Objective. In small intestinal malignant lymphoma (SIML), the correlation between specific chromosomal abnormalities and clinicopathological features remains unclear. The aim of this study was to determine the frequen...Objective. In small intestinal malignant lymphoma (SIML), the correlation between specific chromosomal abnormalities and clinicopathological features remains unclear. The aim of this study was to determine the frequency of chromosomal translocations involving the BCL1, BCL2, c- MYC, BCL6 and MALT1 genes by using fluorescence in situ hybridization directly on paraffin- embedded tissue sections (tissue- FISH). Material and methods. Twenty- six cases diagnosed as having SIML between 1996 and 2003 were the subjects of the clinicopathological investigation conducted in this study. Tissue- FISH was performed with specific probes on paraffin- embedded tissue sections as described previously. Results. The primary site was frequently located at the duodenum (9 cases, 35% ). In accordance with the World Health Organization classification, 14 (53% ) cases were diagnosed as having diffuse large B- cell lymphoma (DLBCL) and 6 (23% ) as marginal zone B- cell lymphoma of mucosa- associated lymphoid tissue (MALT). Macroscopically, DLBCL and MALT lymphoma displayed various macroscopic features. Cytogenetically, IGH- BCL2 translocation was detected in 3 (21% ) out of 14 DLBCL cases, but in none of the MALT lymphomas. BCL6 translocation was detected in 5 (35% ) of 14 DLBCL cases and in 1 (17% ) of 6 MALT lymphoma cases (17% ). API2- MALT1 translocation was detected in 1 (7% ) of 14 DLBCL cases and in 1 (17% ) of 6 MALT lymphoma cases. Conclusions. The duodenum was preferentially involved in SIML.DLBCL and MALT lymphoma showed various macroscopic features. Tissue- FISH analysis disclosed that DLBCL is cytogenetically heterogeneous. Furthermore, our study validated tissue- FISH as an additional promising diagnostic tool for detecting specific chromosomal translocations in NHL.展开更多
A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice...A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice previously. However, numerous investigations, including hematological and biochemical studies, gastroscopy, colonoscopy, computed tomography, scintigraphy, and angiography had failed to detect the source of bleeding in the gastrointestinal tract. On this a dmission,double-balloon enteroscopy was performed and revealed several ulcer scars with localized dilation of the ileum. Histopathological examination of the biopsy specimens reveled no abnormal finding. Partial resection of the ileum was performed to prevent further gastrointestinal bleeding, and histopathological examination of the resected specimen revealed aggregation of atypical lymphocytes, predominantly in the muscularis propria layer. Immunohistochemical examination demonstrated that the tumor cells were positive for CD20 and BCL2, but negative for UCHL1. Based on these findings, the lesion was diagnosed as a marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue. Eighteen months after surgery, the patient was still in complete remission.展开更多
Reports of cytomegalovirus (CMV) colitis mainly concern patients with immunocompromisation resulting from, among others, HIV infection, allogeneic bone marrow transplantation and solid organ transplantation. CMV colit...Reports of cytomegalovirus (CMV) colitis mainly concern patients with immunocompromisation resulting from, among others, HIV infection, allogeneic bone marrow transplantation and solid organ transplantation. CMV colitis rarely occurs during standard chemotherapy for non-Hodgkin’s lymphoma (NHL). An unusual case of CMV enterocolitis in a 62-year-old patient is reported. After a first course of salvage chemotherapy for NHL, diffuse erosions and sloughing mucosa were seen throughout the large bowel. The final diagnosis was based on histological findings. Although ganciclovir and foscarnet are effective for CMV viremia, their use in the treatment of severe diarrhea in our patient did not result in improvement for one week, whereas concomitant use of octreotide led to rapid improvement. Octreotide may therefore be an effective agent for severe colitis.展开更多
文摘Objective. In small intestinal malignant lymphoma (SIML), the correlation between specific chromosomal abnormalities and clinicopathological features remains unclear. The aim of this study was to determine the frequency of chromosomal translocations involving the BCL1, BCL2, c- MYC, BCL6 and MALT1 genes by using fluorescence in situ hybridization directly on paraffin- embedded tissue sections (tissue- FISH). Material and methods. Twenty- six cases diagnosed as having SIML between 1996 and 2003 were the subjects of the clinicopathological investigation conducted in this study. Tissue- FISH was performed with specific probes on paraffin- embedded tissue sections as described previously. Results. The primary site was frequently located at the duodenum (9 cases, 35% ). In accordance with the World Health Organization classification, 14 (53% ) cases were diagnosed as having diffuse large B- cell lymphoma (DLBCL) and 6 (23% ) as marginal zone B- cell lymphoma of mucosa- associated lymphoid tissue (MALT). Macroscopically, DLBCL and MALT lymphoma displayed various macroscopic features. Cytogenetically, IGH- BCL2 translocation was detected in 3 (21% ) out of 14 DLBCL cases, but in none of the MALT lymphomas. BCL6 translocation was detected in 5 (35% ) of 14 DLBCL cases and in 1 (17% ) of 6 MALT lymphoma cases (17% ). API2- MALT1 translocation was detected in 1 (7% ) of 14 DLBCL cases and in 1 (17% ) of 6 MALT lymphoma cases. Conclusions. The duodenum was preferentially involved in SIML.DLBCL and MALT lymphoma showed various macroscopic features. Tissue- FISH analysis disclosed that DLBCL is cytogenetically heterogeneous. Furthermore, our study validated tissue- FISH as an additional promising diagnostic tool for detecting specific chromosomal translocations in NHL.
文摘A 72-year-old man was admitted to our hospital to undergo a novel small-intestinal endoscopic procedure. He had had occasional episodes of hematochezia over a 2-year period, during which he had been hospitalized twice previously. However, numerous investigations, including hematological and biochemical studies, gastroscopy, colonoscopy, computed tomography, scintigraphy, and angiography had failed to detect the source of bleeding in the gastrointestinal tract. On this a dmission,double-balloon enteroscopy was performed and revealed several ulcer scars with localized dilation of the ileum. Histopathological examination of the biopsy specimens reveled no abnormal finding. Partial resection of the ileum was performed to prevent further gastrointestinal bleeding, and histopathological examination of the resected specimen revealed aggregation of atypical lymphocytes, predominantly in the muscularis propria layer. Immunohistochemical examination demonstrated that the tumor cells were positive for CD20 and BCL2, but negative for UCHL1. Based on these findings, the lesion was diagnosed as a marginal-zone B-cell lymphoma of mucosa-associated lymphoid tissue. Eighteen months after surgery, the patient was still in complete remission.
文摘Reports of cytomegalovirus (CMV) colitis mainly concern patients with immunocompromisation resulting from, among others, HIV infection, allogeneic bone marrow transplantation and solid organ transplantation. CMV colitis rarely occurs during standard chemotherapy for non-Hodgkin’s lymphoma (NHL). An unusual case of CMV enterocolitis in a 62-year-old patient is reported. After a first course of salvage chemotherapy for NHL, diffuse erosions and sloughing mucosa were seen throughout the large bowel. The final diagnosis was based on histological findings. Although ganciclovir and foscarnet are effective for CMV viremia, their use in the treatment of severe diarrhea in our patient did not result in improvement for one week, whereas concomitant use of octreotide led to rapid improvement. Octreotide may therefore be an effective agent for severe colitis.
