL cases express CD4, but a small subset of ALCL cases has been reported to express CD8. Little is known about the clinicopathologic and prognostic features of CD8+ ALCL. In this study, CD8 was assessed in 158 patients with systemic ALCL: CD8 was positive in 13 of 67 (19%) ALK+ and 13 of 91 (14%) ALK-negative neoplasms. In ALK+ ALCL, the CD8+ subgroup more often showed a noncommon morphologic pattern (69% vs 13%, P = .0001) and was more often positive for CD2 (100% vs 45%, P = .001), CD3 (92% vs 24%, P = .0001), and CD7 (100% vs. 39%, P = .002), but less frequently positive for CD25 (50% vs. 100%, P = .02). Patients with ALK+ ALCL and CD8+ neoplasms also had a higher relapse rate (82% vs 48%, P = .05) and more often underwent stem cell transplant (73% vs 36%, P = .04). CD8 expression did not correlate with patient overall survival or progression-free survival regardless of ALK status (all P > 0.05). We conclude that CD8+ ALCL cases appear to be biologically different from the more common CD8-negative ALCL cases. Our data suggest that CD8 positivity in ALK+ ALCL helps to identify a subset of patients more prone to relapse or more in need of stem cell transplant during their clinical course, although there was no impact on survival in this cohort.
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Affiliation(s)
- Jing Shen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Hematology, Capital Medical University Beijing Friendship Hospital, Beijing, China
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pei Lin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan P Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeffrey L Jorgensen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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22
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Gajzer DC, Fletcher CD, Agaimy A, Brcic I, Khanlari M, Rosenberg AE. Primary gastrointestinal liposarcoma-a clinicopathological study of 8 cases of a rare entity. Hum Pathol 2019; 97:80-93. [PMID: 31884085 DOI: 10.1016/j.humpath.2019.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/15/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022]
Abstract
Primary gastrointestinal liposarcoma is rare, and information regarding this entity is largely based on single case studies. We report on 8 patients with primary liposarcoma of the gastrointestinal tract and review the pertinent literature. The cohort includes 6 men and 2 women who ranged in age from 51 to 81 years (median 68.5). Two tumors arose in the stomach, 4 in the small intestine, and 2 in the large intestine. Tumors ranged in size from 2.5 to 14.5 cm (median 7 cm), originated in the submucosa or muscularis propria of the intestinal wall, and frequently protruded into the bowel lumen, resulting in mucosal ulceration and luminal obstruction. Six tumors were dedifferentiated liposarcomas, and 2 were well-differentiated liposarcoma. Surgical excision was performed on all tumors except for 1 case of dedifferentiated liposarcoma. On follow-up, 1 patient with dedifferentiated liposarcoma developed a lytic sacral lesion suspicious for metastasis 4 months after resection of the primary, and another underwent marginal resection and presented with recurrence 4 years later, had tumor re-resection, and was considered disease-free at 6 weeks postsurgery. A third patient with dedifferentiated liposarcoma was alive with unknown disease status at 17 months following surgery, and another patient with dedifferentiated liposarcoma was alive without evidence of disease at 30 months following surgery. No follow-up information on the remaining patients is available. Overall, liposarcomas of the intestinal tract are most frequently high-grade dedifferentiated tumors that are biologically aggressive and require surgical excision with widely negative margins to help reduce the risk of local recurrence and dissemination. Important in the differential diagnosis is malignant gastrointestinal stromal tumor. Care must be taken not to misdiagnose one entity for the other because the correct diagnosis carries important therapeutic implications.
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Affiliation(s)
- David C Gajzer
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL
| | - Christopher D Fletcher
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Germany
| | - Iva Brcic
- Institute of Pathology, Medical University of Graz, Austria
| | - Mahsa Khanlari
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL
| | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL.
