Reactive Lymphoid Hyperplasia Research Articles

Contrast-Enhanced Ultrasound Features of Hepatic Reactive Lymphoid Hyperplasia: Correlation With Histopathologic Findings.

To find certain specifics of hepatic reactive lymphoid hyperplasia (HRLH) on contrast-enhanced ultrasound (CEUS) imaging as diagnostic imaging clues by retrospectively analyzing its enhancement features. From June 2010 to June 2017, 18 histopathologically confirmed HRLH lesions in 18 patients were included in this retrospective study. The lesion's location, maximum diameter, shape, margin, echogenicity, and color flow signal on conventional ultrasound (US) imaging and enhancement pattern, presence of a feeding artery, and donutlike enhancement on CEUS imaging were observed and recorded. The lesion size on CEUS imaging at peak enhancement and that on conventional US imaging were compared and recorded. All of the lesions showed homogeneous hypoechogenicity with a regular well-defined margin on conventional US imaging, with a mean diameter ± SD of 14.3 ± 4.6 mm (range, 8-24 mm). On CEUS imaging, all of the lesions showed "quick-wash-in and quick-wash-out," which showed complete homogeneous hyperenhancement in the arterial phase and wash-out in the second half of the arterial phase or first half of the portal phase. In 83.3% (15 of 18) of the lesions, the lesion size that was enhanced at peak was enlarged compared with the hypoechoic area on conventional US imaging, and transient donutlike enhancement appeared when the lesion showed wash-out. In 55.6% (10 of 18) of cases, the feeding artery was detected. Enlarged complete homogeneous hyperenhancement in the arterial phase, consequently followed by quick wash-out of the lesion and the appearance of donutlike enhancement, may be the CEUS features of HRLH.

Outcome of Adenotonsillar Specimen Histology in a Private Hospital Setting.

Background:All adenoid and tonsils tissue specimens are routinely histologically examined in pediatric otorhinolaryngology practice worldwide. This study aimed at determining the sociodemographic features, clinical presentation, indications, postoperative management, and histological diagnosis of the adenoid and tonsils tissues.Materials and Methods:This is a retrospective hospital-based study of patients who had adenotonsillectomy done between August 2008 and July 2018 at Golden Cross Infirmary Hospital, Festac Town, Lagos, Nigeria. All data were obtained from the patients' record, case note, and theater operation register. All the data obtained were collated and analyzed using SPSS version 18.0.Results:There were 59.2% of males with a male-to-female ratio of 1.5:1. Clinical presentation among the pediatric patients was 71.8% difficulty breathing, 64.8% snoring, 63.4% sleep apnea, 60.6% catarrh, and 54.9% noisy breathing. The most common indications for adenoid and tonsils surgery were obstructive sleep apnea in 64.8%. Adenoidectomy in 42.3% was the most common form of pediatric adenoid and tonsils surgery. The most common complication of adenoid and tonsils surgery was pain at surgical site/odynophagia in all the patients. Postoperative histological reports were reactive lymphoid hyperplasia in all the patients.Conclusion:Adenoid and tonsils surgeries are common pediatric otorhinolaryngology, head-and-neck surgical procedures. The most common indication found for adenoid and tonsils surgery was obstructive sleep. Adenoidectomy was the most common form of pediatric adenoid and tonsils surgery. All the adenoid and tonsils tissue specimens revealed histological benign diseases.

Idiopathic inflammatory diseases of orbit and ocular adnexa: Histopathological and immunochemical analysis.

