Differential Diagnostic Significance Research Articles

Differential Expression, Diagnostic and Prognostic Significance of Stathmin-1 and CD147 in Various Uterine Smooth Muscle Tumors

Differential Expression, Diagnostic and Prognostic Significance of Stathmin-1 and CD147 in Various Uterine Smooth Muscle Tumors

Differential diagnostic significance of epithelial and stromal CD10 expression in tumors of trichogenic origin.

The histological differential diagnosis between benign trichogenic skin tumors and basal cell carcinoma may be challenging. We therefore set out to investigate whether expression of CD10, a cell surface protein with neutral endopeptidase activity, might be a suitable marker for the histological differential diagnosis of trichogenic skin tumors. We immunohistochemically analyzed 119 cases of benign trichogenic skin tumors and basal cell carcinoma. These included 28 nodular and 15 sclerosing basal cell carcinomas, 21 Pinkus tumors, 20 trichoblastomas, nine trichofolliculomas, eleven trichoepitheliomas, five desmoplastic trichoepitheliomas, and ten seborrheic keratoses. The majority of nodular basal cell carcinomas expressed CD10 in tumor cells at the peripheral (22/28 [75%]). On the other hand, trichoblastomas revealed peripheral CD10 expression in only 10% (2/20) of cases, whereas 50% showed central expression (10/20). Peripheral epithelial expression of CD10 was also found in Pinkus tumors (9/21 [42.9%]) and trichoepithelioma (4/11 [36.4%]). Desmoplastic trichoepithelioma showed no tumoral CD10 expression at all (0/5 [0%]), while the majority of sclerosing basal cell carcinomas was positive for CD10 (13/15 [86.7%]). Our findings suggest that epithelial expression of CD10 -and not peritumoral stromal CD10 expression, as has been postulated -may well be of differential diagnostic significance. The pattern of distribution of CD10-positive neoplastic cells in particular can be useful in the diagnosis of trichogenic tumors.

Identity Disturbance, Feelings of Emptiness, and the Boundaries of the Schizophrenia Spectrum.

Historical and current research on borderline personality disorder reveal certain affinities with schizophrenia spectrum psychopathology. This is also the case for the borderline criteria of “identity disturbance” and “feelings of emptiness,” which reflect symptomatology frequently found in schizophrenia and schizotypal personality disorder. Unfortunately, the diagnostic manuals offer limited insight into the nature of these criteria, including possible deviations and similarities with schizophrenia spectrum symptomatology. In this article, we attempt to clarify the concepts of identity disturbance and feelings of emptiness with an emphasis on the criteria’s differential diagnostic significance. Drawing on contemporary philosophy, we distinguish between a “narrative” self and a “core” self, suggesting that this distinction may assist differential diagnostic efforts and contribute to mark the psychopathological boundaries of these disorders.

Telomerase reverse transcriptase (TERT) promoter mutations are rare in urachal cancer.

High rates of telomerase reverse transcriptase (TERT) promoter mutations have recently been described in urothelial carcinoma (UC). Unlike UC in the bladder, adenocarcinomas account for the majority of urachal cancer (UrC) cases. As data in UrC is unclear, we analyzed TERT promoter mutations in a large cohort of UrC for its differential diagnostic, clinicopathological and prognostic significance. UrC cases from six academic centers were analyzed for c.-146C>T (C250T) and c.-124C>T (C228T) TERT promoter mutations by PCR and Sanger sequencing. Clinicopathological and survival data were collected. The cohort consisted of 15 men (56%) and 12 women (44%) with a median age of 50 years including 23 adenocarcinomas, two squamous cell carcinomas (SCC), one UC and one undifferentiated carcinoma. In one case of (mucinous) urachal adenocarcinoma a C228T mutation was detected (1/23; 4%), like in a case of SCC in addition to one C250T mutation in the UC case. TERT promoter mutations are very rare in urachal adenocarcinomas (unlike in UC) with differential diagnostic implications. Additionally, the low TERT promoter mutation rate in urachal adenocarcinomas is more comparable to colorectal adenocarcinomas than to UC, giving further support to recent genetic findings and therapeutic considerations.