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23
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Bamdad S, Bamdad M, Khanlari M, Daneshbod Y, Khademi B. Teratogenic Effects of Intravitreal Injection of Bevacizumab in a Pregnant Rat Model. Iran J Pharm Res 2017; 16:670-676. [PMID: 28979321 PMCID: PMC5603876] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this research study, to investigate teratogenic effect of intravitreal injection of bevacizumab in pregnant rat model, twenty seven female Wistar rats were inseminated. Pregnant rats were divided into 6 groups (three groups as case and three as control groups). Each case and control groups were divided according to the day of intravitreal injections (day 2, 10 and 18). Rats in the case groups received 4 µL intravitreal injection of bevacizumab and the control groups received the same volume of distilled water. The tail and umbilical cord length in case groups 1, 2, and 3 did not display any significant differences compared to their control groups. The fetal weight was significantly lower in the case groups 1 (p>0.001) and 2 (p>0.001) compared to their control groups. Furthermore, the placental weight was only lower in the case group 1 (p>0.001). Case group 2 had a shorter crown rump length in comparison with its control group (p=0.029). Morphological investigations showed two abnormal cases of gastroschisis in group 1 and a case of a cleft in the skull in one of the rats in case group 2. The results show that intravitreal bevacizumab has developmental effect when administered in the early stages of pregnancy; but it is safe when administered in the last week of pregnancy in rats.
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Affiliation(s)
- Shahram Bamdad
- Department of ophthalmology, Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
| | - Mina Bamdad
- Department of Developmental Biology, Islamic Azad University, Shiraz, Iran.
| | - Mahsa Khanlari
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Lab, Shiraz, Iran.
| | - Yahya Daneshbod
- Shiraz Molecular Pathology Research Center, Dr Daneshbod Lab, Shiraz, Iran.
| | - Behzad Khademi
- Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.,Corresponding author: E-mail:
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24
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Khanlari M, Bahreini M, Mirfazaelian H, Rasekhi A, Daneshbod Y. A bulging in the back. Assoc Med J 2015. [DOI: 10.1136/bmj.h6273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Khanlari M, Daneshbod Y, Shaterzadeh Yazdi H, Shirian S, Negahban S, Aledavood A, Oryan A, Khademi B, Daneshbod K, Field A. Labelling errors in fine needle aspiration cytology. Cytopathology 2015; 27:297-9. [PMID: 26307937 DOI: 10.1111/cyt.12264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Khanlari
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Y Daneshbod
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - H Shaterzadeh Yazdi
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - S Shirian
- Department of Pathology, School of Veterinary Medicine, Shahrekord University, Shahrekord, Iran.,Shefa Neuroscience Research Centre, Khatam Alanbia Hospital, Tehran, Iran
| | - S Negahban
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - A Aledavood
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - A Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - B Khademi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - K Daneshbod
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - A Field
- Hospital and University of Notre Dame Medical School, Sydney, N.S.W, Australia
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26
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Khanlari M, Daneshbod Y, Shaterzadeh Yazdi H, Shirian S, Negahban S, Aledavood A, Oryan A, Khademi B, Daneshbod K, Field A. Discrepancy of target sites between clinician and cytopathological reports in head neck fine needle aspiration: Did I miss the target or did the clinician mistake the organ site? Cancer Med 2015; 4:1374-80. [PMID: 26108921 PMCID: PMC4567022 DOI: 10.1002/cam4.489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/30/2015] [Accepted: 05/28/2015] [Indexed: 12/17/2022] Open
Abstract