PurposeTo present histopathological and immunohistochemical analysis of idiopathic inflammatory diseases of orbit and ocular adnexa.Methods:Design- A retrospective laboratory-based study. The study was carried out in an ocular pathology laboratory in a tertiary institute of northeast India where analysis of 93 cases was done in 5 years, during the period from 2011 to 2016. Hematoxylin--eosin and special stains were done for the diagnoses. Immunohistochemistry (IHC) panel was also carried out. For infectious pathology, Grocott's methenamine silver (GMS) stain for fungus, tissue Gram's stain for bacteria's, and acid-fast stains for tubercular bacilli were done. IHC panels were done for CD 20 (B-cells), CD-3 (T-cells), CD-45 (Leukocyte common antigen, LCA), BCL-2, CD-138 (Plasma cells), Kappa, Lambda, IgG-4 in tissue, IgG-4 in serum, etc. IHCs were done using kit methods (standardized) and adequate controls were taken for each sample.Results:93 cases of nonspecific orbital inflammation were reported out of 1,467 specimens. Orbital pseudotumors (idiopathic orbital inflammatory disease, IOID) were seen in 27 cases (sclerosing variety-6); benign lymphoid hyperplasia in two cases; reactive lymphoid hyperplasia in 10 cases; atypical plasma lymphoproliferative reactive (polyclonal immunophenotypically, IgG4 negative) lesions in four cases; IgG-4 related disease in one case; nonspecific inflammatory reactions (conjunctiva, sclera, and lid) in 49 cases. In all the diagnoses, infections and lymphomas were excluded.Conclusion:Biopsy supported study on nonspecific orbital inflammation was important to know the pattern.

Extranodal lymphoma of the tongue, a very rare entity-report of two cases with literature review

BackgroundLymphomas are malignant neoplasms of the lymphocyte cell lines affecting the lymph nodes, spleen and other nonhemopoietic tissues. Of the extranodal lymphomas found in the head and neck region, 3–5% of malignant lymphomas arise in the oral and paraoral region, mainly from Waldeyer's ring. The involvement of the base of the tongue is extremely rare. Summarised CaseCase 1: 64 year old female who presented initially with an enlarged occipital lymph node which gradually became generalized cervical lymphadenopathy with initial histology confirmed reactive lymphoid hyperplasia. Biopsy of left postero-lateral tongue lesion eventually showed high grade T cell lymphoma.Case 2: 85 year old male presented with history of dysphagia for one year who was found to have a lesion extending from his base of tongue into the nasopharynx. Histology showed a diffuse B cell lymphoma. DiscussionBoth patients were noted to have lesion of the tongue, but tongue lesions are noted in the literature to be extremely rare. When tongue lymphomas do occur, most are of B-cell origin; the diffuse large-cell variety is the most common. Extranodal lymphomas of the T cell phenotype tend more to be sinonasal in origin than of the tongue, with T cell lymphomas of the tongue being even rarer than B cell lymphomas. ConclusionWith regards to tumours arising in the tongue, squamous cell carcinomas are still classified as the most common. Lymphomas however, should still be kept in consideration as a differential diagnosis with regards to lesions arising from this site.

Primary Cutaneous Follicle Center Lymphoma.

Primary cutaneous follicle center lymphoma is a low-grade B-cell lymphoma that is limited to the skin at diagnosis. It has a differential diagnosis that includes systemic/nodal follicular lymphoma secondarily involving the skin; primary cutaneous diffuse large B-cell lymphoma leg type; reactive lymphoid hyperplasia; and primary cutaneous marginal zone lymphoma. To review the clinical, morphologic, immunophenotypic, and genetic features of primary cutaneous follicle center lymphoma; its differential diagnosis; and the evidence that supports use of immunohistochemistry and genetic testing in the diagnosis and prognosis of this entity. Pertinent literature regarding cutaneous B-cell lymphomas is summarized and University of Michigan cases are used to highlight characteristics of primary cutaneous follicle center lymphoma. Primary cutaneous follicle center lymphoma is a low-grade B-cell lymphoma with distinctive features, although some cases may have elements that overlap with other lymphomas, complicating interpretation.

