1 European Federation of Cytology Societies 4tu Annual Tutorial in Cytopathology Trieste, June 6-10, 2011 Fine needle cytology of lymph nodes: Non neoplasticneoplastic condictions Pio Zeppa MD PhD Pio Zeppa MD, PhD Dipartimento di Scienze Biomorfologiche e Funzionali, Università di Napoli, Federico II Naples, Italy
2 Why cytology for lymph nodes? REACTIVE!!
3 Why cytology for lymph nodes? Peri carotideal lymph node, the surgeon refused to perform the excision, US guided FNC: NHL Deep cervical node: suspect NHL, FNC: metastasis t high h respiratory tract, nasopharyngeal carcinoma, RX therapy No surgery! Diffuse spleen enlargement patient t F. S.: fourth relapse from MCL! t(11;14)(q13;q32)
4 Why cytology for lymphoma? 1,5 million of new cases in the world Doubled incidence in the last 20 yrs patients and new cases yrs, in Italy Increased n. of complete remissions and prolonged survivals 30% of patients will develop recurrences 30% will develop non lymphomatous swellings Non invasive procedures do not produce definitive diagnoses
5 Why cytology for lymphoma?
6 Lymph nodal cytology and ancillary techniques Hodgkin s disease immunocytochemistry metastases large cell NHL Diff Quik flow cytometry reactive? small medium cell NHL? FISH PCR others
7 From Zajicek to flow cytometry Colorado M, et al: Simultaneous cytomorphologic and multiparametric flow cytometric analysis onlymph node samples is faster than and as valid as histopathologic study todiagnose most non Hodgkin lymphomas. Am J Clin Pathol. 2010; 133:81. Katz RL et al.: Fine needle aspiration cytology of peripheral T cell lymphoma. A cytologic, immunologic, and cytometric study. Am J Clin Pathol. 1989; 9:120. Dunphy CH, Katz RL et al: Leukemic lymphadenopathy: diagnosis by fine needle aspiration. Hematol Pathol. 1989; 3:35.
11 Normal lymph node histology
12 Reactive hyperplasia (BRH)
13 non-specific hyperplasia with follicular centre expansion Non-specific hyperplasia with follicular centre expansion: smears show numerous centrocytes and centroblasts with two or more eccentrical nucleoli intermingled with small mature lymphocytes with slightly lengthened nuclei and cytoplasmic tales, plasma cells and immunoblasts.
14 non-specific hyperplasia with follicular centre expansion Cy: numerous centrocytes and centroblasts intermingled with a variable number of small lymphocytes. Differential diagnosis with a NHL is often pointed out. FC :T and B-cell populations a follicular centre cell population which co-expresses CD19/CD10 and FC :T and B-cell populations, a follicular centre cell population which co-expresses CD19/CD10 and balanced expression of kappa and lambda light chains
15 non-specific hyperplasia with interfollicular expansion Non specific hyperplasia with interfollicular expansion: the smear shows a prevalence of mature Non specific hyperplasia with interfollicular expansion: the smear shows a prevalence of mature lymphocytes with large nucleolated immunoblasts and plasma cells.
16 non-specific hyperplasia with interfollicular expansion FC in non specific hyperplasia with interfollicular expansion may shows a prevalence of T-lymphocytes (CD5) with CD2/3/7 co-expression.
17 Viral and post-vaccinial FNC show small lymphocytes and numerous centrocytes t and centroblasts intermingled with small mature lymphocytes, plasma cells and immunoblasts. Capillary structures, phagocyting histiocytes and eosinophils may also be present. Differential diagnosis: follicular lymphoma (see NHL).
18 Mononucleosis FNC shows normal cell type constituents including centrocytes and centroblasts. Numerous immunoblasts with large nucleoli and a rim of blue cytoplasm are present. Macrophages and capillary structures may be present. Differential diagnosis: Hodgkin lymphoma (see HL).
19 Histiocytosis This is mainly observed in lymph nodes draining inflamed tissues or organs or cancer. Corresponding smears may show histiocytes, small lymphocytes and macrophages with engulfed cytoplasm. Differential diagnosis: Sinus histiocytosis with massive lymphadenopathy.
20 Suppurative lymphadenitis This condition can be observed in lymph nodes draining bacterial infections. Smears show of granulocytes and a variable amount of lymphocytes in a necrotic background. Attention should be paid because metastatic squamous cell carcinoma and rarely HL, may show a prevalent necrotico-suppurative background.
