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Carolyn Faught - One of the best experts on this subject based on the ideXlab platform.
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reed Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis hodgkin lymphoma
European Journal of Haematology, 2014Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
Zhaodong Xu - One of the best experts on this subject based on the ideXlab platform.
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reed Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis hodgkin lymphoma
European Journal of Haematology, 2014Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
Fabienne Meggetto - One of the best experts on this subject based on the ideXlab platform.
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Comparative analysis of oncogenic properties and nuclear factor-kappaB activity of latent membrane protein 1 natural variants from Hodgkin's lymphoma's Reed-Sternberg cells and normal B-lymphocytes.
Haematologica, 2009Co-Authors: Nathalie Faumont, Aurélie Chanut, Alan Benard, Nadine Cogné, Georges Delsol, Jean Feuillard, Fabienne MeggettoAbstract:BACKGROUND: In Epstein-Barr virus-associated Hodgkin's lymphomas, neoplastic Reed-Sternberg cells and surrounding non-tumor B-cells contain different variants of the LMP1-BNLF1 oncogene. In this study, we raised the question of functional properties of latent membrane protein 1 (LMP1) natural variants from both Reed-Sternberg and non-tumor B-cells. DESIGN AND METHODS: Twelve LMP1 natural variants from Reed-Sternberg cells, non-tumor B-cells of Hodgkin's lymphomas and from B-cells of benign reactive lymph nodes were cloned, sequenced and stably transfected in murine recombinant interleukin-3-dependent Ba/F3 cells to search for relationships between LMP1 cellular origin and oncogenic properties as well as nuclear factor-kappaB activation, and apoptosis protection. RESULTS: LMP1 variants of Reed-Sternberg cell origin were often associated with increased mutation rate and with recurrent genetic events, such as del15bp associated with S to N replacement at codon 309, and four substitutions I85L, F106Y, I122L, and M129I. Oncogenic potential (growth factor-independence plus clonogenicity) was consistently associated with LMP1 variants from Reed-Sternberg cells, but inconstantly for LMP1-variants from non-tumor B-cells. Analysis of LMP1 variants from both normal B-cells and Reed-Sternberg cells indicates that protection against apoptosis through activation of nuclear factor-kappaB - whatever the cellular origin of LMP1 - was maintained intact, regardless of the mutational pattern. CONCLUSIONS: Taken together, our results demonstrate that preserved nuclear factor-kappaB activity and protection against apoptosis would be the minimal prerequisites for all LMP1 natural variants from both normal and tumor cells in Hodgkin's lymphomas, and that oncogenic potential would constitute an additional feature for LMP1 natural variants in Reed-Sternberg cells.
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Comparative analysis of oncogenic properties and nuclear factor-κB activity of latent membrane protein 1 natural variants from Hodgkin’s lymphoma’s Reed-Sternberg cells and normal B-lymphocytes
Haematologica, 2009Co-Authors: Nathalie Faumont, Aurélie Chanut, Alan Benard, Nadine Cogné, Georges Delsol, Jean Feuillard, Fabienne MeggettoAbstract:Background In Epstein-Barr virus-associated Hodgkin’s lymphomas, neoplastic Reed-Sternberg cells and surrounding non-tumor B-cells contain different variants of the LMP1-BNLF1 oncogene. In this study, we raised the question of functional properties of latent membrane protein 1 (LMP1) natural variants from both Reed-Sternberg and non-tumor B-cells. Design and Methods Twelve LMP1 natural variants from Reed-Sternberg cells, non-tumor B-cells of Hodgkin’s lymphomas and from B-cells of benign reactive lymph nodes were cloned, sequenced and stably transfected in murine recombinant interleukin-3-dependent Ba/F3 cells to search for relationships between LMP1 cellular origin and oncogenic properties as well as nuclear factor-κB activation, and apoptosis protection. Results LMP1 variants of Reed-Sternberg cell origin were often associated with increased mutation rate and with recurrent genetic events, such as del15bp associated with S to N replacement at codon 309, and four substitutions I85L, F106Y, I122L, and M129I. Oncogenic potential (growth factor-independence plus clonogenicity) was consistently associated with LMP1 variants from Reed-Sternberg cells, but inconstantly for LMP1-variants from non-tumor B-cells. Analysis of LMP1 variants from both normal B-cells and Reed-Sternberg cells indicates that protection against apoptosis through activation of nuclear factor-κB - whatever the cellular origin of LMP1 - was maintained intact, regardless of the mutational pattern. Conclusions Taken together, our results demonstrate that preserved nuclear factor-κB activity and protection against apoptosis would be the minimal prerequisites for all LMP1 natural variants from both normal and tumor cells in Hodgkin’s lymphomas, and that oncogenic potential would constitute an additional feature for LMP1 natural variants in Reed-Sternberg cells.