GLILD IS THE INITIAL PRESENTATION OF CVID. A CASE REPORT

Introduction Common variable immunodeficiency (CVID) is the most common clinically significant primary immunodeficiency in the adult. The risk for recurrent infections, lymphoproliferative, granulomatous and autoimmune diseases are high. We report a case of an adult female who presented initially with the clinical manifestations of granulomatous-lymphocytic interstitial lung disease (GILID) prior to CVID. Case Description Patient has a history of Asperger's syndrome who was referred to rule out primary immunodeficiency disorder. Patient was newly diagnosed with massive hepatosplenomegaly, diffuse lymphadenopathy, pancytopenia, hypogammaglobinemia and multiple pulmonary nodules after a comprehensive testing was performed for chronic abdominal pain. She denies any infectious disease history aside of recurrent acute sinusitis. At first, the malignancy was the major concern however all bone marrow, lymph node, BAL and trans-bronchial biopsies were negative. Although, splenectomy was done for the concern of lymphoma, pathology only revealed reactive follicular lymphoid hyperplasia. The immunological testes for autoimmune lymphoproliferative syndrome (ALPS), hyper-IgM syndrome and whole exam sequencing were negative. Later, interval increase of the mesenteric LN size was noted thus an open lung biopsy was completed which, demonstrated severe follicular bronchiolitis with associated prominent granulomatous inflammation; changes compatible with granulomatous-lymphocytic interstitial lung disease (GILID). Discussion The diagnosis of GLILD can be challenging and requires a multidisciplinary approach with thoughtful integration of clinical, radiologic, and pathological data. The presence of GLILD in patients with CVID associated with higher morbidity and mortality rate. The previous studies reported if a GLILD patient is left untreated, will lead to progressive respiratory failure which is the most common cause of death.

MiR‑101 regulates the cell proliferation and apoptosis in diffuse large B‑cell lymphoma by targeting MEK1 via regulation of the ERK/MAPK signaling pathway

MAPK kinase1 (MEK1) is an upstream protein kinase of extracellular signal regulated kinase (ERK), which activates the ERK/MAPK (mitogen activated protein kinase) pathway. Importantly, bioinformatic analysis has shown that there is a target complementary binding site between miR‑101 and MEK1. The present study aimed to ascertain whether or not miR‑101 plays a role in regulating MEK1 expression, ERK/MAPK pathway activity, and the proliferation and apoptosis in a diffuse large Bcell lymphoma (DLBCL) cell line. DLBCL tumor samples were collected from patients in our hospital, and lymphatic tissues with reactive lymphoid hyperplasia were selected as controls. The patients were divided into high and low expression groups, and then the survival rate of the two groups was compared using Kaplan‑Meier method, as well the effect of miR‑101 and MEK1 mRNA expression on survival and prognosis was analyzed. The expression of miR‑101, MEK1 and p‑MEK1 between normal lymphoblastic cell lines (HCC1954 BL and NCI‑BL2009) and lymphoma cell lines (SU‑DHL‑4 and Farage) was compared. Lymphoma SU‑DHL‑4 and Farage cells were cultured invitro, and then divided into the following groups: miR‑NC group; miR‑101 mimic group; siRNA‑NC group; and siRNA‑MEK1 group. The expression of miR‑101, MEK1, p‑MEK1, p‑ERK1/2 and Bcl‑2 was compared. Cell apoptosis was detected by flow cytometry, and cell proliferation was detected by EdU staining. The results showed that targeted regulation existed between miR‑101 and MEK1, and the decreased expression of miR‑101 was related to the pathogenesis and prognosis of DLBCL. Upregulation of miR‑101 inhibited DLBCL cell proliferation and facilitated apoptosis by inhibiting the expression of MEK1.

Expression of sB7-H4 in Serum and Lymphoma Tissues of Patients with Malignant Lymphoma and Its Value for Diagnosis and Re-Examine of Lymphoma