21 Granulomatous lymphadenitis Granulomatous lymphadenitis may be determined d by several infective agents or by different pathological processes, sarcoidosis and tuberculosis being the most frequent. Granulomatous lymphadenitis may also occur along hematological diseases or after chemotherapy or radiotherapy. Smears show epithelioid cells and/or multinucleated giant cells, either isolated or in a granulomatous arrangement in a lymphoid background.
22 Toxoplasmosis Reactive lymph node with toxoplasmosis:small groups of epitheliod cells intermingled with lymphocytes.
28 FC sub classification of small/medium cell size NHL phenotype LpcL SLL MCL FCL MZL/ MALT SNCL PTCL NK k:λ>4:1 or <1: /- - - CD19/CD CD19/CD CD19/CD23+ +/ CD19/FMC7+ +/ / CD19/CD bl2+/cd10 bcl-2+/cd CD4+/CD8-, CD4-/CD CD3+, CD5+, CD CD2/CD3+CD7- or CD2/CD7+CD CD3+/- CD56+ CD
29 Cytology, phenotype (FC), IGH quantitative assessment (PCR), IGH integrity evaluation (FISH) of lymphoid cells IGH probe, split signal
30 IGH (14q32) is the most frequently involved in different translocations of B cell NHL t (14;18)(q32;q21) in FL and a subset of DLBCL t (11;14)(q13;q32) in MCL t (q14;q32) in 60 % in MM with different chromosomal partners t (9;14)(p13;q32) in 50% of LPCL and some cases of MZL t (8;14)(q24;q32) in 100% of BL The IGH FISH DNA probe, split signal, is a mixture of two fluorochrome: the green labelled DNA probe that binds to a 612 kb telomeric segment, and the red labelled that binds to a 460 kb centromeric segment, to the IGH breakpoint Therefore IGH FISH DNA probe, split signal should detect any breakage involving the IGH locus at chromosome 14q32.
31 Indirect FC markers of malignancy CD5/CD19 co expression CD19/CD10 co expression in >50% of the gated cells
37 bcl 2 in follicular lymphoma Laane E et al.: Flow cytometric immunophenotyping including Bcl 2 detection on fine needle aspirates in the diagnosis of reactive lymphadenopathy and non Hodgkin's lymphoma. Cytometry B Clin Cytom. 2005;64:34. Bcl 2 quantification might be useful using antisense oligonucleotides
38 FL with dim or not expressed light chains t(14;18)(q32;q21) p T(
39 Marginalzone B cell lymphoma (MZL)
40 Extranodal B cell lymphoma of mucosa associated lymphoid tissue (MALT lymphoma)
41 Diffuse large B cell lymphoma
42 Burkitt lymphoma (BL)
43 Peripheral T cell lymphoma (PTL) CD45 Ro
44 Peripheral T cell lymphoma (PTL)
45 Peripheral T cell lymphoma (PTL) CD45Ro
46 NK cell lymphoma/leukemia
47 Pitfalls and shortcomings! Hodgkin Lymphoma anaplastic large cell lymphoma CD30
48 F, 57 yrs, FNC of 50 mm nodule in the left thyroidal area Cytological diagnosis: T cell lymphoproliferative process
49 Histological i l diagnosis: i benign type B1 ectopic thymoma CD45Ro CK-pan
50 Thymic lymphocytes: y mature polyclonal T cells profile: (CD2+,CD3+,CD5+,CD7+) CD10+ in an immature T cell subsets maturation: CD4 CD8 in the cortex, continues as CD4+ CD8+, reaches maturation as CD4+ CD8 or CD4 CD8+ in the medulla. CD4+/CD8+ is a specific feature of intrathymic T cells
51 40 yrs old female, HIV positive with right cervical swelling. The patient suffered from a FL, since 2 yrs, last chemotherapy 10 months before US: 2,5cm large lymph node, oval with hilus preservation FC: CD5:10%, CD19:49%, CD23: 10%, FMC7: 0%, CD10:40%, CD10/19:40%, lambda light chains 40%, kappa light chains 0%. Cytological FC diagnosis: FL
