The incidence of indolent lymphomas in the lymph nodes and extranodal regions is quite different. Follicular lymphoma (FL) is most common in the nodes, and it seems to be least common in the gastrointestinal (GI) tract, where mucosa-associated lymphoid tissue lymphoma arises most frequently. The authors report that the incidence of FL is unexpectedly high in the duodenum compared with other portions of the GI tract. FL was detected in only eight of 222 cases of GI lymphoma (3.6%). However, five cases of FL arose in the duodenum, which accounted for 38.5% of 13 duodenal lymphomas. Only in two patients did FL arise in either the stomach or the colorectum, and in the remaining patients FL was widespread with lymphomatous polyposis. Duodenal FL was composed of neoplastic follicles with small cleaved cells in dominance, and the immunophenotype of the lymphoma cells was CD10+, BCL-2+, CD20+, CD75+, CD79+, CD3-, CD5-, cyclin D1-, CD23-, and CD45RO-. All the patients were women age 37 to 66 years (average age, 52.4 yrs). In all patients the lymphoma was present around the ampulla of Vater, and four of five patients showed multiple small-size polyps. Although lymphoma cell infiltration was confined to the submucosa in the four patients examined, the regional lymph nodes were involved partially in two patients without distant metastasis. All patients are alive at 2 to 50 months of follow up (average, 27 mos), which is comparable with the prognosis for indolent nodal lymphomas. These results suggest that the duodenum has a distinct background of histogenesis of the lymphomas and that biopsy specimens from the duodenum with multiple polyps should be examined carefully.
Expression of the CD30 antigen in lymphoid neoplasms and reactive lesions were examined immunohistologically using the monoclonal antibody BerH2. CD30 antigen was expressed in 17 of 18 patients with Hodgkin's disease (HD), all of three anaplastic large cell lymphomas (ALCL), 11 of 52 T-cell malignant lymphomas (TML) including ALCL, 13 of 153 B-cell malignant lymphomas (BML) including ALCL, two of three malignant histiocytosis and one of four plasmacytomas. Although a single case of small cell lymphoma was positive, in cases of mixed cellular morphology, neoplastic cells of larger or more pleomorphic nuclei tended to be stained more extensively and intensively. This antigen is expressed in TML significantly more often than in BML (P < 0.05). CD30 antigen was expressed less frequently at clinical stage I than those of stages II to IV. There was no significant relationship between CD30 antigen expression and that of proliferating cell nuclear antigen or CD43 antigen in non-Hodgkin's lymphomas (NHL). The CD30 antigen expression did not affect the prognosis of NHL overall, but in high grade TML, CD30 antigen-positive individuals tended to have a more favorable prognosis than those that were negative. In reactive diseases, some plasma cells, immunoblasts, interdigitating cells, follicular center cells and histiocytes were stained positively, but not always, and with variable intensity. These results suggest that CD30 antigen is expressed in various cell lineages to some extent and may relate to cellular activation in some instances. When making the histopathologic diagnosis of HD or NHL including ALCL, CD30-positive cell should be carefully interpreted.(ABSTRACT TRUNCATED AT 250 WORDS)
Aims-To examine the expression of CD44 variant exon 9 in early colorectal malignancies. Methods-Formalin fixed, paraffin wax embedded tissue sections from 30 cases of tubular adenoma and 35 cases of adenoma with focal carcinoma of the colon were examined immunohistochemically using a monoclonal antibody (MAb 11.24) directed against CD44-9v. Results-In the normal colorectal mucosa immunoreactivity was confined to the basal part of the crypts and was expressed in less than 10% of crypt cells. CD44-9v was expressed in the superficial part of tubular adenoma with mild atypia in 67% ofthe cases and in 19% ofthe tumour cells. The immunoreactivity was observed along the basement membrane in mild atypia, as in the non-neoplastic crypts. In the course of progression to severe atypia the spatial polarity of immunoreactivity was lost, and the extent of CD44-9v expression increased in intensity and in the percentage of positive cases and positive cells. In the carcinomatous lesions of adenoma with focal carcinoma, 94% ofthe cases and 44% of the tumour cells were positive for CD44-9v protein.Conclusion-CD44-9v may be overexpressed at the early stage of colorectal tumorigenesis and this increase continues thoughout the course of the disease. (7 Clin Pathol 1996;49:478-481) Keywords: colorectal carcinoma, adenoma with focal carcinoma, tumour marker, colorectal tumorigenesis, CD44 variant exon 9, immunohistochemistry. CD44-9v is very weakly expressed on leucocytes, and CD44-6v and -4v are virtually absent. However, exons 9v and 6v are transiently upregulated on T cells after mitogenic stimulation.6 8 In rats, expression of exon 6v conferred metastatic potential to nonmetastasising pancreatic carcinoma cells.9 10 Several CD44v isoforms are also overexpressed in human tumours, including colorectal carcinomas.8 11-16 Regarding colorectal tumorigenesis, there are two theories which have been the subject of much discussion: the de novo carcinogenesis theory2 17 18 and the adenoma-carcinoma sequence theory.`-21 Recently, it has been reported that expression of CD44-6v, which is a human homologue of the rat metastasis associated variant of CD44, is largely restricted to the advanced stages of tumour development and is also found at a greater incidence and intensity in metastatic than in non-metastatic carcinomas.'6 However, little is known about the expression of exon 9v in colonic adenomas and cancers. The present study was conducted to investigate the expression of CD44-9v on human colonic polyps with particular attention to early colonic carcinogenesis from the standpoint of the multistep carcinogenesis model.22Methods Sixty five colonic polyps were selected from the files of the Department of Pathology, Okayama University Medical School. All of them had been resected by endoscopic polypectomy, fixed in 10% buffered or non-buffered formalin, and embedded in paraffin wax. They comprised 35 cases of adenoma with focal carcinoma, 18 of adenoma with mild atypia, and 12 of adenoma with moderate atypia.
A 41-year-old male patient with aggravated epigastralgia and nausea was admitted to Central Aizu General Hospital in February 1997. His past history showed a colonic polyp and anemia in the fourth decade. The patient looked healthy, but showed abdominal distension and tenderness, and pigmented lips. A plain abdominal X-ray revealed a dilation of the small intestine with niveau. Computed tomography disclosed multiple target signs. An emergency laparotomy clarified four intussusceptions of the small intestine with numerous polyps. Three were successfully reduced, while one jejunal intussusception was resected. Due to a fear of recurrence, a total of over 290 polyps were removed. His illness was diagnosed to be Peutz-Jeghers syndrome with a histology of hamartomatous polyps. He thereafter did well for 6 years, when he underwent an ileal resection for another intussusception caused by a newly grown lipoma. He was able to retain his job, but anemia and hypoproteinemia due to the proliferation of polyps necessitated treatments at the outpatient clinic. In May 2005, he underwent a third emergency laparotomy for an intussusception, followed by a resection of the ileum and 54 polyps. Since then he has been able to lead a normal life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.