The diagnostic accuracy of fine needle aspiration cytology (FNAC) of head and neck lesions is relatively high, but cytologic interpretation might be confusing if the sample is lacking typical cytologic features according to labeled site by physician. These errors may have an impact on pathology search engines, healthcare costs or even adverse outcomes. The cytology archive database of multiple institutions in southern Iran and Australia covering the period 2001–2011, were searched using keywords: salivary gland, head, neck, FNAC, and cytology. All the extracted reports were reviewed. The reports which showed discordance between the clinician's impression of the organ involved and subsequent fine needle biopsy request, and the eventual cytological diagnosis were selected. The cytological diagnosis was confirmed by histology or cell block, with assistance from imaging, clinical outcome, physical examination, molecular studies, or microbiological culture. The total number of 10,200 head and neck superficial FNAC were included in the study, from which 48 cases showed discordance between the clinicians request and the actual site of pathology. Apart from the histopathology, the imaging, clinical history, physical examination, immunohistochemical study, microbiologic culture and molecular testing helped to finalize the target organ of pathology in 23, 6, 7, 8, 2, and 1 cases respectively. The commonest discrepancies were for FNAC of “salivary gland” [total: 20 with actual final pathology in: bone (7), soft tissue (5), lymph node (3), odontogenic (3) and skin (2)], “lymph node” [total: 12 with final pathology in: soft tissue (3), skin (3), bone (1) and brain (1)], “soft tissue” [total: 11 with final pathology in: bone (5), skin (2), salivary gland (1), and ocular region (1)] and “skin” [total: 5 with final pathology in: lymph node (2), bone (1), soft tissue (1) and salivary gland (1)]. The primary physician requesting FNAC of head and neck lesions are incorrect in their clinical impression of the actual site in nearly 0.5 percent of cases, due to the overlapping clinical and imaging findings or possibly due to inadequate history taking or physical examination.
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Affiliation(s)
- Mahsa Khanlari
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Yahya Daneshbod
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | | | - Sadegh Shirian
- Department of Pathology, Shahrekord University, School of Veterinary Medicine, Shahrekord, Iran.,Shefa Neuroscience Research Center, Khatam-Al-Anbia Hospital, Tehran, Iran.,Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Negahban
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Azita Aledavood
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Bijan Khademi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khosrow Daneshbod
- Department of Cytopathology, Dr. Daneshbod Pathology Laboratory, Shiraz, Iran
| | - Andrew Field
- Hospital and University of Notre Dame Medical School Sydney, Fremantle, Australia
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27
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Daneshbod Y, Khanlari M, Mirfazaelian H, Akrami M, Sasani MR, Mosalaee A. Man of the dark. Assoc Med J 2015. [DOI: 10.1136/bmj.h2703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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28
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Khanlari M, Bagheri B, Vojdani R, Mohammadianpanah M, Paydar S, Daneshbod Y. Conjunctival mass as an initial presentation of mantle cell lymphoma: a case report. BMC Res Notes 2012; 5:671. [PMID: 23210924 PMCID: PMC3549763 DOI: 10.1186/1756-0500-5-671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 10/15/2012] [Indexed: 01/16/2023] Open
Abstract
Background To describe a rare manifestation of mantle cell lymphoma (MCL) in conjunctiva, with clinical, hisologic, immunohistologic and genetic findings together with review of the Literature. Case presentation Most ocular adnexal lymphomas are extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT). A few cases of ocular adnexal mantle cell lymphomas have been reported in the literature. We present a case of mantle cell lymphoma presenting as right conjunctival mass of at least three months duration in a 64-year-old man. Histopathologic examination showed a proliferation of monomorphous small-to-medium-sized lymphoid cells with cleaved nuclei in the subconjunctiva. By immunohistochemistry, the infiltrate was positive for CD20, CD5, BCL-2, cyclin D1, and the transcription factor SOX11. Fluorescent in situ hybridization demonstrated the presence of IGH-CCND1 fusion indicating t(11;14). Conclusion A rigorous approach to initial diagnosis and staging of small cell lymphomas of the ocular adnexa is needed. The recognition of ocular MCL requires appropriate immunohistochemical staining and/or genetic confirmation to differentiate this rare form of presentation of MCL from other more frequent small cell lymphomas.