52 Final lhistological i l diagnosis: i reactive hyperplasia with florid follicular proliferation!
54 Incidence, phenotypical and molecular data of non-lymphomatous, clonal B-cell population: a review of the literature Author/year organ sample n. of cases clinical background light chain restriction FC ICC IHH ( pos./total) IgH clonality PCR (pos./total) Berthold F, 1989 lymph node histology 1 Herpes virus 6 NP + (1/1)* negative Matsubayashi S, 1990 thyroid FNA 15 Hashimoto thyroiditis FC/ + (7/15) NP NR Cartagena N, 1992 lymph node FNA 86 NP ICC/ + (1/86) NP NR Jordan RC, 1996 minor salivary histology 50 Sjogren s syndrome NP + (4/50) NR glands follow up Zhou XG, 1999 lymph node tonsils histology 9 NR NP + (9/9) negative Saxena A, 2000 stomach histology 20 Helicobacter pylori NP + (10/20) negative gastritis Kussik SJ, 2004 lymph node histology and FNA 6 5 negative,1 HIV FC/ + (6/6)* + (3/6) negative Chen H, 2006 thyroid histology 21 Hashimoto FC/ + (18/21) negative and FNA thyroiditis Venkatraman L, 2006 lymph node FNA 26 NHL, reactive, HIV (1case) ICC+ (1 HIV/26) + (1/26) negative Bangerter M, 2007 lymph node FNA 131 NR FC+ (3/131) NP negative Nam Cha SH, 2008 lymph node histology 8 Castleman s, LES, EBV, HIV (1 case) IHH/+ (8/8)* + (3/8) 6 negative, 2 developed NHL Bhargava P, 2008 lymph node FNA 1 HIV FC/+ negative Zeppa P, 2009 thyroid FNA 34 Hashimoto thyroiditis FC/+ (5/34) negative Fan HB, 2009 liver histology 40 HCV hepatitis + (4/40) negative
55 FUTURE PERSPECTIVES New antibodies for diagnosis Schniederjan SD et al.: A novel flow cytometric antibody panel for distinguishing Burkitt lymphoma fromcd10+ diffuse large B cell lymphoma. Am J Clin Pathol. 2010;133: expression of CD44 and CD54 differs significantly between BL and CD10+ DLBCL.. Leshchenko et al.: Genomewide DNA methylation analysis reveals novel targets for drug development in mantle cell lymphoma. Blood. 2010;116:1025..CD37 surface expression in 93% MCL.
56 FUTURE PERSPECTIVES
57 Non Hodgkin lymphoma, monoclonal lantibodies and Flow Cytometry Monoclonal antibodies have a direct action against IgG constant regions and a cross fire effect (radio conjugated) Flow cytometry may quantify the target cells by the evaluation of antigen coexpression and their numerical evaluation
58 FUTURE PERSPECTIVES Högerkorp CM et al.: Identification of uniquely expressed transcription factors in highly purified B cell lymphoma samples. Am J Hematol. 2010;85:418. AndréassonU et al.: Identification of molecular targets associated with transformed diffuse large B cell lymphoma using highly purified tumor cells. Am J Hematol. 2009;84:803.
59 acknowledgments Prof. L. Palombini Dr. A. Iaccarino Prof. A. Vetrani Prof. G. Troncone Dr. I. Cozzolino Dr. C. Frangella Dr. U. Malapelle Dr. F. Plaitano Dr. M. Russo Dr. M. Salatiello Dr. L.V. Sosa Fernandez
61 mantle cell lymphoma and mtor gene activationation Farnesyltransferase (Rapamicyn): hampers the progression G1 S inhibiting the transduction of mtor, reduces cyclin D2 D3 and increases CDk and p27 p27 may be evaluated on FNC samples by FC or ICC P27/kip1
62 lymphoplasmacytic lymphoma
63 why cytology for lymphomas? Lymphomas are an increasing pathology: new cases per year in USA 30% of these patients will develop recurrences 30% develop non lymphomatous swellings Non invasive procedures do not produce definitive diagnoses* *Zinzani PL, et al.: Histological verification of positive positron emission tomography findings in the follow up of patients with mediastinal lymphoma. Haematologica. 2007; 9()77 92(6):
64 palpable lymph node 148 thyroid 13 parotid 15 breast 4 impalpable us/ct guided lymph node 98 spleen 20 liver 2 small bowel 1 FNC/FC inadequate 15 suspicious 10 BRH 135 NHL 70 soft tissue 5 soft tissue 1 NHLr 77 Total 185 Total 122 Total 307
