Hematopoietic Lesions Research Articles

Character and Frequency of the Syntropic Extrahepatic Lesions in Cirrhotic Patients with Hepatopulmonary Syndrome of Various Severity Degree

Introduction. All over the world, and in Ukraine in particular, the incidence of liver diseases is constantly increasing. By practicing the most effective individualized appointment of complex treatment, it should be taken into consideration the involvement of different organ systems to the pathological processes of the cirrhotic patients, which we define as syntropic polymorbid lesions. The aim of the study. To determine the frequency and character of syntropic extrahepatic lesions in cirrhotic patients depending on the hepatopulmonary syndrome severity degree. Materials and methods. In a randomized manner with preliminary stratification by the presence of hepatopulmonary syndrome were studied 93 patients with liver cirrhosis, who underwent the comprehensive clinical-laboratory and instrumental examination. Results. According to the obtained results, most often in patients with liver cirrhosis associated with hepatopulmonary syndrome syntropic extrahepatic lesions affected other organ systems as follows: digestive system - 100.0 % patients under investigation; hematopoietic system - 84.9 %; nervous system - 81.7 %; integumentary system and mucous membranes - 78.5 %; blood circulatory system - 76. 3%;osteoarticular system - 67.7 %; urinary system - 22.6 %. Increased severity of hepatopulmonary syndrome significantly (p < 0.05) correlated with thein creased frequency of lesions. Among syntropic polymorbid lesions of the integumentary system and mucous membranes, 68.8 % patients with hepatopulmonary syndrome had jaundice, 66.7 % - telangiectasia. Among lesions of the osteoarticular system osteopenia was diagnosed in 44.7 % of patients, osteoporosis - in 27.7 %. Among lesions of the circulatory system 52.7% of patients suffered from heart rhythm disorders, 49.5 % - from arterial hypotension, 20.4 % - from cirrhotic cardiomyopathy. Among lesions of the hematopoietic system anemia (76.3 %), coagulopathy (73.1 %) and thrombocytopenia (61.3 %) were diagnosed most often. Digestive system lesionsinclude esophageal veins varicosities (94.6 % of patients), hemorrhoidal veins varicosites (68.8 %), and cirrhotic gastropathy (62.4 %). Among lesions of the urinary systemin 21.5 % of patientswas diagnosed type II hepatorenal syndrome. Among the lesions of central nervous system in 81.7 % of patientswas diagnosed hepatic encephalopathy. The frequency of syndromes and nosological units increased significantly (p < 0.05) with the increase of hepatopulmonary syndrome severity. Conclusions. 100.0 % patients with liver cirrhosis accompanied byhepatopulmonary syndromewere affected by syntropic polymorbid lesionsof the digestive system, 94.6 % of which were represented by esophageal vein varicosites. Out of 84.9 % of patients with hematopoietic lesions anemia was diagnosed in 76.3 %, coagulopathy - in 73.1 % of cases. Of total 81.7 % patients withnervous system injurieshepatic encephalopathy was diagnosed in 81.7 % patients. In 78.5 % cases of damaged skin, its appendages and mucous membranesjaundice covered 68.8 %, and telangiectasia 66.7 % of cases. In 76.3 % of cardiovascular system lesions arrhythmias were diagnosed in 52.7 %.With the increasing severity of hepatopulmonary syndrome, the frequency of the above lesions increased significantly (p < 0.05).

Pediatric Sarcomas: The Next Generation of Molecular Studies.