Etiologic and differential diagnostic significance of tumor location in the supraclavicular fossa.

Patients presenting with a cervical mass are common for head and neck specialists and present a diagnostic challenge against the backdrop of a wide variety of etiologies. The objective of the present study was to evaluate the significance of a mass in the supraclavicular fossa for etiology, diagnostic procedure, and therapy. Individual retrospective cohort study. We reviewed the data of 211 consecutive cases (116 male, 95 female) with excisional biopsy or tumor removal of a supraclavicular mass. In 202 of 211 cases, a biopsy was taken from a lymph node. In 182 biopsies, a malignant lymphadenopathy was found (117 metastases, 65 malignant lymphoma). The histologic findings of metastatic diseases were adenocarcinoma (48), followed by squamous cell carcinoma (22). The majority of primary carcinomas were located below the clavicle (94), in the lung (32), in the breast (29), and in the head and neck region (18). In the left supraclavicular fossa, only metastases of the genitourinary tract were significantly more frequent (16 of 17). In nonmalignant tumors (29), tuberculosis (11) was most prevalent. In 79% of biopsies, the neck mass was the first manifestation of the disease. The location of a cervical mass in the supraclavicular fossa provides a strong indication of malignancy. A biopsy is mandatory in the majority of patients presenting with a supraclavicular mass. In cases of metastatic disease, the location of a cervical mass helps identify the primary site. Histologic findings are essential for further diagnostic steps, therapy, and prognosis. 4. Laryngoscope, 128:646-650, 2018.

CYTOKINES IN THE DIAGNOSIS OF THE SEVERITY OF THE ACTIVE PHASE OF CHRONIC PYELONEPHRITIS

Introduction. cytokines may serve as markers of the inflammatory process during exacerbation (i.w. active phase) and further progression of chronic pyelonephritis. The estimation of cytokine constellation in this field is important problem of clinical nephrology. Purpose of the study. the aim of the study was to evaluate the severity of chronic pyelonephritis during its exacerbation by measurement of cytokines concentration in urinalysis. Materials and methods. In 64 patients with active phase of chronic pyelonephritis at the age of 25 to 65 years, the results of the study of the content of proinflammatory (iL-1β, iL-6, iL-8, TNFα, iFNγ) and anti-inflammatory (iL-2, iL-4, iL- 10) cytokines in urine taken from the ureter, bladder and blood plasma to determine the severity of exacerbation of chronic pyelonephritis. Results. The level of proinflammatory cytokine iL-8 in urine from the ureter of the affected kidney can serve as the main marker determining the severity of the active phase of chronic pyelonephritis. With a mild degree of exacerbation of the inflammatory process, the content of iL-8 in urine from the ureter is 4 times higher than normal values; at an average degree - in 8 times, and at a serious current of an exacerbation of a chronic pyelonephritis - in 54 times. Conclusions. Determination of proinflammatory cytokines in the diagnosis of the severity of pyelonephritis flow has a large diagnostic and differential diagnostic significance that will allow for differentiated therapy depending on the severity of the inflammatory process and improve the results of treatment.

Oral cavity changes in the course of infectious diseases, during childhood

Introduction: A number of infectious diseases, occurring in childhood take its clinical course with typical changes in the oral cavity. Those changes are pathognomonic sign of the disease or increase the clinical thinking about the concrete disease. Aim: In the present review we introduce the infectious diseases in childhood that cause different changes in the mouth. In accordance with it we set some tasks : to introduce pathophysiological mechanisms for mucosa damage and its role about diagnosis. Materials and methods: We based on literature data about that problem. It is discussed in four aspects: diseases with enanthem, changes in the tongue, stomatitis and pharyngitis. Examples and pictures are given. Conclusions: Our review presents that the throat inspection in the children with infectious diseases is important stage of clinical examination, should not be missed and the changes have to be recognized in details because of their great diagnostic and differential diagnostic significance.