65 Follicular lymphoma (FL)
66 new drugs for non Hodgkin lymphomas DRUG PATHOGENETIC TARGET MECHANISM TARGET Antisense oligonucleotides Bcl-2 over expression Inhibition of target gene Follicular lymphoma (Bcl-2 antisense) G3139 chemotherapy resistance Anti ubiquitin proteasome NF-kB over (Bortezomib) expression p21, p27 degradation Anti ubiquitin proteasome action Myeloma, p21, p27 restoration Mantle, Marginal, Small lymphocytic lymphoma Protease inhibitors Farnesyltransferase (Rapamicyn) mtor gene activation progression G1 - S Transduction inhibition of mtor cyclin D2, D3 reduction CDK, p27 increase Mantle cell lymphoma Monoclonal antibodies Clonal expansion of Direct action against IgG constant region, Follicular lymphoma (unconjugated and radioconjugated): anti CD20 (Rituximab) anti CD22(Epratuxumab) anti HLA-DR(Apolizumab) lymphocytes cross-fire effect (radioconjugated) Histone deacetylase inhibitors depsipepside, hydroxamic acids (TSA,SAHA) 3q27 translocation bcl-6 over expression Bcl-6 gene deacetylation Diffuse large B-cell lymphoma
67 new drugs for non Hodgkin lymphomas DRUG PATHOGENETIC TARGET MECHANISM TARGET Antisense oligonucleotides (Bcl-2 antisense) G3139 Bcl-2 over expression chemotherapy resistance Inhibition of target gene Follicular lymphoma Anti ubiquitin proteasome (Bortezomib) NF-kB over expression p21, p27 degradation Anti ubiquitin proteasome action p21, p27 restoration Myeloma, Mantle, Marginal, Small lymphocytic y lymphoma Farnesyltransferase, (Rapamicyn) mtor gene activation progression G1 - S Transduction Inhibition of mtor cyclin D2,D3 riduction CDK, P27 increase Mantle cell lymphoma Monoclonal antibodies (unconjugated and radioconjugated): anti CD20 (Rituximab) anti CD22 (Epratuxumab) anti HLA-DR (Apolizumab) Clonal expansion of lymphocytes Direct action against IgG constant region, cross-fire effect (radio conjugated) Follicular lymphoma Histone deacetylase inhibitors:depsipepside, hydroxamic acids (TSA, SAHA) 3q27 translocation bcl-6 over expression Bcl-6 gene deacetylation Diffuse large B-cell lymphoma
68 marginal zone B-cell lymphoma
69 Diffuse large B cell lymphoma (DLBCL)
70 Past Leukeran Present watch and wait (indolent) Chemotherapeutic agents: COP, Fludarabina, Antraciclina (low grade). CHOP (high grade) therapy of non Hodgkin lymphomas Future Protease inhibitors: Farnesyl transferase Antisense oligonucleotides: Bcl 2 antisense Monoclonal antibodies: Unconjugates: Rituximab (anti CD20), Epratuxumab (anti CD22), Apolizumab, (anti CD52) Radioconjugates: Iodine 131 anti CD20 CD20, 90 Yttrium anti CD20 Monoclonal antibody: Rituximab (anticd20) Bone marrow transplantation Histone deacetylase inhibitors: depsipepside, hydroxamic acids (TSA, SAHA) Vaccines
71 new drugs for non Hodgkin lymphomas Antifolate: Pralatrexate, PTL Heat Shock Protein Inhibitors DLBCL Antiangiogenetic Aggressive NHL 15th Congress of the European Hematology Association, Barcelona June 2010 Monoclonal antibodies bi-specific T-cell engager (BiTE) (Blimatumomab)
72 Lymphomas are the most complex and heterogeneous set of human malignancies Lymphomas comprise some of the fastest (Burkitt, lymphoblastic) and slowest growing (small lymphocytic, follicular low grade) malignancies
80 Chronic lymphatic leukemia/small lymphocytic lymphoma (CLL/SLL) lambda kappa ICC of SLL/CLL on cytospins showing negativity for lambda and positivity for kappa light chains (peroxidase/anti peroxidase immunostain)
81 LymphoplasmacytoidLymphoma Lymphoma (LPCL)
82 Diffuse large B cell lymphoma (DLBCL) GCB (germinal center B) ABC (peripheral B cell) 5 years overall survival GCB ABC 76% 24% Alizadeh AA et al: Distinct types of diffuse large B cell lymphoma identified by gene expression profiling. fl Nature 2000; 3;403:503.