Simple SummaryThere has been an incredible amount of discovery in pediatric sarcomas, but much remains to be accomplished. Clinical challenges include diagnostic heterogeneity and the poor outcome of patients with high risk, metastatic, and relapsed disease. The emergence of single cell sequencing has allowed the ability to document tumor cell heterogeneity in amazing detail, but it does not allow the ability to visualize spatial orientation. This problem has been solved by spatial multi-omics, which can be used to map tumors and visualize the distribution of critical transcripts, mutations, and proteins. However, these tools only offer observational data. High-throughput functional genomics provides a powerful way to highlight oncogenic drivers and potential therapy opportunities. Research has been hamstrung by a need for annotated specimens, particularly in post-therapy, relapsed, and metastatic disease, and initial biopsies offer only limited data opportunities. Data complexity, variability, and inconsistency present problems best approached with AI/machine learning. We stand on the threshold of a revolution in cancer cell biology that has the potential for translation into more effective and more directed therapies, particularly for previously recalcitrant diseases.Pediatric sarcomas constitute one of the largest groups of childhood cancers, following hematopoietic, neural, and renal lesions. Partly because of their diversity, they continue to offer challenges in diagnosis and treatment. In spite of the diagnostic, nosologic, and therapeutic gains made with genetic technology, newer means for investigation are needed. This article reviews emerging technology being used to study human neoplasia and how these methods might be applicable to pediatric sarcomas. Methods reviewed include single cell RNA sequencing (scRNAseq), spatial multi-omics, high-throughput functional genomics, and clustered regularly interspersed short palindromic sequence-Cas9 (CRISPR-Cas9) technology. In spite of these advances, the field continues to be challenged by a dearth of properly annotated materials, particularly from recurrences and metastases and pre- and post-treatment samples.

Studies of clinical symptoms of panleukopenia in cats in the Donetsk People’s Republic

Feline panleukopenia is a highly contagious viral disease of the members of the family Felidae caused by a DNA-virus of the family Parvoviridae. After infection, the virus is detected in saliva, nasal discharge, urine and feces; it is transmitted through excrements, water, food, and, according to some reports, by bloodsucking insects. The disease is characterized by gastrointestinal tract, central nervous system, hematopoietic tissue lesions. The paper describes the clinical signs of panleukopenia in cats in the territory of the Donetsk People’s Republic. Based on the records of a state-financed veterinary hospital and a charitable animal shelter located in the town of Yasinovataya, as well as those of private veterinary clinics and a veterinary office located in Donetsk, a classification of the clinical signs of the disease in pet and stray cats is suggested with the signs grouped according to their occurrence rate and by age groups. The paper provides evidence of feline panleukopenia occurrence in the territory of the Donetsk People’s Republic. In particular, the period from 2015 to 2018 was characterized by an increase in panleukopenia morbidity in stray animals; pet cats were also involved in the epidemic process. It was found that most of the clinical symptoms of panleukopenia were reported in cats of all age categories irrespective of their sex. Specific symptoms characteristic for different age groups were reported. It was found that panleukopenia morbidity rates for stray kittens aged 0–12 months were 1.8 times higher than those for pet kittens of the same age group. The disease was reported in adult pet cats 2.4 times less frequently than in stray cats. It is shown that the number of the disease cases in female cats is 1.5 times higher than in male ones. It is concluded that the violation of quarantine rules and insufficient vaccination coverage in cats are risk factors for the disease outbreak occurrence precipitating the multiple recurrent outbreaks of the disease.

Mediastinal pathology and the contributions of Dr. Juan Rosai.

Dr. Juan Rosai is one of the most prolific contributors to the literature on mediastinal pathology, and he has added steadily to that body of work over a 50-year period. Rosai has written several landmark articles in this topical area, including articles on thymic epithelial lesions, mediastinal neuroendocrine tumors, mediastinal lymphoma and other hematopoietic lesions, thymolipoma, thymoliposarcoma, mediastinal solitary fibrous tumor, intrathymic langerhans-cell histiocytosis, mediastinal germ cell neoplasms, and multilocular thymic cyst. This review recounts his role as one of the principal figures in the surgical pathology of mediastinal diseases.

Unusual involvement of cervix and vulva in a case of chronic lymphocytic leukemia

