The recent decline in mortality from Hodgkin lymphomas in central and eastern Europe

BACKGROUND: Hodgkin lymphoma (HL) is a largely curable disease and its mortality had steadily declined in western Europe since the late 1960s. Only modest declines were, however, observed in central/eastern Europe. MATERIALS AND METHODS: We updated trends in mortality from HL in various European areas up to 2004 and analyzed patterns in incidence for selected European countries providing national data. RESULTS: In most western European countries, HL mortality continued to steadily decline up to the mid 2000s. More recent reductions were also observed in eastern European countries. Overall, mortality from HL declined from 1.17/100,000 (age-standardized, world population) in 1980-1989 to 1.42/100,000 in 2000-2004 in men from the 15 member states of the European Union (EU) from western and northern Europe. In the EU 10 accession countries of central and eastern Europe, male mortality from HL was 1.42/100,000 in 1980-1984, 1.32 in 1990-1994, and declined to 0.76 in 2000-2004. Similar trends were observed in women. No consistent patterns were found for HL incidence. CONCLUSIONS: The present work confirms the persistent declines in HL mortality in western European countries, and shows favorable patterns over more recent calendar years in central/eastern ones, where rates, however, are still at levels observed in western Europe in the early 1990s.

Breast implant-associated anaplastic large cell lymphoma: two distinct clinicopathological variants with different outcomes.

BACKGROUND: ALK-negative anaplastic large cell lymphoma associated with breast implant (i-ALCL) has been recently recognized as a distinct entity. Among 43 830 lymphomas registered in the French Lymphopath network since 2010, 300 breast lymphomas comprising 25 peripheral T-cell lymphomas (PTCL) were reviewed. Among PTCL, ALK-negative ALCL was the most frequent and all of them were associated with breast implants. PATIENTS AND METHODS: Since 2010, all i-ALCL cases were collected from different institutions through Lymphopath. Immuno-morphologic features, molecular data and clinical outcome of 19 i-ALCLs have been retrospectively analyzed. RESULTS: The median age of the patients was 61 years and the median length between breast implant and i-ALCL was 9 years. Most implants were silicone-filled and textured. Implant removal was performed in 17 out of 19 patients with additional treatment based on mostly CHOP or CHOP-like chemotherapy regimens (n = 10/19) or irradiation (n = 1/19). CHOP alone or ABVD following radiation without implant removal have been given in two patients. The two clinical presentations, i.e. effusion and less frequently tumor mass correlated with distinct histopathologic features: in situ i-ALCL (anaplastic cell proliferation confined to the fibrous capsule) and infiltrative i-ALCL (pleomorphic cells massively infiltrating adjacent tissue with eosinophils and sometimes Reed-Sternberg-like cells mimicking Hodgkin lymphoma). Malignant cells were CD30-positive, showed a variable staining for EMA and were ALK negative. Most cases had a cytotoxic T-cell immunophenotype with variable T-cell antigen loss and pSTAT3 nuclear expression. T-cell receptor genes were clonally rearranged in 13 out of 13 tested cases. After 18 months of median follow-up, the 2-year overall survival for in situ and infiltrative i-ALCL was 100% and 52.5%, respectively. CONCLUSIONS: In situ i-ALCLs have an indolent clinical course and generally remain free of disease after implant removal. However, infiltrative i-ALCLs could have a more aggressive clinical course that might require additional therapy to implant removal.

Linfoma não-Hodgkin de cordão espermático

Non-Hodgkin´s lymphoma of the spermatic cord are rare. There is the registration of 14 (fourteen) cases of spermatic cord lymphoma in the literature, all treated with radical orchiectomy with or without radiotherapy. The adjuvant chemotherapy still is not a consensus, therefore the therapy must be individualized and applied according to the stage of the disease. The present study report a new case of primary non-Hodgkin´s lymphoma of the spermatic cord treated with radical orchiectomy through inguinal via with precocious ligature of the spermatic cord and adjuvant chemotherapy. Presently found with 2 and a half years of follow-up without recidivation clinical evidence, as the image exams show to be normal.

Linfoma não-Hodgkin de órbita: relato de caso

O objetivo é relatar manifestação incomum de linfoma não-Hodgkin de órbita. Paciente masculino, de 75 anos, se apresentou com queixa de lacrimejamento crônico bilateral. Havia feito dacriocistorrinostomia endonasal à direita e à esquerda por duas vezes, sem sucesso. Ao exame, massas de consistência fibroelástica, em topografia das bolsas de gordura das pálpebras inferiores e proptose axial. O paciente negava outros sintomas ou sinais sistêmicos. Hemograma sem alteração, hormônios tireoidianos normais. A tomografia computadorizada mostrava infiltrado difuso na órbita e proptose axial. Biópsia de gordura orbitária e de medula óssea diagnosticaram linfoma não-Hodgkin. O paciente foi tratado com quimioterapia, sendo em seguida submetido à cirurgia da via lacrimal bilateral, com resolução do quadro. A doença sistêmica que exigia diagnóstico e tratamento adequados para que se tivesse bom prognóstico estava mascarada pelo quadro de epífora bilateral.

