Primary pulmonary lymphoma.
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Lymphoproliferative Disorders
Malignant lymphoma
Broad spectrum
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Nasopharyngeal carcinoma (NPC) and malignant lymphoma are common malignant tumors which frequently involve nasopharynx and cervical lymph nodes. Sometimes, it is difficult to distinguish poorly-differentiated NPC, especially undifferentiated NPC, from malignant lymphoma. Paraffin sections of 221 cases of poorly differentiated or undifferentiated NPC and malignant lymphomas were analysed by immunohistochemical techniques (IGSS, ABC, double stain, etc.), The immunohistochemical criteria of differential diagnosis between NPC and malignant lymphomas were proposed and with these criteria, 40 cases which were difficult to distinguish between NPC and malignant lymphoma were identified. In comparison with the methods of SPA, PAP, ABC, IGSS, etc., and the probes of Ke, EMA, LCA, Vi, etc. on paraffin sections, IGSS or ABC method and probes of Ke and LCA were considered to be more sensitive.
Malignant lymphoma
Cervical lymph nodes
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Lymphoproliferative Disorders
Malignant lymphoma
Broad spectrum
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Three cases of lung carcinomas with unusual histologic appearances that have received little or no comment in the literature are presented. They were initially confused with malignant lymphoma because of a diffuse proliferation of relatively monotonous cells simulating large‐cell immunoblastic lymphoma. In each case, the possibility of malignant lymphoma was excluded with confidence after the immuno‐histochemical study (leucocyte common antigen negative and cytokeratins positive), although with conventional microscopy several foci of cohesive groups of tumor cells were observed. The tumors were ranked at the clinical stage II or III when they were initially discovered, but all patients died of disease within 1 year. The present three tumors show an aggressive behavior and could be classified into a peculiar variant of ‘large cell’ carcinoma. It is necessary for surgical pathologists to have an idea of these variants of lung carcinoma in order to avoid erroneous diagnosis.
Large cell
Malignant lymphoma
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Immunodysregulation appears to play a prominent role in the evolution of some lymphomas, as evidenced by the strong associations between congenital and acquired immunodeficiencies and lymphoid neoplasia, and abnormal ratios of helper T cells in lymphoid proliferations. Lympho-proliferative diseases of the ocular adnexa encompass a spectrum of lesions that may present with similar clinical and radiological features. Most primary lymphoid proliferations of the ocular adnexa consist of small lymphocytes of B-cell origin. Employing morphological, immunohistochemical, and molecular genetic criteria, proliferations may be separated into polyclonal and monoclonal categories. Increased insight into the biology and behavior of these tumors tells us that seemingly benign, as well as frankly malignant proliferations, might disseminate to nodal or extranodal sites. The diagnosis of lymphoproliferative disease of any type necessitates a complete workup for systemic lymphoma. Major prognostic criteria for lymphomas are anatomical site, stage, and histological features. Radiotherapy is employed for localized lymphoid proliferations, with chemotherapy recommended for disseminated disease. Long-term follow-up with semiannual examination is recommended. A significant percentage of primary ocular adnexal lymphoid lesions are MALT-type lymphomas, extranodal low-grade B-cell lymphomas usually associated with mucosal tissues or glandular epithelia. The pathogenesis of this lymphoma in orbital soft tissue, which normally is devoid of lymphoid tissue, lymphatic vessels, and epithelium, is unclear. MALT-type lymphomas of the ocular adnexa follow an indolent course, with long periods between relapses, and are responsive to therapy. Dissemination, when it occurs, preferentially affects other extranodal sites.
Lymphoproliferative Disorders
Mucosa-associated lymphoid tissue
Pseudolymphoma
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The authors report on the cases of five patients who suffered from primary pulmonary lymphoproliferative disease. Of 4 pseudolymphoma cases 3 were free of symptoms and complaints. One patient was operated on 14 years earlier and suffered also from associated Sjögren's syndrome. In this case the monoclonal immune globulin containing cell groups found earlier in the lymph node referred to the possibility of chronic dysproteinemia and to the transformation into malignant lymphoma of the hepato-splenomegaly. The contralateral pulmonary recurrence following the lung resection of a patient with malignant lymphoma was successfully treated with telecobalt irradiation. In connection with the literature and their cases the authors discuss the problems of differential diagnostics, therapy and prognosis as well.