Role of CyclinD1/IgH Detection by FISH in Differential Diagnostic Significance between Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

To investigate the feasibility of CyclinD1/IgH detection by FISH in diferential diagnosis between mantle cell lymphoma (MCL) and chronic lymphocytic leukeamia (CLL). The FISH detection was performed for CyclinD1/IgH fusion gene. A comprehensive analysis was carried out for clinical features, such as age, sex , WBC count and lymphocyte count, the bone marrow morphology and immunohistochemical staining were carried for CyclinD1/IgH. It is often difficult to distinguish MCL from CLL by bone marrow morphology, when the cell morphology was not typical; there was no difference in age, sex, WBC count and lymphocyte count between MCL and CLL groups; 9 out of 52 patients were diagnosed as MCL, and the direction of CyclinD1/IgH by FISH was positive in 7 of 9 MCL, while 3 of the 7 patients were negative by immunohistochemical staining for CyclinD1. Detection of CyclinD1/IgH by FISH can be used as a specific and feasible method for differential diagnosis of mantle cell lymphoma from chronic lymphocytic leukeamia.

Criteria for early etiological diagnosis of serous meningitis in children

To improve early etiological diagnosis of serous meningitis in children, the differential diagnostic algorithms have been developed.Methods. 220 children with serous meningitis(SM) aged 1 to 17 years were divided into 3 groups depending on the etiological factor: 1) enterovirus SM (n=130); 2) herpesvirus SM (n=14); 3) enterovirus SM combined with persistent herpes virus infection (n=76). In the alternative groups of patients (in all combinations), the differential diagnostic significance of clinical and laboratory parameters has been evaluated by means of Wald–Genkin heterogeneous sequential procedure. All studied traits were divided into gradations and then differential diagnostic coefficients (DC) and diagnostic information (I) were obtained separately for the clinical indicators, CSF indicators and full blood count. The indicators were distributed in the descending order of their self-descriptiveness that, in future, taking into account the most significant of them, allowed to form a generalized diagnostic algorithms in each comparison group.Results. Differential algorithmic diagnosis is obtained by means of algebraic summation of DC until the diagnostic threshold is reached. For 95 percent confidence level, the threshold sum is DK≥13,0. Etiologic diagnosis of SM involves the use of all three algorithms, that is, differentiation is conducted between SM herpesvirus, enterovirus etiology and SM enterovirus etiology in combination with persistent herpes virus infection. When reaching the diagnostic threshold in favor of certain etiology, the appropriate diagnosis is made. In case the diagnostic threshold for two etiological factors is reached, the final diagnosis is formulated on the basis of the differential diagnosis data.Conclusions. The developed algorithms of early etiological diagnosis of SM in children are highly reliable (≥95%) and minimize the number of indicators required for diagnosis with a given level of reliability

In the labyrinth of calcium metabolism

The authors present the case of a 27-year-old male patient. In 2010, he suffered from a bone fracture of the pelvis. As imaging techniques showed multiple osseal lytic lesions, diagnostic investigations were performed for multiple myeloma. Later, a mass lesion measuring 37 mm in size was removed from the left side of his mandible. Histology revealed a giant-cell tumour of the bone and oncologic therapy was considered. However, before this planned treatment a PET-CT was performed, which showed numerous distinct lesions with enhanced glucose metabolism in the skeleton as well as in soft tissue behind the right lobe of the thyroid. Hence, the patient was referred to endocrinologists. On the basis of severe hypercalcemia (serum calcium 3.66 mmol/l) and high serum parathyroid hormone level (162.5 pmol/l) the diagnosis of a right sided parathyroid tumour was established. After surgical excision of the parathyroid tumour, high levels of serum calcium and parathyroid hormone returned to normal. Histology failed to show malignancy and the patient recovered soon. This case report may shed some light on the importance of serum calcium measurements and the differential diagnostic significance of primary hyperparathyroidism.