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Affiliation(s)
- Mahsa Khanlari
- Institute of Hematopathology, Dr Daneshbod Pathology Laboratory, Shiraz, Iran
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29
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Daneshbod Y, Talei A, Negahban S, Soleimanpour H, Aledavoud A, Bagheri N, Khanlari M, Daneshbod K. Problem of foreign body in GI tract. ScientificWorldJournal 2011; 11:2147-9. [PMID: 22125463 PMCID: PMC3217610 DOI: 10.1100/2011/761796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 09/13/2011] [Indexed: 12/04/2022] Open
Abstract
Most foreign bodies pass through the gastrointestinal tract uneventful. We report of a case of inadvertently ingested foreign body, which by endoscopy simulated a polyp and on biopsy reported as cancer, so the patient underwent an unnecessary major operation. This report emphasizes the importance of resemblance of foreign bodies with gastrointestinal neoplasm, and endoscopists, surgeons and pathologists should consider this entity in their daily practice.
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Affiliation(s)
- Yahya Daneshbod
- Department of Surgical Pathology, Dr Daneshled, Pathology Laboratory, Shiraz 71437, Iran.
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31
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Safaei A, Khanlari M, Momtahen M, Monabati A, Robati M, Amooei S, Valibeigi B, Azarpira N. Prevalence of high-risk human papillomavirus types 16 and 18 in healthy women with cytologically negative pap smear in Iran. INDIAN J PATHOL MICR 2011; 53:681-5. [PMID: 21045392 DOI: 10.4103/0377-4929.72030] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Because human papillomavirus (HPV) is one of the causal factors in cervical cancer, understanding the epidemiology of this infection is an important step towards developing strategies for prevention. MATERIALS AND METHODS We evaluated the prevalence of high-risk human papillomavirus Types 16 and 18 in cervical samples from 402 healthy women with normal Pap smears by testing with type-specific primers in the polymerase chain reaction. Participants were seen at two gynecological clinics affiliated to the Shiraz University of Medical Sciences in Iran. RESULT The prevalence of positive HPV findings was 5.5%; high-risk HPV human papillomavirus Type 16 prevalence was 2% and no patient harbored HPV-18. The prevalence of HPV was 4.5% in younger age group and gradually increased to 20% in the 4 th decade. CONCLUSION The prevalence of high-risk HPV was highest in the youngest women and gradually decreased with age. Overall, the prevalence of HPV in our population is low.
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Affiliation(s)
- Akbar Safaei
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
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32
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Karimi M, Khanlari M, Rachmilewitz EA. Erratum: “Cerebrovascular accident in β-thalassemia major (β-TM) and β-thalassemia intermedia (β-TI)” by Karimi et al. Am J Hematol 83:77-79, 2008, DOI number 20938. Am J Hematol 2010. [DOI: 10.1002/ajh.21860] [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: 11/10/2022]
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33
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Karimi M, Khanlari M, Khanlari M, Rachmilewitz EA. Cerebrovascular accident in beta-thalassemia major (beta-TM) and beta-thalassemia intermedia (beta-TI). Am J Hematol 2008; 83:77-9. [PMID: 17696211 DOI: 10.1002/ajh.20938] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chronic hypercoagulable state expressed clinically by thromboembolic events has been described in thalassemia. One of the affected organs is the brain where symptomatic and asymptomatic damage has been reported. The present report describes seven cases who presented with the signs of cerebrovascular accident (CVA), five ischemic and two with hemorrhage. Two of them died. All patients were splenectomized, five received regular blood transfusions, and their ferritin levels were between 1,200 and 3,000 mg %. In addition, four patients had congestive heart failure and atrial fibrillation, and three had "Bronze diabetes," The recommendation on the basis of the results is that well-designed clinical trials are indicated to monitor asymptomatic brain damage by magnetic resonance imaging in splenectomized patients over the age of 20 years, who are not regularly transfused and have a high risk to develop thromboembolic events. In this subset of patients, anticoagulant and/or antiplatelet therapy should be considered. Moreover, treatment of additional complications resulting from iron overload, which may contribute to the etiology of CVA such as cardiac failure and arrhythmia with or without "bronze diabetes," is mandatory.
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Affiliation(s)
- Mehran Karimi
- Department of Pediatrics, Thrombosis and Hemostasis Unit, Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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