Epstein-Barr Virus (EBV) detection and typing by PCR: a contribution to diagnostic screening of EBV-positive Burkitt's lymphoma

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Proliferating cell nuclear antigen (PCNA) in non-Hodgkin's lymphomas: Correlation with working formulation and Kiel classification in formalin-fixed paraffin-embedded material

PCNA is a 36-KD proliferating cell nuclear antigen associated with the cell cycle. The immunocytochemical detection of PCNA represents a useful tool for the study of tumor proliferation activity. This study documents the detection of PCNA, using antibody PC 10 in formalin-fixed, paraffin-embedded tissue, and correlates the proliferative activity of the non-Hodgkin's lymphomas (NHL) with histological grading assessed by the International Working Formulation (WF) and Kiel classification. In 92 cases of NHLs we found a strong correlation between the PCNA index and lymphoma grading. Statistically significant differences were also found between the proliferative index (PI) in low and high grade lymphomas according to the Kiel classification (t = 9.519; p < 0.001) and between low, intermediate and high grade lymphomas according to the WF classification (F = 79.01; p < 0.001). In the Kiel classification the mean of low grade lymphomas was 39.5% and of high grade 75.7%. In the WF the average of low grade lymphomas was 29.7%, intermediate 53.1% and high 75.1%. Although the differences among the groups had been significant, we found variations inside each histological subgroup in both classifications. The intermediate lymphomas were the most heterogeneous group, with PI inside the same histologic subtypes coincident with low and high grade lymphomas. Since PCNA may be used as a marker of cell proliferation in clinical studies to estimate the biological aggressiveness of lymphomas, its determination in intermediate grade NHL could be very useful to evaluate individual cases in this group and determine prognosis and probably the appropriate therapy.

Emperipolesis in a Case of B-Cell Lymphoma: A Rare Phenomenon Outside of Rosai-Dorfman Disease

We describe a case of a diffuse large B-cell lymphoma with extensive emperipolesis phenomenon. Light microscopy revealed numerous CD68-positive/S-100-negative histiocytes containing viable neoplastic hematopoietic cells in their cytoplasm. Electron microscopy confirmed these findings. In this case, there was no evidence of Rosai-Dorfman disease either clinically or histologically. This report emphasizes that emperipolesis is not restricted to Rosai-Dorfman disease and can be found in other conditions including non-Hodgkin lymphomas. © 2003 Elsevier Inc. All rights reserved.

Avaliação do nível sérico de IL-6 e IL-13 antes e após o tratamento do linfoma de Hodgkin clássico

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avalição de polimorfismos de nucleotídeos simples (SNPs) na região promotora de gene da interleucina 10 em pacientes com Linfoma de Hodgkin

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detecção do genoma do vírus de Epstein Barr (EBV) em tecidos de pacientes com doença de Hodgkin da região Norte do Brasil

O vírus de Epstein Barr (EBV) é o agente causador da mononucleose infecciosa e está associado com várias desordens proliferativas malignas tais como: linfoma de Burkitt, linfoma de Hodgkin e linfomas não Hodgkin. Um total de 118 casos de linfomas diagnosticados no Hospital Ofir Loyola no período de 1996 e 2005 foram analisados no Instituto Evandro Chagas, Ananindeua, Brasil; com o objetivo de detectar o genoma do EBV mediante a identificação dos genes EBER 1 e EBNA1 em casos de doença de Hodgkin. Os espécimes parafinizados foram analisados por hibridização in situ (gene EBER 1) e PCR em tempo real (EBNA 1). Do total, 61% (72/118) dos pacientes eram do sexo masculino e 39% (46/118) do sexo feminino com faixa etária variando entre 3- 98 anos. Sessenta e cinco (55%) foram diagnosticados como doença de Hodgkin e cinqüenta e três (45%) como linfomas não-Hodgkin. O EBV foi identificado nas células Reed Sternberg e variantes em 76,9% (50/65) dos casos de linfoma de Hodgkin com idade média de 28,3 anos (variação, 2-84 anos). Os subtipos histológicos de casos EBV-positivos foram o seguinte: esclerose nodular em 50% (25/50), celularidade mista em 28% (14/50), depleção linfocitária em 14% (7/50) e predominância linfocitária em 8% (4/50). O DNA do EBV foi detectado em 53% (26/49) com um coeficiente de regressão para a curva padrão de 0,99. Este estudo foi a primeira descrição do vírus de Epstein Barr em casos de doença de Hodgkin na região Norte do Brasil; reforçando a hipótese de que o EBV seja um co-fator no processo de transformação neoplásica em conjunto com a predisposição genética e imunidade do paciente, justificando a condução de estudos posteriores a nível molecular.

Classificação morfológica e imunostoquímica em microarranjo de tecido (TMA) de linfomas não-Hodgkin em cães conforme os critérios da Histological Classification od Hematopoietic Tumors of Domestic Animals (WHO)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Flow sorting and exome sequencing reveal the oncogenome of primary Hodgkin and Reed-Sternberg cells

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Paracoccidioidomycosis in patients with Lymphoma and review of published literature

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Applying enhancement filters in the pre-processing of images of lymphoma

Lymphoma is a type of cancer that affects the immune system, and is classified as Hodgkin or non-Hodgkin. It is one of the ten types of cancer that are the most common on earth. Among all malignant neoplasms diagnosed in the world, lymphoma ranges from three to four percent of them. Our work presents a study of some filters devoted to enhancing images of lymphoma at the pre-processing step. Here the enhancement is useful for removing noise from the digital images. We have analysed the noise caused by different sources like room vibration, scraps and defocusing, and in the following classes of lymphoma: follicular, mantle cell and B-cell chronic lymphocytic leukemia. The filters Gaussian, Median and Mean-Shift were applied to different colour models (RGB, Lab and HSV). Afterwards, we performed a quantitative analysis of the images by means of the Structural Similarity Index. This was done in order to evaluate the similarity between the images. In all cases we have obtained a certainty of at least 75%, which rises to 99% if one considers only HSV. Namely, we have concluded that HSV is an important choice of colour model at pre-processing histological images of lymphoma, because in this case the resulting image will get the best enhancement.