Diagnostic significance of CK19, TG, Ki67 and galectin-3 expression for papillary thyroid carcinoma in the northeastern region of China

BackgroundTo evaluate the expression and differential diagnostic significance of CK19, TG, Ki67 and galectin-3 in papillary thyroid carcinoma (PTC) (metastatic and non metastatic), follicular adenoma and nodular goiter in patients from the northeastern part of China.Methods441 PTC specimens and 151 other benign thyroid specimens (97 cases of nodular goiter, 54 cases of nonmalignant follicular adenoma) were collected. Immunohistochemistry for CK19, TG, Ki67 and galectin-3 was performed.ResultsCK19, TG, Ki67 and galectin-3 expression was 96.37% (425/441), 82.77% (365/441), and 40.59% (179/441), 96.82% (427/441), respectively, for the PTC group and the expression of these markers in the benign thyroid lesions group was 25.83% (39/151), 79.47% (120/151), and 37.09% (56/151), 50.99% (77/151), respectively. The expression of CK19 and galectin-3 in PTC was much higher than that in the nonmalignant group (p < 0.05). However, the expression of TG, Ki67 did not differ among these two groups (p > 0.05). The diagnostic efficiency of CK19 and galectin-3 for PTC was 96.37% (537/592) and 84.63% (501/592). CK19 and galectin-3 expression rate in PTC was higher than that in benign disease cases.ConclusionsThe diagnostic efficiency of CK19 for PTC was slightly better than galectin-3. The utilization of these markers combined with morphologic evaluation may be helpful in the differential diagnosis of papillary thyroid carcinoma in the northeastern region of China.

Die Spiroergometrie in der arbeitsmedizinischen Eignungsuntersuchung und Begutachtung

Medical expert opinion by occupational physicians and pneumologists has two main objectives: making a diagnosis with probability bordering on certainty and clarifying a causal relationship to a present or former occupational exposure to irritant toxic, allergenic or fibrosing dusts, gases, welding fumes or mineral fibres. Especially for conditions that are associated with exertional dyspnea, the diagnosis at rest using spirometry, body plethysmography, pulmonary function test, blood gas analysis, electrocardiogram and echocardiography is of limited use. This paper identifies the indications for cardiopulmonary exercise testing (CPET) in occupational medicine, explains the related measurements and their differential diagnostic value with special consideration of the flow-volume curve under exercise as well as the alveolar-arterial oxygen gradient. Diagnostic statements on the relevance of oxygen uptake measured at continuous and peak load compared to the wattage ascertained on the bicycle ergometer are presented. Characteristic CPET findings are explained in terms of their differential diagnostic significance. Furthermore, the importance of CPET for the assessment of occupational disease-related functional loss (clinical proportions in the reduction of working capacity) is shown.

Significance of AgNOR analysis and the expression of Ki-67 in the precursor lesions of the breast carcinoma

Objective To study the diagnostic and differential diagnostic significance of argyrophilic nucleolar organizer region (AgNOR) and cellular proliferation index ( PlKi-67 ) in the precursor lesions of the breast carcinoma. Methods Image quantitative analysis of AgNOR and immunostains of Ki-67 in tissue microarray sections from 76 biopsies of the precursor lesions of the breast carcinoma. Results There were some differences in granulae sizes and shapes of AgNOR among the precursor lesions of the breast carcinoma. The number of AgNORs per nucleu, total area of AgNORs, mean area of a single AgNOR, PIKi-67 were increasing from ADH to high-grade DCIS, and there was statistical difference between ADH, low-grade DCIS,respectively and high-grade DCIS. The number of AgNORs per nucleu was statistically different between ADH and low-grade DCIS. Conclusion AgNOR and Ki-67 could be regarded as assistant indicators in the diagnosis and differential diagnosis of the precursor lesions of the breast carcinoma. Key words: Breast neoplasia; Atypical ductal hyperplasia; Ductal carcinoma in situ; Argyrophilic nucleolar organizer regions; Ki-67; Tissue microarray