LYMPHOMA BACHIR ALOBEID, M.D. HEMATOPATHOLOGY DIVISION PATHOLOGY DEPARTMENT Columbia University/ College of Physicians & Surgeons Normal development of lymphocytes Lymphocyte proliferation and differentiation:
Lymphoma Diagnosis and Classification By Atef Shrit, MD, Pathology B- and T/NK-cell lymphomas are clonal neoplasms of immature and mature B-lymphocytes, T-lymphocytes or natural killer cells at various
Malignant Lymphomas and Plasma Cell Myeloma Dr. Bruce F. Burns Dept. of Pathology and Lab Medicine Overview definitions - lymphoma lymphoproliferative disorder plasma cell myeloma pathogenesis - translocations
Mature Lymphoproliferative disorders (2): Mature B-cell Neoplasms Dr. Douaa Mohammed Sayed Small lymphocytic lymphoma/b-cell chronic lymphocytic leukemia BMB: nodular, interstitial, diffuse or a combination
Bone Marrow Evaluation for Lymphoma Faizi Ali, MD Hematopathology Fellow William Beaumont Hospital Indications One of the most common indications for a bone marrow biopsy is to evaluate for malignant lymphoma.
Aggressive lymphomas Michael Crump Princess Margaret Hospital What are the aggressive lymphomas? Diffuse large B cell Mediastinal large B cell Anaplastic large cell Burkitt lymphoma (transformed lymphoma:
MALIGNANT LYMPHOMAS Dr. Olga Vujovic (Updated August 2010) Malignant lymphomas consist of Hodgkin and non-hodgkin lymphomas. The current management of these diseases involves a multi-disciplinary approach.
Interesting Case Review Renuka Agrawal, MD Dept. of Pathology City of Hope National Medical Center Duarte, CA History 63 y/o male with h/o CLL for 10 years Presents with worsening renal function and hypercalcemia
About B Cell Lymphomas Groupmeeting Klipp/Spang, December 09 2002 Dennis Kostka Max-Planck-Institute for Molecular Genetics Computational Molecular Biology Berlin 1 Overview Short History of Lymphoma Classification
New Developments in Mantle Cell Lymphoma John P. Leonard, M.D. Richard T. Silver Distinguished Professor of Hematology and Medical Oncology Associate Dean for Clinical Research Vice Chairman, Department
A 32 year old woman comes to your clinic with neck masses for the last several weeks. Masses are discrete, non matted, firm and rubbery on examination. She also has fever, weight loss, and sweats. What
Non-Hodgkin s Lymphoma Luis Fayad, MD Assistant Professor Clinical Medical Director Lymphoma/Myeloma Department Non-Hodgkin s Lymphoma Non-Hodgkin s lymphomas (NHL) are a heterogeneous group of malignant
Leukemias and Lymphomas: A primer Normal blood contains circulating white blood cells, red blood cells and platelets 700 red cells (oxygen) 1 white cell Neutrophils (60%) bacterial infection Lymphocytes
Diffuse Large B-cell Lymphoma, Burkitt Lymphoma and the Gray Zone L. Jeffrey Medeiros, M.D. M.D. Anderson Cancer Center Relative Frequency of B-cell NHL Diffuse large B-cell lymphoma 37 % Follicular lymphoma
Gabriele Pozzato M.D. University of Trieste Anti-HCV therapy in HCV-related NHL Questions about HCV+ in NHL Is the NHL related with HCV infection? Which is the best therapeutic strategy? Is the antiviral
Clin Lab Med 27 (2007) 487 512 Flow Cytometric Evaluation of B-cell Lymphoid Neoplasms Fiona E. Craig, MD Division of Hematopathology, Department of Pathology, University of Pittsburgh School of Medicine,
Additional Questionnaire (MED C) CALM study Inclusion period: 01/01/2008 to 31/12/2011 PATIENT REGISTRATION FORM Disease Diagnosis Lymphoma S Non Hodgkin Lymphoma (NHL) Mature B-cell neoplasm Follicular
2012 1 31,, PROTOCOLS FOR TREATMENT OF MALIGNANT LYMPHOMA Version 1.0 2012 DIVISION OF HAEMATOLOGY / ONCOLOGY DEPARTMENT OF MEDICINE KAOHSING VETERAN GENERAL HOSPTIAL General Guide Diagnosis 1.Adequate
Self evaluation 1 Clinical Case 55-year-old woman Bilateral enlargement of cervical, axillary and inguinal lymph nodes, largest diameter > 6 cm Hepatosplenomegaly. Enlargement of retroperitoneal, mesenteric