To study the soluble B7-H4 (sB7-H4) expression in serum and lymphoma tissues of patients with malignant lymphoma (ML) and its value for diagnosis and re-examination lymphoma. The serum samples from 83 cases of ML were collected, among them 69 cases of newly diagnosed ML were enrolled in group A including 11 cases of Hodgkin's lymphoma (NHL group) and 58 cases of non-Hodgkin's lymphoma (NHL group), the serum samples from 14 cases of relapsed ML were enrolled in group B; at the same time the serum samples of 50 healthy persons conformed by physical examination were collected and enrolled in control group. The double antibody sandwich ELISA was used to detect the serum level of sB7-H4 in each group, and immunohistochemistry method was used to detect the expression of sB7-H4 in malignant lymphoma and reactive lymphoid hyperplasia tissues. The serum level of sB7-H4 in the group A was significantly increased in comparison with the group B and control group, and the level of group B was significantly higher than that in the control group (P<0.05); the serum level of sB7-H4 in the NHL group was significantly increased in comparison with HL group and control group, and the level of HL group was higher than that of control group (P<0.05). The expression of sB7-H4 in reactive lymphoid hyperplasia tissues was negative, but the positive expression rate in malignant lymphoma tissues was 47.50%, suggesting the positive rate of sB7-H4 in malignant lymphoma tissues was significantly higher than that of reactive lymphoid hyperplasia tissues (P<0.05). The high expression of sB7-H4 in serum and lymphoma tissues of patients with malignant lymphoma has a certain value for the diagnosis and re-examination of patients with malignant lymphoma.

Platelet-derived growth factor receptor alpha (PDGFRα) is overexpressed in NK/T-cell lymphoma and mediates cell survival

Nasal-type natural killer/T-cell lymphoma (NKTCL) is a subtype of non-Hodgkin lymphoma (NHL) that is clinically aggressive and has a poor prognosis. Platelet-derived growth factor receptors (PDGFRs) and their ligands (PDGFs) play important roles in angiogenesis, cancer cell proliferation, survival, migration and poor prognosis in various tumours. However, the significance of PDGFRs in NKTCL remains unknown. Herein, the present study aimed to investigate the important role of PDGFRα in pathogenesis, progression and prognisis of NKTCL. Firstly, we performed immunohistochemical staining, qRT-PCR and western blotting to determine PDGFRα expression in formalin-fixed, paraffin-embedded tissue sections from 78 NKTCL cases and in cell lines. Secondly, correlations between PDGFRα expression and NKTCL clinical parameters and prognosis were analysed. Moreover, a biological assessment of PDGFRα blockade in two NKTCL cell lines was conducted through proliferation assay, cell-cycle evaluation and apoptosis detection by flow cytometry analyses. Furthermore, we detected in vivo activity of imatinib in mouse model of NKTCL. We found that the expression of PDGFRα was significantly higher in NKTCL tissues compared to the reactive lymphoid hyperplasia of the nasopharynx (P = 0.028). High PDGFRα expression was strongly associated with a high LDH level (P = 0.028) and III-IV stage (P = 0.013). NKTCL patients with high PDGFRα expression displayed a reduced median overall survival time and progression-free survival time when compared with those with low PDGFRα expression (P = 0.011, P = 0.005, respectively). Cox multivariate analysis showed that III-IV stage (P = 0.024) and high PDGFRα expression (P = 0.003) were independent prognostic factors in NKTCL patients. Biological assessment assays in two NKTCL cell lines revealed that a specific PDGFR antagonist, imatinib, inhibited cell viability, blocked cell cycle progression at G0/G1 stage and induced apoptosis. Similarly, the in vivo assay showed that imatinib delayed mouse model tumour growth. In conclusion, NKTCL tumour cells have prominent PDGFRα expression, which can serve as a candidate prognostic marker. PDGFR antagonists have significant biological effect on NKTCL and may be useful therapeutic agents for treatment of NKTCL.

Expression and clinical significance of ubiquitin‑specific‑processing protease 34 in diffuse large B‑cell lymphoma.