Clonality analysis for differentiating multicentric origin and intrahepatic metastasis in multiple hepatocellular carcinomas

Objective To explore the differential diagnostic significance of clone analysis for multicentric occurrence (MO) and intrahepatic metastasis (IM) in hepatocellular carcinomas (HCCs).Methods Loss of heterozygosity (LOH) and microsatellite instability (MSI) were analyzed by microsatellite polymorphism test and the integration sites of HBV were assessed by Southern blot in each nodule of the HCCs. The clonalities were then compared between each nodule of the same patient and the diagnosis of MO or IM was concluded. Finally, the results based on clonality analysis were compared with those according to clinicopathological and imaging data. Results According to the results of LOH and MSI in 79 nodules and nontumorous tissue from 35 cases of mutiple HCCs, 5 (14.3%)and 29 cases (82.9 %) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The integration sites of HBV could be analyzed in 77 nodules from 34 multiple HCCs. Among them, 6 (17. 6%) and 27 cases (79.4%) were divided into MO and IM, respectively. Both MO and IM presented simultaneously in 1 patient (2.9%). The classification results of microsatellite polymorphism test and HBV integration sites analysis demonstrated a significant positive correlation (rs = 0.909, P＜0.001). Nevertheless, neither the classification of microsatellite polymorphism test nor that of HBV integrate sites analysis was correlated with the discrimination according to clinicopathologic and imaging data (rs=0. 133, P=0. 468, rs =0. 262, P=0. 155, respectively). Recurrence in patients in the MO group occurred significantly later than that in IM cases who were diagnosed by clonality analyses (P=0. 001). Conclusion The clonality analysis based on the results of LOH and MSI or assessments of HBV integrate sites is useful for the differential diagnosis of MO and IM and their treatment and prognosis. Key words: Carcinoma, hepatocellular; Multicentric occurrence; Intrahepatic metastasis; Clonality analysis

Gelenkpunktion und -injektion – Die Geschichte

Up until the middle of the 20th century joint puncture was considered a dangerous surgical intervention performed primarily to drain pus. The differential diagnostic significance of synovial analysis only became clear in the second half of the 20th century. Thus it became possible to reliably distinguish between inflammatory and non-inflammatory diseases, and establish whether arthritides are bacterial or crystal-induced. Attempts to inject disinfecting or anti-inflammatory solutions into the joint go back to the end of the 19th century. In the mid 20th century, cortisone became the panacea of intraarticular therapy. After surgeons at the end of the 19th century succeeded in surgically removing the inflamed synovium, internal medicine specialists attempted to destroy the synovial membrane by injecting it with various chemicals around the mid 20th century; however, hardly any of these substances survived. Only with "internal radiation" by injecting radionuclides was a breakthrough seen in the middle of the 20th century. Since then radiosynoviorthesis and synovialectomy have become standard methods in the treatment of chronic inflammatory joint disease.

Expression of fascin and CK14 in different histological types of cancer and its differential diagnostic significance

