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The expression of cyclin D1 in malignant lymphomas is largely restricted to mantle cell lymphoma, plasma cell myeloma and hairy cell leukemia. In virtually all cases of mantle cell lymphoma and some cases of plasma cell myeloma, the t(11;14) translocation between the immunoglobulin heavy chain and the CYCLIN D1 genes can be demonstrated using fluoroscence in situ hybridization. There are also anecdotal reports of the expression of cyclin D1 in other lymphoma subtypes including small lymphocytic lymphoma, Hodgkin lymphoma and anaplastic large cell lymphoma. In our routine practice, we have encountered a few cases of diffuse large B-cell lymphomas with immunohistochemical evidence of cyclin D1-expression. Therefore, an unselected large number of diffuse large B-cell lymphomas (n=231) from archived material collected at three university hospitals in Sweden were stained for cyclin D1 and microscopically evaluated with regard to cyclin D1-expression. The lymphomas studied included 11 of anaplastic subtype, 4 of immunoblastic subtype, 6 of T-cell/histiocyte rich subtype and the remainder of centroblastic subtype. 10 (4%) of the 231 cases showed nuclear positivity for cyclin D1. 9 of these were of centroblastic subtype and 1 of anaplastic subtype. All of the cyclin D1 positive cases were negative for CD5. The cyclin D1-positive cases were further subjected to fluoroscence in situ hybridization to determine the presence of the t(11;14) translocation. One of these cases (of centroblastic subtype) showed a hybridization pattern consistent with the t(11;14) rearrangement. Two other cases (one of centroblastic subtype and one of anaplastic subtype) displayed a fluoroscence pattern with amplified cyclin D1 signals in the absence of evidence of the t(11;14) translocation, possibly related to CYCLIN D1 gene amplification. Thus, contrary to the current view, there appears to exist a certain number of cyclin D1-positive and CD5-negative diffuse large B-cell lymphomas some of which display amplified cyclin D1 signals or the t(11;14) translocation. The results emphasize the importance of CD5 and cyclin D1 immunostaining in routine diagnostics of diffuse large B-cell lymphomas. Whether CD5-negative cyclin D1-positive lymphomas with the t(11;14) translocation and classic centroblastic morphology should be classified as mantle cell lymphomas or diffuse large B-cell lymphomas remains debatable.

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Fine needle spleen aspirates from 18 cases of uncomplicated polycythaemia vera, 9 of which had splenomegaly, were scrutinized in retrospect. Only in one of these specimens were a few normoblasts and myelocytes found; in the remaining 17 cases no trace of myeloid metaplasia could be detected. The only conspicuous abnormality observed in this material was a very high number of platelets observed in most of the aspirates.

Objective The indication of surgery in primary hyperparathyroidism has been controversial, as many patients experience mild disease. The primary aim was to evaluate fracture incidence in a contemporary population‐based cohort of patients having surgery for primary hyperparathyroidism. The secondary aim was to investigate whether preoperative serum calcium, adenoma weight or multiglandular disease influence fracture incidence. Design A retrospective cohort study with population controls. Primary outcomes, defined by discharge diagnoses and prescriptions, were any fracture and fragility fracture, secondary outcomes were multiple fractures anytime and osteoporosis. Subjects were followed 10 years pre‐ and up to 10 years postoperatively (or 31 December 2015). Multiple events per subject were allowed. Fracture incidence rate ratios (IRRs) for patients pre‐ and postoperatively were tabulated and evaluated with mixed‐effects Poisson regression. Secondary outcomes were evaluated using conditional logistic regression. Patients A Swedish nationwide cohort of patients having surgery for primary hyperparathyroidism (n = 5009) from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery between 2003 and 2013 was matched with population controls (n = 14,983). Data were cross‐linked with Statistics Sweden and the National Board of Health and Welfare. Measurements Preoperative serum calcium and adenoma weight at pathological examination. Results Patients had an increased incidence rate of any fracture preoperatively, IRR 1.27 (95% confidence interval: 1.11–1.46), highest in the last year before surgery. Fracture incidence was not increased postoperatively. Serum calcium, adenoma weight and multiglandular disease were not associated with fracture incidence. Conclusions Fracture incidence is higher in patients with primary hyperparathyroidism but is normalized after surgery.