Pseudolymphoma
Lymphoproliferative Disorders
Malignant lymphoma
Lymphoid hyperplasia
Large cell
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The cytological, histological and immunophenotypical markers of lymphoproliferative diseases are evaluated in the collection of 950 trepanobiopsies, and correlated with types of extramedullary malignant lymphoma. The diagnostic significance of tumor infiltrates topography and basic rules of the differential diagnoses of malignant lymphomas in the bone marrow biopsies are discussed.
Lymphoproliferative Disorders
Malignant lymphoma
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Objective:To investigate the clinicopathological feature and the diagnosis,differential diagnosis of pulmonary lymphoma of mucosa-associated lymphoid tissue.Methods: Four cases of pulmonary lymphoma of mucosa-associated lymphoid tissue were studied by clinical data histopathology and immunohistochemistry analysis.Results: Grossly,the tumors showed nodules.On microscopic examination,marginal zone B-cell proliferated,and infiltrated alveolar and alveolar walls could be seen,which looked like string.Immunohistochemically,the tumor cells were positive for CD20,CD79a,BCL-10,Igλ,and negative for CD3,CD45RO,CD5,CD23,CyclinD1,CD10,BCL-2.Conclusion: Pulmonary lymphoma of mucosa-associated lymphoid is a rare lung tumor,and its diagnosis mainly depends on histopathologic feature.immunohistochemistry is helpful for differential diagnosis.
CD5
Mucosa-associated lymphoid tissue
Histopathology
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Aims: This study was focused on unusual cases of mucosa‐associated lymphoid tissue (MALT) lymphoma presenting with multiple polypoid lesions of the colon and rectum with a special reference to the differential diagnosis of mantle cell lymphoma. Methods and results: The lesions of these five cases grossly showed a segmental distribution of nodular protrusions in three patients and of innumerable small polyps in two. These patterns of involvement simulated those of multiple lymphomatous polyposis, known as the gastrointestinal presentation of mantle cell lymphoma (MCL), and caused a differential diagnostic problem between MALT lymphoma and MCL, which have different prognostic and therapeutic implications. Their histological features are almost indistinguishable from each other, especially in the small biopsy specimens via endoscope. The most important procedure for their differentiation is cyclin D1 immunohistochemistry and its negative reaction provides strong indication of MALT lymphoma. Of interest, one case showed a rare karyotypic abnormality of t(11;18)(q21;q21), which has been reported specifically in MALT lymphoma. Conclusions: This study has indicated that the multiple polypoid lesions of the colon occur not only in MCL, but also in MALT lymphoma, making differential diagnosis between the two entities necessary, and cyclin D1 immunohistochemistry is indispensable for distinguishing between them.
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Low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the thymus is a very rare tumor with characteristic morphologic features. We describe a case of thymic low-grade B-cell MALT lymphoma occurring in a 59-yr-old woman with Sjögren's syndrome, in whom the definite diagnosis was difficult at the time of surgery. An immunohistologic and genotypic study, however, was diagnostic of lymphoma. A review of cytologic material was undertaken, and it was felt that the cytologic features in Giemsa-stained preparations in imprint smears were present that initially should have enabled the correct cytodiagnosis and distinction from the other thymic lesions. The findings presented in this study were considered to contribute to the cytodiagnosis of a thymic lesion, which might, in the past, have been erroneously interpreted as another lymphoproliferative disorder.
Mucosa-associated lymphoid tissue
Lymphoproliferative Disorders
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To explore the frequency, context and diagnostic impact of B- and T-lymphocyte clonality assay use in the assessment of possible lymphoproliferative disorders at a central haematopathology diagnostics hub.All cases reported by haematopathologists over a sixteen-month period were identified, n = 4462, and those which had clonality studies undertaken analysed further.Clonality studies were requested in 9% of cases, directly contributing to a diagnosis being made in 79%. They were most frequently used to help distinguish reactive lymphoid infiltrates from low-grade B-cell lymphomas and in cases of possible T-cell lymphoma, facilitating a diagnosis being made in over 90% of these. In contrast when clonality assays were requested as a diagnostic adjunct in cases with an atypical cutaneous lymphoid infiltrate, and in occasional cases of lymphoid proliferations with Hodgkin-like cells or EBV-driven proliferations, a definitive final diagnosis was possible in less than 60% of cases.Clonality studies were used in 9% of cases assessed for a possible lymphoproliferative disorder and had a differing impact depending on the differential diagnoses being considered. These findings can be used to guide access to clonality assays by highlighting the likelihood of an informative result in different diagnostic settings.
Lymphoproliferative Disorders
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