Ubiquitin‑specific‑processing protease 34 (USP34) is a deubiquitinase that is involved in the pathogenesis of various cancers. Its roles in diffuse large B‑cell lymphoma (DLBCL) are unknown. The present study aimed to determine the level of USP34 expression and to explore its association with clinicopathological features and prognosis in patients with DLBCL; a total of 30cases of reactive lymphoid hyperplasia and 131cases of DLBCL were included in this study. The level of USP34 expression was examined by immunohistochemistry (IHC), and correlations between USP34 expression and clinicopathological features and prognosis were analyzed. In addition, mutations, expression and clinical significance of USP34 in DLBCL were evaluated using data from The Cancer Genome Atlas (TCGA). USP34 expression was significantly higher in DLBCL compared with expression in reactive lymphoid hyperplasia. In DLBCL, overexpression of USP34 was associated with older age, germinal center B cell‑like (GCB) subtype, multiple extranodal involvements and higher International Prognostic Index (IPI) scores. No significant association was identified between USP34 protein level and patient survival. In the TCGA dataset, low USP34 mRNA expression was demonstrated to be associated with a poor disease‑free survival (DFS), but not with overall survival (OS) in patients with DLBCL. In conclusion, high expression of USP34 protein in DLBCL was associated with older age, GCB subtype, multiple extranodal involvement and high IPI scores of DLBCL. USP34 may be a valuable marker for the assessment of patients with DLBCL, and further studies are needed to clarify USP34 expression on DLBCLs.

Comparison of Routine Histopathological Examination Results in Children and Adults After Tonsillectomy and/or Adenoidectomy.

Tonsillectomy and/or adenoidectomy is one of the most common otolaryngologic surgical procedures. There is still an ongoing debate as to whether or not histopathological examination should be performed in which cases after these surgeries. The aim of this study is to compare the histopathologic examination results of routine tonsillectomy and/or adenoidectomy surgical specimens of children and adults. The routine histopathological examination results of patients who had adenoidectomy and/or tonsillectomy between April 2010 and April 2017 in Tokat State Hospital were evaluated from medical records retrospectively. The results were compared in terms of malignancy between children and adult patients. A total of 1849 histopathological examination results were included in the present study. Of the patients, 1574 were children, and 275 were adults. All of the patients who underwent adenoidectomy were diagnosed with reactive lymphoid hyperplasia. Of the 1356 patients who underwent tonsillectomy, only two were detected with malignancies. These two patients were adults. While routine histopathologic examination is necessary for every case in adult population, risk factors should be considered in pediatric patients after tonsillectomy and/or adenoidectomy.

Leptin and its receptor in glucose metabolism of T-cell lymphoma.

T-cell lymphoma (TCL) is a group of heterogeneous disorders with a poor response to conventional treatment. In order to identify novel therapeutic targets, the present study investigated the effect of leptin and its receptor on glucose metabolism in TCL. The expression of the leptin receptor (ObR), and glucose transporter (Glut)1 and 4 was detected in TCL and reactive lymphoid hyperplasia (RLH) tissues by immunohistochemical analysis. A higher level of ObR expression was observed in the TCL tissues than in the RLH tissues (58.3 vs. 22.2%; P=0.012), and ObR overexpression was associated with high expression of Glut1 (P=0.007). In vitro analysis using the human TCL MOLT-3 cell line demonstrated that leptin stimulated cell glucose uptake via promoting recruitment and expression of Glut1, effects which were abolished by ObR-specific small interfering RNA (siRNA). Additionally, MOLT-3 cell viability was also increased following leptin treatment. ObR-specific siRNA abolished these responses. In conclusion, these results suggested that leptin serves a critical role in TCL glucose uptake via the ObR.