To investigate and analyze the expression of fascin and CK14 in multiple histological types of cancer and to explore the potential value of the two proteins as markers in diagnosis and differential diagnosis of various cancer types. Tissue microarray containing esophageal squamous cell carcinoma (SCC), lung SCC, larynx SCC, uterine cervical SCC, SCC of external genital organs, lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, heptocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating ductal carcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, 30 cases each, as well as corresponding normal controls was constructed. The expression of fascin and CK14 among different types of carcinoma and corresponding normal controls was detected by immunohistochemistry. In normal esophagus, bronchus, larynx, uterine cervix and skin, fascin was mainly expressed in the basal cells or reserve cells, but the expression was diffuse in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, with a positive rate of 90.0%, 90.0%, 96.7%, 78.6% and 89.7%, respectively. In the normal tissue of other organs, except breast and uterine endometrium, fascin was negative. In lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, the positive rates were 38.0%, 23.3%, 14.3%, 10.3%, 73.3%, 13.3%, 6.7%, 60.0%, 66.7% and 10.0%, respectively. The difference between fascin expression in SCC and in other histological types was statistically significant (P < 0.001). CK14 was mainly expressed in the basal cells, reserve cells or myoepithelia of normal tissues. The positive rates of CK14 were 76.7%, 36.7%, 83.3%, 60.7% and 96.3% in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, respectively. It was weak and focal in lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma, and renal clear cell carcinoma, with a positive rate of 13.3%, 13.3%, 20.7%, 41.4%, 46.7%, 6.7%, 40.0%, 13.3%, 20.0% and 6.7%, respectively. The difference between CK14 expression in SCC and in other histological types was statistically significant (P < 0.001). The difference between co-expression of fascin/CK14 in SCC and in other histological types was also statistically significant (P < 0.001). Fascin and CK14 are highly expressed in SCC, compared with other histological types of carcinoma. Combination of fascin and CK14 should be a valuable marker in diagnosis and differential diagnosis of carcinoma.

Report on erythroderma and scabies infection in connection with two cases of scabies norvegica

Erythroderma is an inflammation of almost the whole surface of the skin, characterized by erythema, skin infiltration and desquamation. Despite the etiological factors, the generalized inflammation of a large body surface can lead to a life-threatening condition in itself. Parasite infection lies rarely in the background of erythroderma. The Sarcoptes scabiei var. hominis belonging to the mite family is the cause of scabies disease. While the prevalence of "classic" scabies is high world-wide, the more severe and more dangerous form - scabies norvegica - is only seldom observed. Diagnosis and treatment is highly important from an epidemiological aspect. The authors discuss the differential diagnostic problems and epidemiological significance of scabies infection and erythroderma using two cases.

Ultrasonic diagnosis of biliary atresia: A retrospective analysis of 20 patients

To investigate the clinical value of ultrasonographic diagnosis of biliary atresia (BA), a retrospective analysis of the sonogram of 20 children with BA was undertaken. Ultrasonography (US) was performed in 20 neonates and infants with BA, which was confirmed with cholangiography by operation or abdominoscopy. The presence of triangular cord, the size and echo of liver, the changes in empty stomach gallbladder and postprandial gallbladder were observed and recorded. The triangular cord could be observed at the porta hepatis (thickness: 0.3-0.6 cm) in 10 cases. Smaller triangular cord (0.2-0.26 cm) can be observed in 3 cases. The gallbladder was not observed in 2 cases, and 1 case showed a streak gallbladder without capsular space. The gallbladders of 15 cases were flat and small. The gallbladders of 2 cases were of normal size and appearance, however, there was no postprandial contraction. The livers of all cases showed hepatomegaly and hetreogeneous echogenicity. Statistical analysis was performed to compare the hepatomegaly and hetreogeneous echogenicity and the stage of hepatic fibrosis. The presence of the triangular cord at the porta hepatis is specific. However, it is not the only diagnostic criterion, since flat and small gallbladder and poor contraction are also of important diagnostic and differential diagnostic significance. The degree of hepatomegaly and hetreogeneous echogenicity is proportional with liver fibrosis, and able to indicate the duration of course and prognosis.

