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  • 1
    In: Pathobiology, S. Karger AG
    Abstract: Introduction: Primary effusion lymphoma (PEL) is a malignant lymphomatous effusion, which by definition is Kaposi sarcoma herpesvirus/human herpesvirus 8-positive. PEL typically occurs in HIV-infected patients, but can also occur in HIV-negative individuals, including in organ transplant recipients. Tyrosine kinase inhibitors (TKIs) are currently the standard of care for patients with chronic myeloid leukemia (CML), BCR::ABL1-positive. Although TKIs are extremely effective in treating CML, they alter T-cell function by inhibiting peripheral T-cell migration and altering T-cell trafficking and have been associated with the development of pleural effusions. Case Presentation: We report a case of PEL in a young, relatively immunocompetent patient with no history of organ transplant receiving dasatinib for CML, BCR::ABL1-positive. Discussion: We hypothesize that the loss of T-cell function secondary to TKI therapy (dasatinib) may have resulted in the unchecked cellular proliferation of KSHV-infected cells, leading to the emergence of a PEL. We recommend cytologic investigation and KSHV testing in patients being treated with dasatinib for CML who present with persistent or recurrent effusions.
    Type of Medium: Online Resource
    ISSN: 1015-2008 , 1423-0291
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483541-1
    SSG: 12
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  • 2
    In: Acta Cytologica, S. Karger AG, Vol. 64, No. 1-2 ( 2020), p. 71-80
    Abstract: In the era of smaller and smaller biopsies submitted to pathology departments for diagnosis and the advent of personalized medicine, it has become imperative to efficiently and effectively use patient material to reach individualized, actionable diagnoses. The use of fine needle aspirates and core biopsies as acceptable methods for obtaining sufficient material for hematopoietic neoplasms under nonemergent conditions is debatable. There are, however, scenarios where only limited material is obtainable due to anatomic site, size of the lesion or condition of the patient. In these types of settings, thoughtful approaches and unconventional means are often necessary to reach a diagnosis. In this article, we describe three such scenarios and the unique tactics taken in each to obtain a personalized actionable diagnosis.
    Type of Medium: Online Resource
    ISSN: 0001-5547 , 1938-2650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2256676-4
    SSG: 12
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  • 3
    In: Acta Haematologica, S. Karger AG, Vol. 118, No. 4 ( 2007), p. 209-214
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 The 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 mutation, which has been found in patients with myeloproliferative disorders (MPD), has not yet been evaluated in lymphoproliferative disor- ders by any adequately sensitive techniques. 〈 i 〉 Methods: 〈 /i 〉 We investigated whether low levels of 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 are present in lymphoid neoplasms using a highly sensitive and highly specific amplification refractory mutation system PCR (ARMS-PCR) assay. 〈 i 〉 Results: 〈 /i 〉 While 234 of 237 cases did not carry the 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 allele, it was identified in the bone marrow of 3 B cell lymphoma patients. The mutation was found to be neither associated with the lymphomas per se, nor with any signs, symptoms or laboratory findings of MPD. Moreover, 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 appeared subsequently in the peripheral blood of 2 of the 3 patients. 〈 i 〉 Conclusion: 〈 /i 〉 These findings suggest that 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 arises in the bone marrow of individuals before clinical manifestation of any myeloid disorders. Presence of 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 in bone marrow might therefore increase the risk of future MPD development, just as monoclonal gammopathy of undetermined significance (MGUS) increases the risk of multiple myeloma. We term this phenomenon ‘ 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 of undetermined significance’ (JMUS). Its clinical significance remains to be determined. To our knowledge, these findings represent the first identification of 〈 i 〉 JAK2 〈 /i 〉 〈 sup 〉 V617F 〈 /sup 〉 in the bone marrow of patients without myeloid malignancies.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 4
    In: Pathobiology, S. Karger AG, Vol. 88, No. 1 ( 2021), p. 56-68
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 A novel coronavirus, SARS-CoV-2, was identified in Wuhan, China in late 2019. This virus rapidly spread around the world causing disease ranging from minimal symptoms to severe pneumonia, which was termed coronavirus disease (i.e., COVID). Postmortem examination is a valuable tool for studying the pathobiology of this new infection. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We report the clinicopathologic findings from 32 autopsy studies conducted on patients who died of COVID-19 including routine gross and microscopic examination with applicable special and immunohistochemical staining techniques. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 SARS-CoV-2 infection was confirmed by nasopharyngeal RT-PCR in 31 cases (97%) and by immunohistochemical staining for SARS-CoV-2 spike-protein in the lung in the remaining 1 case (3%). The ethnically diverse cohort consisted of 22 males and 10 females with a mean age of 68 years (range: 30–100). Patients most commonly presented with cough (17 [55%]), shortness of breath (26 [81%] ), and a low-grade fever (17 [55%]). Thirty-one (97%) of the patients had at least 1 comorbidity (mean = 4). Twenty-eight patients (88%) had widespread thromboembolic disease, as well as diffuse alveolar damage (30 [94%] ), diabetic nephropathy (17 [57%]) and acute tubular injury. Patterns of liver injury were heterogeneous, featuring 10 (36%) with frequent large basophilic structures in sinusoidal endothelium, and increased immunoblast-like cells in lymph nodes. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 This series of autopsies from patients with COVID-19 confirms the observation that the majority of severely affected patients have significant pulmonary pathology. However, many patients also have widespread microscopic thromboses, as well as characteristic findings in the liver and lymph nodes.
    Type of Medium: Online Resource
    ISSN: 1015-2008 , 1423-0291
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1483541-1
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    S. Karger AG ; 2018
    In:  Acta Cytologica Vol. 62, No. 2 ( 2018), p. 130-136
    In: Acta Cytologica, S. Karger AG, Vol. 62, No. 2 ( 2018), p. 130-136
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We sought to assess the utility and limitations of both flow cytometry (FC) and cytology for the analysis of cerebrospinal fluid (CSF) in a practical clinical setting. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 393 consecutive CSF samples from 171 patients submitted for both cytomorphologic and FC assessments were analyzed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Both FC and cytology findings were negative for malignancy in 315/393 samples (80%), and either positive (POS) or suspicious/atypical (SUSP/AT) in 7% of samples. This resulted in high agreement between FC and cytology (87%). Minor discrepancies were present in 4% of the cases. In 28 samples, an abnormal population was detected by FC but not by cytology. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 FC and cytology are important complementary methods for analyzing CSF samples. In cases where cytology is SUSP/AT and FC is inconclusive or negative, additional specimens should be submitted for immunostaining, cytogenetics, and/or molecular studies.
    Type of Medium: Online Resource
    ISSN: 0001-5547 , 1938-2650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2256676-4
    SSG: 12
    Location Call Number Limitation Availability
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