An overview of CLL care and treatment Dr Dean Smith Haematology Consultant City Hospital Nottingham What is CLL? CLL (Chronic Lymphocytic Leukaemia) is a type of cancer in which the bone marrow makes too
Immunohistochemical classification of malignant lymphomas Prof. Mogens Vyberg NordiQC Institute of Pathology Aalborg, Denmark Thanks to Jan Klos Important issues Distinction from non-hematopoietic neoplasms
Non Hodgkin Lymphoma: Non Hodgkin Lymphoma, often referred to as NHL, is a cancer originating in the lymphocytes, a type of blood cell, which are integral to the body s immune system. Non Hodgkin Lymphoma
Cancer is a major cause of morbidity and mortality in dogs. Approximately 25% of dogs will die as a result of cancer. 1 Lymphoma is one of the most common cancers in dogs and is the most common one treated
Hello, I m Lauren Berger and I m the Senior Director of Patient Services Programs at The Leukemia & Lymphoma Society. I m pleased to welcome Dr. Rebecca Elstrom. Dr. Elstrom is an Assistant Professor in
Non-Hodgkin Lymphoma Richard Orlowski, MD The American Cancer Society (ACS) estimates that 69,740 Americans will be diagnosed with non-hodgkin lymphoma (NHL) in 2013. Excluding non-melanoma skin cancers,
Current Diagnostic Pathology (2000) 6, 55 63 2000 Harcourt Publishers Ltd doi:10.1054/cdip.2000.0015, available online at http://www.idealibrary.com on REVIEW Immunophenotyping in the differential diagnosis
Two Retroperitoneal Low-Grade B-Cell Lymphoma Successfully Treated With a Combination of Chimeric Anti-CD20 Monoclonal Antibody and CHOP Chemotherapy Yoichi Kitamura, MD Kazuhiko Hayashi, MD Kazumi Uchida,
ABOUT BLOOD CANCERS Leukemia, Hodgkin lymphoma (HL), non-hodgkin lymphoma (NHL), myeloma, myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPNs) are types of cancer that can affect the
(Form 2018) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form. E-mail comments regarding the content
Diffuse Large B-Cell Lymphoma: Variants & Subtypes Patrick Treseler, MD, PhD University of California San Francisco Subclassifying DLBCL An Entity in Search of a Meaningful Classification Subclassifying
Flow Cytometric Diagnosis of Low Grade B-cell Leukemia/Lymphoma Maryalice Stetler-Stevenson, M.D., Ph.D. Flow Cytometry Unit, Laboratory of Pathology, DCS, NCI,NIH DEPARTMENT OF HEALTH & HUMAN SERVICES
LEUKEMIA LYMPHOMA MYELOMA Advances in Clinical Trials OUR FOCUS ABOUT emerging treatments Presentation for: Judith E. Karp, MD Advancements for Acute Myelogenous Leukemia Supported by an unrestricted educational
UPDATE ECIL-4 2011 2011 Update on the ECIL-3 guidelines for EBV management in patients with leukemia and other hematological disorders Jan Styczynski, Hermann Einsele, Rafael de la Camara, Catherine Cordonnier,
Waldenström Macroglobulinemia: The Burning Questions IWMF Ed Forum May 18 2014 Morie Gertz MD, MACP Are my kids going to get this? Familial seen in approximately 5 10% of all CLL patients and can be associated
What is non-hodgkin lymphoma, how is it treated, and what is the unmet need? Tim Illidge BSc PhD MRCP FRCR FRCPath Institute of Cancer Sciences, University of Manchester Manchester Cancer Research Centre,
CANCER FISH PROBES INDIVIDUAL AND PANEL S Acute Lymphoblastic Leukemia (ALL) ALL FISH Panel (includes all probes below) 8010 LSI MYB/CEP6 LSI p16 (CDKN2A) LSI BCR/ABL with ASS LSI ETV6 (TEL)/AML1 (RUNX1)
Indications Cytology of Lymph Nodes Lymph node enlargement That was easy Mary Anna Thrall Don Meuten Indications Lymph node enlargement Suspect metastasis Normal sized lymph nodes are Normal Do NOT aspirate
Metastatic breast cancer Immunostain Update: Diagnosis of metastatic breast carcinoma, emphasizing distinction from GYN primary 1/3 of breast cancer patients will show metastasis 1 st presentation or 20-30
Malignant Lymphomas Donald Innes, M.D. with special thanks to John Cousar, M.D. Hodgkin Lymphoma and Non-Hodgkin Lymphomas I. Overview of the Lymphoid System: 1. The lymphoid system consists of circulating