Lacrimal gland tumors in Turkey: types, frequency, and outcomes

To evaluate the clinical, radiological, and treatment features of lacrimal gland tumors. Retrospective review of 99 eyes of 92 patients with lacrimal gland tumors diagnosed and managed in a single institution between January 1999 and March 2017. Clinical and radiological features, histopathology, treatment methods, and prognosis were evaluated. The mean patient age was 40.3 (range: 7-80)y. The diagnosis was made histopathologically in 91 (91.9%) tumors and on a clinical and radiological basis in 8 (8.1%) tumors. Final diagnoses included idiopathic orbital inflammation (pseudotumor) in 46 (46.5%) lesions, pleomorphic adenoma in 14 (14.1%), adenoid cystic carcinoma in 12 (12.1%), granulomatous inflammation in 10 (10.1%), lymphoma in 5 (5.0%), benign reactive lymphoid hyperplasia in 3 (3.0%), dacryops in 3 (3.0%), carcinoma ex pleomorphic adenoma in 2 (2.0%), adenocarcinoma in 1 (1.0%), dermoid cyst in 1 (1.0%), cavernous hemangioma in 1 (1.0%), and leukemic infiltration in 1 (1.0%). Non-epithelial tumors comprised 64.6% (n=64) of all lacrimal gland tumors, epithelial tumors 32.3% (n=32), dermoid cyst 1% (n=1), cavernous hemangioma 1% (n=1), and leukemic infiltration 1% (n=1). There were in total 78 (78.8%) benign and 21 (21.2%) malignant tumors. Overall, 65% of lacrimal gland tumors were of non-epithelial origin and 32% of epithelial origin. By histopathology and clinical evaluation, 79% of lacrimal gland tumors were benign. The most common lacrimal gland tumors include idiopathic orbital inflammation (46.5%), epithelial (32.3%), and lymphoproliferative (8.1%) lesions.

Increased expression of hypoxia-inducible factor-1 alpha and its impact on transcriptional changes and prognosis in malignant tumours of the ocular adnexa

To investigate the expression profile of the hypoxia-inducible transcription factor-1α (HIF-1α) and its downstream targets in malignancies of the ocular adnexa and to determine its relevance as a prognostic factor for clinical outcome. We included 49 subjects with malignant tumours (25 squamous cell carcinomas (SCC), 15 non-Hodgkin lymphomas, 9 melanomas) and 30 patients with benign tumours of the ocular adnexa (13 papillomas, 7 reactive lymphoid hyperplasias (RLHs) and 10 nevi) as controls. We quantified HIF-1α protein expression by immunohistochemistry and assessed the association between HIF-1α and clinical outcome via Kaplan-Meier analysis. Furthermore, we assessed the expression of HIF-1α downstream factors by transcriptional sequencing using the MACE (massive analysis of cDNA ends) technology. SCCs revealed a strong HIF-1α expression in 61% of tumour cells in comparison with only 22% in papillomas (p < 0.0001). In contrast, malignant melanomas and lymphomas revealed a similar HIF-1α expression compared with nevi and RLHs. Transcriptional sequencing and Gene Ontology Cluster analysis demonstrated 37 hypoxia-associated factors, including HIF-1α, VEGF, SFRP1 and LOXL2 that are significantly increased in SCC and may contribute to tumour proliferation, angiogenesis, and metastasis. Association analysis between HIF-1α immunoreactivity and clinical outcome revealed a trend towards an unfavourable prognosis in malignant tumours with increased HIF-1α expression. HIF-1α protein is increased in malignant tumours of the ocular adnexa, which is associated with an increase in multiple HIF-1α-downstream factors and a trend towards an unfavourable clinical outcome.

Strategy for esophageal non-epithelial tumors based on a retrospective analysis of a single facility.

Although most esophageal non-epithelial tumors are benign tumors, such as leiomyomas, they also include gastrointestinal tumors (GISTs); thus, a histopathological diagnosis is indispensable to determine the optimal treatment strategy. However, no consensus has been reached as to the diagnostic methods and treatments for esophageal non-epithelial tumors. The purpose of this study was to evaluate the reliability of the diagnostic methods and treatments for esophageal non-epithelial tumors in our hospital. All 28 cases of esophageal non-epithelial tumors at Kobe University Hospital from 2008 to 2016 were analyzed retrospectively with respect to the diagnostic methods, histopathological diagnosis, and treatments. Three diagnostic methods, endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA), endoscopic incisional biopsy, and endoscopic submucosal dissection (ESD)/endoscopic mucosal resection (EMR), were performed in our hospital. All GIST cases could be correctly diagnosed by EUS-FNA. Tumors less than approximately 20mm in diameter and located in the superficial layer are good indications for ESD/EMR, which both play roles in diagnosis and treatment. The final diagnoses by these methods consisted of the following: 13 leiomyomas, 5 GISTs, 3 schwannomas, 2 liposarcomas, 3 cysts, 1 reactive lymphoid hyperplasia, and 1 granulosa cell tumor. Fifteen cases underwent surgery. Enucleation or partial resection was performed for leiomyomas, schwannomas and liposarcomas, while esophagectomy was performed for GISTs. Thus, sufficient management of non-epithelial tumors is achieved. Improved endoscopic procedures, including EUS-FNA and ESD/EMR, enabled the appropriate diagnosis and treatment of esophageal non-epithelial tumors.