To the editor: Chronic lymphocytic leukemia (CLL) is a malignant proliferation and accumulation of abnormal mature lymphocytes. Though extranodal involvement is common, vulovaginal involvement by CLL is extremely uncommon, especially as the primary presentation. This case is presented for its rarity and to highlight the importance of exact pathologic diagnosis in the management of these patients. A 55-year-old female was evaluated for swelling and ulcerative lesion of the vulva for which she had consulted two separate gynecologists and had been treated with topical antifungals and antibiotics without any improvement. She presented to us with a persistent vulval lesion of 8 months duration. By this time she had also developed bilateral neck nodes enlargement of 2 months duration. On examination she had generalized lymphadenopathy and hepatomegaly. Detailed gynecological examination was performed and an ulcerative lesion with rolled out edges was found in the inner surfaces of both labia majorae (Fig. 1A). Speculum examination revealed an inflamed vaginal mucosa with prominent mucosal folds. The cervix was unhealthy with mucosal irregularity. Investigations revealed a haemoglobin of 98 gm/L, total white cells of 110×109/L with differential count showing lymphocyte of 88%, and platelet count of 359×109/L. Her bone marrow examination and flow cytometry was suggestive of CLL. The patients' labial biopsy showed sheets of mature appearing lymphocytes which was CD 5, CD 20, CD 23, LCA and CD 79α, CD 43 positive (Fig. 1B, C, E) and the endocervical smear also showed many mature appearing lymphoid cells suggestive of CLL involvement (Fig. 1F). The patient has been treated with 2 cycles of bendamustine and is responding well to treatment with significant regression of the vulval swelling (Fig. 1D). Fig. 1 (A) Swelling and ulcerative lesion over inner surface of both labia majora. (B) Labial biopsy showed sheets of mature appearing lymphocytes (H&E, ×100). (C) Immunohistochemistry (IHC) showing CD 5 positivity of mature lymphocyte (×100). ... CLL is commonly diagnosed incidentally in asymptomatic patients when a routine physical examination reveals non-tender lymphadenopathy, or routine blood investigation shows unexplained absolute lymphocytosis. CLL can also present as involvement of extralymphoid organ, and skin being most common, accounting for 8% of cases [1]. Female genital tract involvement can occur in Non-Hodgkin's lymphomas (NHLs) and the most common is diffuse large B cell lymphoma [2]. Very few cases of vulvovaginal involvement of CLL have been reported in the English literature and this is only the second case of CLL with involvement of vulva as well as cervix [2-4]. In addition to carcinoma of the vagina/vulva, many unusual cancers have been reported to involve these areas. The differential diagnosis vulvovaginal lesions which needs to be kept in mind by practicing gynecologists and physicians include vaginal NHL and other hematopoietic lesions (granulocytic sarcoma, Langerhan's cell histiocytosis), malignant mixed Mullerian tumor, epithelioid leiomyosarcoma, endometrial stromal tumors including endometrial stromal sarcoma, melanoma, and extraosseous Ewing's sarcoma/primitive neuroectodermal tumor [5]. Our patient initially presented with swelling and ulceration in vulva, the diagnosis of which was missed due to rarity of the presentation. She was diagnosed as having CLL eight months later, only after she developed generalized lymphadenopathy. It is beneficial to identify patients with CLL in its early stages so that they may be monitored for disease progression, and therapy can be initiated as soon as indicated. In our case, early pick of the CLL would have been possible if the gynecologist performed a biopsy when the vulval lesion had failed to respond to antifungal and antibiotic treatment. We present this case for its rarity and to highlight the importance of early biopsy in gynecological lesions not responding to conventional therapy.

Hematopoietic Proliferative Lesions in the Spleen of rasH2 Transgenic Mice Treated with MNU

In this study, rasH2-Tg mice treated with N-methyl-N-nitrosurea (MNU) developed exuberant hematoproliferative changes in the spleen that included dysplasia and features of neoplasia. Hematoproliferative change was characterized as exuberant proliferation of hematopoietic cells within the spleen that distorted but did not displace normal splenic morphologic features. The hematopoietic cells were of mixed lineage, but one type, often erythroid, predominated. Cellular atypia was present in all mice with hematoproliferative change, and dysplasia was present in five of eight examined. Hematoproliferative neoplasia was characterized by similar cytologic features but also resulted in displacement/disruption of normal splenic architecture and increased numbers of unidentified blast cells. One case was differentiated toward myeloid proliferation, suggesting granulocytic leukemia. Affected mice had other neoplasms, such as lymphoma and anemia. These proliferative and dysplastic lesions of the spleen in rasH2-Tg mice treated with MNU require additional characterization to definitively differentiate them from the reactive hematopoiesis that can occur in response to inflammatory, neoplastic, or hematopoietic insults in mice.