Lymphoplasmacytic Lymphoma versus IGM Multiple Myeloma Hematology fellows conference 4/12/2013 Christina Fitzmaurice, MD, MPH Hematology consult patient 48 yo woman presents to ER with nonspecific complaints:
General Rules SEER Summary Stage 2000 Linda Mulvihill Public Health Advisor NCRA Annual Meeting May 2014 National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention
HOVON Staging and Response Criteria for Non-Hodgkin s Lymphomas Page 1 This document describes the minimally required staging and evaluation procedures and response criteria that will be applied in all
Interesting Case Series Periorbital Richter Syndrome MarkGorman,MRCS,MSc, a Julia Ruston, MRCS, b and Sarath Vennam, BMBS a a Division of Plastic Surgery, Royal Devon and Exeter Hospital, Exeter, Devon,
TEL #: (650) 725-5604 FAX #: (650) 725-7409 Med. Rec. No.: Date of Procedure: Sex: A ge: Date Received: Date of Birth: Account No.: Physician(s): Client Name Address SPECIMEN SUBMITTED: LEFT PIC BONE MARROW,
Neoplasms (C00-D49) March 2014 2014 MVP Health Care, Inc. CHAPTER SPECIFIC CATEGORY CODE BLOCKS C00-C14 Malignant neoplasms of lip, oral cavity and pharynx C15-C26 Malignant neoplasms of digestive organs
Update in Hematology Oncology Targeted Therapies Mark Holguin 25 years ago Why I chose oncology People How to help people with possibly the most difficult thing they may have to deal with Science Turning
Activation and effector functions of HMI Hathairat Thananchai, DPhil Department of Microbiology Faculty of Medicine Chiang Mai University 25 August 2015 ว ตถ ประสงค หล งจากช วโมงบรรยายน แล วน กศ กษาสามารถ
c o n s u l t a n t o n c a l l O N C O L O G Y David M.Vail, DVM, Diplomate ACVIM (Oncology), University of Wisconsin Madison Lymphoma in Dogs: Diagnosis & Treatment Profile Definitions Lymphoma can be
Lec.5 Z.H.Al-Zubaydi Medical Physiology White Blood Cells (WBCs) or Leukocytes Although leukocytes are far less numerous than red blood cells, they are important to body defense against disease. On average,
1 2 3 4 The FAB assigns a cut off of 30% blasts to define AML and relies predominantly on morphology and cytochemical stains (MPO, Sudan Black, and NSE which will be discussed later). Subtypes of AML follow
Update on Diagnosis and Treatment of Lymphoma Wei Ai, M.D., Ph.D. Assistant Clinical Professor of Medicine May 2010 Cancer Incidence New Cancer Cases Lymphoma 63,000 - NHL 53,600 - HL 75,00 Cancer Death
Indolent Lymphomas American Academy of Insurance Medicine 121 st Annual Meeting Hilton LaJolla October 2012 Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Joseph Mikhael, MD, MEd, FRCPC,
Update on Follicular Lymphoma Brad Kahl, M.D. Follicular Lymphoma: 25% of NHL Cases Other subtypes (9%) T and NK cell (12%) Burkitt (2.5%) Diffuse large B cell (DLBCL) (30%) Mantle cell (6%) Follicular
Chemotherapy Options Stephanie A. Gregory, M.D. The Elodia Kehm Professor of Medicine Director, Section of Hematology Rush University Medical Center Chicago, Illinois Frequency of NHL Subtypes in Adults
CLINICAL Extent of disease before any treatment y clinical staging completed after neoadjuvant therapy but before subsequent surgery PRIMARY TUMOR (T) No T category exists for Hodgkin and Non-Hodgkin Lymphoma
Fighting cancer with information Report series: General cancer information Eastern Cancer Registration and Information Centre ECRIC report series: General cancer information Cancer is a general term for
o The Lymphatic System and Body Defenses Lymphatic system Anatomy Non specific defenses o The Lymphatic System Consists of two semi-independent parts Lymphatic vessels Lymphoid tissues and organs Lymphatic
Pathology of lung cancer EASO COURSE ON LUNG CANCER AND MESOTHELIOMA DAMASCUS (SYRIA), MAY 3-4, 2007 Gérard ABADJIAN MD Pathologist Associate Professor, Saint Joseph University Pathology Dept. Hôtel-Dieu
CHAPTER 26 LATE BREAKING DEVELOPMENTS: IMPACT OF ANTI-CD20 MONOCLONAL ANTIBODIES ON LYMPHOMA THERAPY 26.1 Introduction rituximab Subsequent to the completion of drafts for the guidelines earlier in 2004,