A retrospective study of the treatment-associated mortality of the patients with primary ocular adnexal mucosa-associated lymphoid tissue lymphoma after the molecular and immunological diagnosis.

e19534Background: Differentiation between primary ocular adnexal mucosa-associated lymphoid tissue (POA-MALT) lymphoma and reactive lymphoid hyperplasias sometimes may be difficult. We have examine...

Reactive Lymphoid Hyperplasia or Tubercular Lymphadenitis: Can Real-Time PCR on Fine-Needle Aspirates Help Physicians in Concluding the Diagnosis?

Background: Enlarged lymph nodes in adult patients often present a diagnostic challenge. In the absence of granuloma or necrosis, the cytology/tissue findings are misleading and relate the enlarged lymph nodes to reactive lymphoid hyperplasia (RLH), because granuloma formation is an immunological response that usually takes 14–100 days to develop. This study assesses the role of real-time (RT)-PCR in the diagnosis of the Mycobacterium complex (MTBC) in lymph node aspirates compared with culture in cases of RLH. Methods: A cross-sectional study was conducted on 112 patients, aged 15–74 years, with a diagnosis of RLH on cytology. RT-PCR for MTBC detection and culture on Löwenstein-Jensen medium for tubercular bacilli was done on lymph node aspirates. Comparative values with reference to culture were calculated. The χ² value, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LR) were calculated. Results: Out of 112 RLH cases, 35 (31%) were positive on both RT-PCR and culture. RT-PCR was positive in 43 cases and culture was positive in 44 cases. The χ² test was found to be highly significant. PPV, NPV, positive LR, and negative LR were 81.4%, 87%, 6.76, and 0.23, respectively. Conclusion: RT-PCR for MTBC proves to be useful in arriving at a conclusive diagnosis in patients with a cytological diagnosis of RLH.

Expression and clinical significance of miR-23a and MTSS1 in diffuse large B-cell lymphoma.

The present study investigated the expression and clinical significance of micro-ribonucleic acid-23a (miR-23a) and metastasis suppressor 1 (MTSS1) in diffuse large B-cell lymphoma (DLBCL). A total of 70 cases of tumor tissues of patients with DLBCL and 30 cases of reactive lymphoid hyperplasia tissues were collected. OCI-LY10 cell was transfected with miR-23a antisense oligonucleotide (miR-23a ASO). The expression of miR-23a and MTSS1 in tumor tissues of patients with DLBCL and reactive lymphoid hyperplasia tissues were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and immunohistochemistry. Spearmans test was used for correlation analysis was also performed for their expression. The relationship of the expressions of miR-23a and MTSS1 with the pathological parameters of patients with DLBCL was further analyzed. The DLBCL OCI-LY10 cells were cultured in vitro, and gene silencing downregulated the expression of miR-23a in OCI-LY10 cells. The expression of miR-23a was studied via RT-qPCR, and the effect of downregulation of miR-23a on MTSS1 protein expression was determined by western blot analysis. Moreover, the effects of miR-23a on the proliferation, metastasis and invasion capacities of OCI-LY10 cells were observed by both methyl thiazolyl tetrazolium (MTT) assay and Transwell chamber assay. The results of RT-qPCR showed that the mRNA expression of miR-23a in DLBCL tissues was significantly higher than that of reactive hyperplasia tissues. Immunohistochemical results revealed that the positive expression rate of MTSS1 in DLBCL tissues (30.00%) was significantly lower in comparison to reactive hyperplasia tissues (90.00%). Correlation analysis revealed that the miR-23a expression had a significant negative correlation with MTSS1 expression (r=−0.538, p=0.01). The expression of miR-23a and MTSS1 were correlated with the Ann Arbor staging, extranodal invasion and International Prognostic Index (IPI) scores of patients (p<0.05). However, they had no significant correlation with the sex and age of patients (p>0.05). After the downregulation of miR-23a expression, the MTSS1 protein expression in OCI-LY10 cells showed a significant increase. However, the proliferation, metastasis and invasion capacities of OCI-LY10 cells were obviously decreased. In conclusion, miR-23a promoted the proliferation, invasion and metastasis of DLBCL OCI-LY10 cells through the targeted inhibition of MTSS1. The high expression of miR-23a and the low expression of MTSS1 protein could be used as reference indexes for the prognosis of DLBCL.