Two-Week Oral Toxicity Study of 1,4-Dichloro-2-Nitrobenzene in Rats and Mice

Subacute toxicity of 1,4-dichloro-2-nitrobenzene (DCNB) was examined by feeding F344 rats and BDF1 mice of both sexes a diet containing DCNB at 625, 1250, 2500, 5000 or 10,000 ppm (w/w) for 2 weeks. All DCNB-fed rats survived to the end of the 2-week administration period, but 2 male and 6 female mice fed 10,000 ppm died during this period. The subacute toxicity was characterized by lesions affecting the liver, kidney, testis and hematopoietic system. The liver was the most responsive to DCNB, as evidenced by a dose-related increase in relative liver weight in rats and mice and centrilobular hypertrophy of hepatocytes in mice. An alteration in liver-associated lipid metabolism was suggested from the concomitant increases in serum concentrations of total cholesterol and phospholipid. A lower confidence limit of the benchmark dose yielding the response with 10% extra risk (BMDL10) for the relative liver weight indicated that rats were more responsive to DCNB than mice. The kidney lesion was characterized by alpha2upsilon-globulin-accumulated hyaline droplets in the renal tubular epithelial cells only in male rats, as indicated by positive anti-alpha2upsilon-globulin immunohistochemical staining. Testicular and hematopoietic lesions appeared at higher dose levels than did the liver and kidney lesions.

Clinical Use of B- and T-Cell Gene Rearrangement Analysis in Hematopoietic Disorders

The clinical application of B- and T-cell gene rearrangement analysis is discussed relative to diagnostic problems in specific lymphoproliferative disorders. This article reviews the use of the Southern blot hybridization technique for B- and T-cell gene rearrangement detection in the analysis of various hematopoietic lesions. Several case studies are presented and analyzed.

Molecular Assessment of Clonality in Hematopoietic Lesions

Molecular Assessment of Clonality in Hematopoietic Lesions

Fine‐needle aspiration cytology of hematopoietic lesions from multiple sites

We reviewed 130 fine-needle aspiration (FNA) biopsies from 118 patients with a variety of benign and malignant hematopoietic lesions. There were 74 (57%) malignant, 45 (35%) benign, and 11 (8%) atypical diagnoses. Immunocytochemistry of the aspirated material was performed in 47 (36%) and electron microscopy in 4 (3%) of the cases. FNA cytology was utilized to make a primary hematopoietic malignant diagnosis in approximately half of the cases and to confirm recurrence in the remainder. The malignant cases included non-Hodgkin's lymphoma. Hodgkin's disease, medullary and extramedullary plasmacytoma, and granulocytic sarcoma. Forty-two malignant cases had either previous or follow-up surgical biopsy with no false-positive diagnoses. Of the 11 atypical cases, seven had surgical confirmation with five malignant and two benign diagnoses. The benign hematopoietic lesions correctly identified included acute and chronic lymphadenitis, granulomatous processes, and eosinophilic granuloma. Only 5 of the 45 benign FNA biopsies had surgical pathology follow-up, with no false-negative diagnoses. The most commonly aspirated sites were lymph nodes (71%), although hematopoietic lesions were correctly identified in a number of extranodal locations, including soft tissue (8%), abdominal viscera (6%), lungs (5%), mediastinum (2.5%), bone (3%), and thyroid, salivary gland, and breast (1.5% each). This study demonstrates the clinical utility and diagnostic accuracy of FNA cytology in the evaluation of benign and malignant hematopoietic disorders from multiple sites. Ancillary studies performed on the aspirated material aided in making a specific and accurate diagnosis.

Morphologic classification and correlation of incidence of hyperplastic and neoplastic hematopoietic lesions in mice with age.

Information from the NCTR control pathology data base was examined to morphologically classify and correlate the incidence off hyperplastic and neoplastic hematopoietic lesions with age in over 15,000 male and female mice of a variety of strains. Hyperplasia affected lymphoid and reticular cells, erythropoietic and granulopoietic cells, mast cells, plasma cells and megakaryocytes. Neoplastic lesions included lymphocytic lymphoma, mixed cell lymphoma, histiocytic lymphoma, granulocytic leukemia, plasma cell neoplasms and mast cell neoplasms. Most hyperplastic and neoplastic hematopoietic lesions increased wtih age and most were slightly more common in the female than in the male mice.