Detection of cyclin D1 mRNA by reverse transcription-polymerase chain reaction in paraffin-embedded tissues and its diagnostic significance for mantle cell lymphoma

To investigate the feasibility of detecting cyclin D1 mRNA in paraffin-embedded tissues by reverse transcriptase polymerase chain reaction (RT-PCR) and competitive RT-PCR and its diagnostic and differential diagnostic significance for mantle cell lymphoma (MCL). Paraffin-embedded samples of 36 cases of MCL, 71 cases of other small B-cell lymphomas and 20 cases of lymphoid reactive hyperplasia as control group were retrieved from archival materials. Cyclin D1 protein and its mRNA was detected by EnVision and RT-PCR and competitive RT-PCR in all samples. House-keeping gene PGK was choosen as internal control. (1) Cyclin D1 protein was expressed in 27 of the 38 MCL (71.1%). No cyclin D1 expression was found in the control group. (2) PGK was detected in 103 of the 116 cases (88.8%) and also detected in 34 of 36 MCL cases (94.7%). (3) cyclin D1 mRNA was detected in 34 nodal mantle cell lymphoma cases by RT-PCR in paraffin-embedded tissues. The positive rate of cyclin D1 mRNA was 94.4% in mantle cell lymphomas after exclusion of the 2 cases which were negative for both cyclin D1 mRNA and PGK. cyclin D1 mRNA was not detected in other nodal small B-cell lymphomas or lymphoid reactive hyperplasia, except 1 case of B-SLL. Sequencing analysis showed that sequences were identical to cyclin D1. (4) Cyclin D1 mRNA overexpression was detected in 27 cases of nodal mantle cell lymphoma by competitive RT-PCR in paraffin-embedded tissues. The positive rate of cyclin D1 mRNA overexpression was 75.0% in mantle cell lymphomas after exclusion of 2 cases which were negative for both cyclin D1 mRNA and PGK. cyclin D1 mRNA overexpression was not detected in other nodal small B-cell lymphomas or lymphoid reactive hyperplasia. RT-PCR and competitive RT-PCR detection of cyclin D1 mRNA overexpression could be used for the diagnosis and differential diagnosis of mantle cell lymphoma in paraffin-embedded blocks.

Bcl-2, Bcl-6 and CD10 expression in cutaneous B-cell lymphoma: further support for a follicle centre cell origin and differential diagnostic significance.

Primary cutaneous follicle centre cell lymphomas (PCFCCLs) are the most common type of cutaneous B-cell lymphoma. There is ongoing discussion on the origin of the neoplastic B cells in these PCFCCLs, and consequently on their relation to the groups of primary cutaneous marginal zone B-cell lymphomas (PCMZLs) and nodal follicular lymphomas. To define better the neoplastic B cells in PCFCCLs, and to find out if differences in the expression of the antiapoptopic protein Bcl-2, and Bcl-6 and CD10, molecules which are normally expressed by the neoplastic B cells in nodal follicular lymphomas, might have diagnostic or prognostic significance in cutaneous B-cell lymphoproliferative disorders. Pretreatment biopsies of well-defined groups of PCFCCL (n = 24), PCMZL (n = 14), primary cutaneous large B-cell lymphoma of the leg (PCLBCL-leg; n = 19), secondary cutaneous follicular lymphoma (n = 3) and cutaneous pseudo-B-cell lymphoma (n = 6) were investigated by immunohistochemistry for expression of Bcl-2, Bcl-6 and CD10. The PCFCCLs consistently expressed Bcl-6, whereas CD10 and Bcl-2 were expressed in only one and two of 24 cases, respectively. In contrast, PCMZLs were always negative for Bcl-6 and CD10, but were Bcl-2 positive, whereas skin and lymph node localizations of secondary cutaneous follicular lymphomas consistently expressed all of Bcl-2, Bcl-6 and CD10. Reactive follicle centre cells in pseudo-B-cell lymphomas expressed Bcl-6 (six of six cases) and CD10 (five of six cases), but not Bcl-2. PCLBCL-leg was Bcl-6 positive and CD10 negative in all cases, irrespective of clinical outcome, and strongly expressed Bcl-2 protein in all but two cases. The results of the present study provide further support for the follicle centre cell origin of both PCFCCL and PCLBCL-leg, and indicate that staining for Bcl-2, Bcl-6 and CD10 can serve as an important adjunct in the differential diagnosis of cutaneous B-cell lymphoproliferative disorders.