Efficacy of Fine-Needle Aspiration Cytology in the Diagnosis of Tuberculous Cervical Lymphadenitis

Objective: This study assesses the role of fine-needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis (TL) in comparison with histology and bacteriology findings. Study Design: We undertook a descriptive retrospective study of 937 FNAC specimens from 851 patients with cervical lymph nodes. The FNAC findings were then compared to histopathology and bacteriology. Results: Of the 937 aspirates, the cytopathological diagnoses consisted of 426 (55.9%) TL, 185 (24.3%) reactive lymphoid hyperplasia, 18 (2.3%) suppurative inflammation, 78 (10.2%) malignant metastatic tumor, and 54 (7%) lymphoma. Of the 426 TL cases, 171 were diagnosed by FNAC combined with bacteriological examination. In this group, 22 cases were found to be positive on Ziehl-Neelsen stain and 16 by culture. A histopathology report was available for 62 cases. Compared to histopathology, the overall diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in the diagnosis of cervical TL were, respectively, 96.77, 100, 100, and 96.67%. When comparing bacteriology to histopathology, these values were 97.44, 100, 100, and 91.67%. Conclusion: Our study shows that FNAC is a sensitive and specific tool for the diagnosis of cervical TL.

Epigenetic silencing of the tumor suppressor genes SPI1, PRDX2, KLF4, DLEC1, and DAPK1 in childhood and adolescent lymphomas

ABSTRACTThe aim of the study was to investigate the expression and methylation status of seven distinctive genes with tumor suppressing properties in childhood and adolescent lymphomas. A total of 96 patients with Hodgkin Lymphoma (HL, n = 41), Non-Hodgkin Lymphoma (NHL, n = 15), and reactive lymphoid hyperplasia (RLH, n = 40, as controls) are included in the research. The expression status of CDKN2A, SPI1, PRDX2, DLEC1, FOXO1, KLF4 and DAPK1 genes were measured with QPCR method after the RNA isolation from paraffin blocks of tumor tissue and cDNA conversion. DNA isolation was performed from samples with low gene expression followed by methylation PCR study specific to promoter regions of these genes. We found that SPI1, PRDX2, DLEC1, KLF4, and DAPK1 genes are significantly less expressed in patient than the control group (p = 0.0001). However, expression of CDKNA2 and FOXO1 genes in the patient and control groups were not statistically different. The methylation ratios of all genes excluding the CDKN2A and FOXO1 were significantly higher in the HL and NHL groups than the controls (p = 0.0001). We showed that SPI1, PRDX2, DLEC1, KLF4 and DAPK1 genes are epigenetically silenced via hypermethylation in the tumor tissues of children with HL and NHL. As CDKN2A gene was not expressed in both patient and control groups, we conclude that it is not specific to malignancy. As FOXO1 gene was similarly expressed in both groups, its relationship with malignancy could not be established. The epigenetically silenced genes may be candidates for biomarkers or therapeutic targets in childhood and adolescent lymphomas.