Harald Stein - One of the best experts on this subject based on the ideXlab platform.
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Hodgkin/Reed-Sternberg Cells Induce Fibroblasts to Secrete Eotaxin, a Potent Chemoattractant for T Cells and Eosinophils
Blood, 1999Co-Authors: Franziska Jundt, Harald Stein, Ioannis Anagnostopoulos, Kurt Bommert, Florian Emmerich, Gerd Müller, Hans-dieter Foss, Hans-dieter Royer, Bernd DörkenAbstract:Hodgkin’s disease is histopathologically characterized by the relative scarcity of neoplastic Hodgkin and Reed-Sternberg cells and for yet unknown reasons by an abundant reactive background of T lymphocytes and often eosinophils. Eotaxin is a CC-chemokine attracting eosinophils and T helper 2 (Th2) cells in allergic inflammation. We now report that eotaxin is strongly expressed in fibroblasts of Hodgkin’s disease tissues, whereas Hodgkin/Reed-Sternberg cells do not express this chemokine. In tissue culture, Hodgkin’s disease tumor cells induce eotaxin expression in cocultured dermal fibroblasts in a concentration leading to a specific chemotactic response of a Th2 cell clone. Production of tumor necrosis factor- (TNF-) by Hodgkin/Reed-Sternberg cells appears to be responsible for this induction, because blocking of TNF- by neutralizing antibodies prevented fibroblast eotaxin expression. Our data suggest that eotaxin is involved in the pathobiology of Hodgkin’s disease by contributing to eosinophil and T-lymphocyte recruitment.
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Clonality of Reed-Sternberg cells in Hodgkin's disease.
New England Journal of Medicine, 1999Co-Authors: Michael Hummel, Theresa Marafioti, Harald SteinAbstract:To the Editor: In 1995 we reported in the Journal the results of a molecular analysis of single Reed–Sternberg cells in biopsy specimens from patients with Hodgkin's disease.1 Amplified immunoglobulin heavy-chain gene sequences bore the hallmarks of B cells, and in 6 of the 12 cases we studied, there was evidence of the presence of monoclonal Reed–Sternberg cells — that is, identical immunoglobulin-gene rearrangements in several different Reed–Sternberg cells. Unexpectedly, we also found polyclonal Reed–Sternberg cells (i.e., cells with unrelated immunoglobulin-gene rearrangements). Other groups have also found polyclonal Reed–Sternberg cells,2 but some investigators indicated that the cells in individual cases . . .
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Hodgkin's Disease with Monoclonal and Polyclonal Populations of Reed–Sternberg Cells
New England Journal of Medicine, 1995Co-Authors: Michael Hummel, Katharina Ziemann, Hetty Lammert, Stefano Pileri, Elena Sabattini, Harald SteinAbstract:Background There is strong evidence that Reed–Sternberg cells have a lymphoid phenotype, but clonally rearranged genes for B-cell and T-cell antigen receptors have not been demonstrable in tumor tissue from most patients with Hodgkin's disease. To elucidate this issue, we assayed single Reed–Sternberg cells from 12 patients with classic Hodgkin's disease of a B-cell immunophenotype to detect rearranged immunoglobulin variable-region heavy-chain (Vh) genes. Methods We isolated single Reed–Sternberg cells from frozen sections that had been immunostained for CD30. The rearranged Vh genes of these cells were amplified by the polymerase chain reaction and analyzed by gel electrophoresis and nucleotide sequencing. Results In all 12 patients, the Reed–Sternberg cells studied contained rearranged Vh genes. Three patterns were observed: in three patients the rearrangements in each patient were identical, in six patients all the rearrangements were unrelated and unique, and in three patients both identical and unre...
