Background Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL) in Western countries. However, it is relatively rare in Asia. This study examined epidemiologic characteristics of FL in South Korea, with an emphasis on recent trends of increase in cases.
Methods We retrospectively examined 239 cases of newly diagnosed FL at a large tertiary institution in Korea (Asan Medical Center, Seoul, Republic of Korea) between 2008 and 2017. Age-adjusted incidence rates and clinicopathological variables were analyzed, and joinpoint regression analysis was used to identify the changes.
Results The age-adjusted incidence of FL significantly increased during the study period (p = .034), and the ratio of (relative incidence) patients with FL to patients with NHL increased from 4.28% to 9.35% in the same period. Over the 10-year study assessment duration, the proportion of patients with stage III/IV FL (p = .035) and expression of BCL2 (p = .022) or BCL6 (p = .039) significantly increased. From 2013–2017, the proportion of patients with highrisk Follicular Lymphoma International Prognostic Index (FLIPI) score increased (21.5% to 28.7%), whereas that of low-risk FLIPI decreased (55.4% to 38.6%), although those results were not statistically significant (p = .066).
Conclusions We found an increasing incidence of FL, with a disproportionate increase in the incidence of high-stage disease and recent changes in the clinicopathologic features of the Korean patient population.
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JL1 is a novel human thymocyte differentiation antigen, which is exclusively expressed by double positive (CD4+ CD8+) cortical thymocytes. We previously reported that the JL1 antigen was selectively expressed on the surface of acute lymphoblastic leukemia cells.
T-Lymphoblastic lymphoma/acute lymphoblastic leukemia (T-LBL/ALL), the 6th prevalent lymphoma in Korea, is composed of immature neoplastic lymphoid cells and shows a rapid response to appropriate treatment. Early and precise diagnosis of LBL/ALL is crucial. Light microscopic distinction of LBL/ALL from other non-Hodgkin's lymphomas can sometimes be difficult and is aided by immunophenotypic studies. This study is designed to investigate the diagnostic utility of anti-JL1 monoclonal antibody (YG5) for LBL/ALL in formalin fixed, paraffin embedded tissue. We collected 25 cases of LBL/ALL (18 T-cell, 5 B-cell and 2 undetermined lineage) from 1993 through 1998. We confirmed the diagnosis using morphologic and immunophenotypic data. Strong JL1 expression along cell membrane was observed in 16 out of 18 T-LBL/ALL cases (89%). In 28 cases of other types of lymphomas of including 7 cases of non-T LBL/ALL and 14 cases of small round cell tumors, no JL1 expression was identified. These results show that the immunostaining for JL1 using YG5 on paraffin embedded sections can be useful for the specific diagnosis of T-LBL/ALL in routine diagnostic service.
We reviewed 2159 consecutive cases of surgically resected appendices. The appendectomy specimen consisted of 91 cases of acute focal appendicitis (5.4%), 926 cases of acute suppurative appendicitis (55.1%), 228 cases of acute gangrenous appendicitis (13.6%), 63 cases of periappendicitis (3.8%), 13 cases of pure fibrous obliteration of the lumen (FOL; 0.8%), 18 cases of other diseases (7 mucoceles, 2 mucinous cystic neoplasms, 4 carcinoids, 2 metastatic carcinomas, 2 tuberculous appendicitides, and 1 eosinophilic appendicitis; 1%), and 342 cases with no diagnostic abnormality (20.3%). Patients having acute appendicitis ranged from 3 to 84 years of age, and patients in their 10's and 20's occupied over half of 2159 cases. Diagnostic accuracy of the acute appendicitis was 79.7%. Incidence of the acute appendicitis was suspected to be 7.2/100,000/year. Twenty eight cases of acute appendicitis were associated with diverticula. In the former acute primary diverticulitis led to acute appendicitis in 14 of 28 cases. Among 478 incidental appendectomy cases, there were 3 acute focal appendicitides, 1 acute suppurative appendicitis, 1 eosinophilic appendicitis, 32 periappendicitides, 1 mucocele, 40 pure FOLs, 1 deciduosis, 1 endometriosis, and 1 diverticulosis without inflammation. There were 69 cases of FOL (32 complete forms and 37 incomplete forms), among which 13 cases were associated with acute appendicitis. FOL was more frequent in female patients as well as patients over 40 years of age. Incomplete FOL was considered to progress to complete form with age. The incidence of appendiceal diverticula was higher, whereas the incidences of carcinoid tumor and FOL were lower compared with that in the western report. In 14 of 28 cases the appendiceal diverticulum was the site in which acute appendicitis began.
BACKGROUND The natural killer cell antigen CD56 (NCAM) is a member of the immunoglobulin superfamily and is expressed on neurons, astrocytes, and Schwann cells. Recently, it has been reported that CD56 expression is detected on plasma cells of multiple myeloma by flow cytometry. METHOD In this study, to test the diagnostic usefulness of the anti-CD56 antibody for plasma cell neoplasm on paraffin-embedded materials, we performed immunohistochemical staining of samples from 19 patients with plasma cell neoplasms. These cases included 14 cases of multiple myeloma, 3 cases of solitary plasmacytoma of the bone, and two cases of extramedullary plasmacytoma. RESULTS The neoplastic plasma cells from 68 % of the patients with plasma cell neoplasms expressed CD56 highly.
CD56 was expressed in all three cases of solitary plasmacytoma of the bone and one of two extramedullary plasmacytoma, and nine out of 14 multiple myeloma cases. In contrast, reactive plasma cells from the 18 patients with miscellaneous lesions were completely negative for CD56. CONCLUSIONS CD56 is aberrantly expressed on the neoplastic plasma cells, and it may be used as a useful marker for the diagnosis of plasma cell neoplasms in paraffin-embedded tissues.
Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46-year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.
BACKGROUND JL1 is a novel antigen that has been reported to be expressed exclusively in immature CD4 CD8 double positive T-cells in the thymic cortex. Thymomas are often infiltrated with lymphocytes that are mostly immature T-cells. METHODS: We evaluated 67 cases of surgically resected thymomas and reviewed their histological, surgical, and clinical findings. Representative sections were immunostained using anti-JL1 monoclonal antibody and the immunostaining score was evaluated in each case. RESULTS: JL1 was strongly positive in immature T cells infiltrated in various subtypes of thymomas. The mean value of the immunostaining score was 0 for type A, 0.24 for the A areas of type AB, 2.71 for the B areas of type AB, 3 for type B1, 1.87 for type B2, 0.67 for type B3, and 0.13 for type C. The immunostaining score correlated with the histological subtypes according to the WHO classification, and stages according to the modified Masaoka system. CONCLUSION: JL1 was specifically detected in immature thymocytes in thymomas. Therefore, JL1 immunostaining can be useful for subtyping thymomas. JL1 can also serve as an adjunctive marker to diagnose thymomas in small biopsy specimens.