Lymphoid Neoplasms Sylvie Freeman Department of Clinical Immunology, University of Birmingham Incidence of Haematological Malignancies UK2001 (CRUK) Malignancy New Cases All Cancers 271,000 Leukaemia 6,760
SUMMARY A PRACTICAL GUIDE TO LEUKEMIA IN DOGS AND CATS Maxey L. Wellman, DVM, PhD, DACVP (Clinical Pathology) Professor, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State
Immuno-Oncology Therapies to Treat Lung Cancer What you need to know ONCHQ14NP07519 Introduction: Immuno-oncology represents an innovative approach to cancer research that seeks to harness the body s own
Name Period Our students consider this chapter to be a particularly challenging and important one. Expect to work your way slowly through the first three concepts. Take particular care with Concepts 43.2
Seattle Montreal IAP September 2006 Case Presentations Allen M. Gown, M.D. Medical Director and Chief Pathologist PhenoPath Laboratories Clinical Professor of Pathology University of British Columbia Case
Human Immunity How our body s cells defend against microbial and viral invaders What is Immunity? The word immunity comes from the Latin immunus meaning free of burden. Thus; it is a body s general ability
for Leucocyte Immunophenotyping Leukaemia Interpretation All Participants Participant: 4xxxx Trial No: 141502 Date Issued: 08-September-2014 Closing Date: 26-September-2014 Trial Comments This was an electronic
The Lymphatic System Transports escaped fluids back to the blood Plays essential roles in body defense and resistance to disease Lymph excess tissue fluid carried by lymphatic vessels Properties of lymphatic
Are CAR T-Cells the Solution for Chemotherapy Refractory Diffuse Large B-Cell Lymphoma? Umar Farooq, MD University of Iowa Hospitals and Clinics Disclosure(s) I do not intend to discuss an off-label use
Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for CLL and SLL File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplantation_for_cll_and_sll
Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against
Non-Hodgkin Lymphoma What is non-hodgkin lymphoma? Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas
CAR T cell therapy for lymphomas Sattva S. Neelapu, MD Associate Professor and Deputy Chair ad interim Department of Lymphoma and Myeloma UT MD Anderson Cancer Center, Houston, TX CAR T cell therapy What
Acute myeloid leukemia (AML) Adult acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes abnormal myeloblasts (a type of white blood cell), red blood cells, or platelets. Adult
Brochure More information from http://www.researchandmarkets.com/reports/1215469/ Pipeline Insight: Lymphomas, Multiple Myeloma & Myelodysplastic Syndromes - Optimization of clinical practice creates opportunities
Dr. Anthony C.H. YING What are? Tumour markers are substances that can be found in the body when cancer is present. They are usually found in the blood or urine. They can be products of cancer cells or
Cytology of Pleural Fluid as a Diagnostic Challenge Paavo Pääkkö,, MD, PhD Chief Physician and Head of the Department Department of Pathology, Oulu University Hospital,, Finland Oulu University Hospital
Introduction 1.1 Introduction: About 10,500 new cases of acute myelogenous leukemia are diagnosed each year in the United States (Hope et al., 2003). Acute myelogenous leukemia has several names, including
Track 2: Treatment Options [Narrator] Many people with non-hodgkin lymphoma have found an educational support group helpful. Support groups take many forms: some meet the needs of people with all kinds
143 Chapter 10 Human Immuno Deficiency Virus Infection Chapter 10 Human Immuno Deficiency Virus Infection...143 HIV infection...144 Clinical Features...146 Clinical Staging of HIV infection recommended
False positive PET in lymphoma Thomas Krause Introduction and conclusion 2 3 Introduction 4 FDG-PET in staging of lymphoma 34 studies with 2227 Patients CT FDG-PET Sensitivity 63 % 89 % (58%-100%) (63%-100%)