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hodgkin s disease with monoclonal and polyclonal populations of reed Sternberg cells
The New England Journal of Medicine, 1995Co-Authors: Michael Hummel, Katharina Ziemann, Hetty Lammert, Stefano Pileri, Elena Sabattini, Harald SteinAbstract:Background There is strong evidence that Reed–Sternberg cells have a lymphoid phenotype, but clonally rearranged genes for B-cell and T-cell antigen receptors have not been demonstrable in tumor tissue from most patients with Hodgkin's disease. To elucidate this issue, we assayed single Reed–Sternberg cells from 12 patients with classic Hodgkin's disease of a B-cell immunophenotype to detect rearranged immunoglobulin variable-region heavy-chain (Vh) genes. Methods We isolated single Reed–Sternberg cells from frozen sections that had been immunostained for CD30. The rearranged Vh genes of these cells were amplified by the polymerase chain reaction and analyzed by gel electrophoresis and nucleotide sequencing. Results In all 12 patients, the Reed–Sternberg cells studied contained rearranged Vh genes. Three patterns were observed: in three patients the rearrangements in each patient were identical, in six patients all the rearrangements were unrelated and unique, and in three patients both identical and unre...
Bruce F. Burns - One of the best experts on this subject based on the ideXlab platform.
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reed Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis hodgkin lymphoma
European Journal of Haematology, 2014Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
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Reed–Sternberg cells detected in the bone marrow aspirate in a young patient with nodular sclerosis Hodgkin lymphoma
European Journal of Haematology, 2013Co-Authors: Zhaodong Xu, Bruce F. Burns, Carolyn FaughtAbstract:A 19-yr-old Caucasian male presented with left neck lymphadenopathy and flu-like symptoms. A computer tomography (CT) scan of the neck demonstrated extensive left-sided cervical lymphadenopathy suggestive of lymphoproliferative disorder (Fig. 1A). An excisional biopsy was performed, and nodular sclerosis classical Hodgkin lymphoma was diagnosed based on histology features and positive staining of CD30, CD15, Pax5 and EBV. Laboratory investigations showed a pancytopenia with hemoglobin concentration 96 g/L, thrombocytopenia with platelet 92 9 10/L and neutropenia with a neutrophil count of 1.4 9 10/L. Due to the pancytopenia, bone marrow involvement was suspected, and a bone marrow staging was performed. Microscopic evaluation of bone marrow aspirate revealed trilineage hematopoiesis without dysplasia. In one location adjacent to a bone marrow particle, a giant binucleated Reed– Sternberg cell resembling an ‘OWL’s Eye’ appearance with prominent eosinophilic inclusion-like nucleoli (Fig. 1B) was observed. The Reed–Sternberg cell had a 3.5-fold diameter longer than an adjacent band with a bluish cytoplasmic hue and vacuolations. In the touch preparation film, another binucleated atypical Reed–Sternberg cell was found, suggesting a bone marrow involvement of the Hodgkin lymphoma. Bone marrow biopsy demonstrated normal marrow without fibrosis; further immunostaining with CD30, CD15, Pax5 and EBER was equivocal due to the small suboptimal size of the biopsy samplings. A repeat bone marrow biopsy request was declined by the patient. Based on the pancytopenia and patient’s conditions, a clinical diagnosis of stage 4 Hodgkin lymphoma was established. Patient received the standard chemotherapy for Hodgkin lymphoma, but was refractory to the treatment. An autologous bone marrow transplant was performed, but patient died of relapsed Hodgkin lymphoma 6 months post diagnosis. Reed–Sternberg cells are pathognomonic for classical Hodgkin lymphoma. They can be found in the tissue sampling of the bone marrow. Observation of Reed–Sternberg cells in the bone marrow aspirate is rare, possibly due to the fibrotic nature of the disease. But in certain age population especially children and young adult, Reed–Sternberg cells can be detected in the aspirate possible due to the less fibrotic young marrow. Thus, careful examination of bone marrow aspirate in young patients with known Hodgkin lymphoma can be useful in making the clinical decision as shown in this case. Financial support
