The incidence and preferential sites of malignant lymphomas were retrospectively investigated by reviewing archived pathological files (1985 to 1996) in 11 major hospitals in Yamagata Prefecture, a HTLV-1-nonendemic area of Japan. In addition, re-evaluation of 212 recent cases based upon the newly-published WHO classification was performed. The following results were obtained: 1) the actual number of lymphoma patients was increasing annually, 2) the incidence rate of extranodal lymphomas was 61.3%, with the gastro-intestinal tract and Waldeyer's ring being the major preferential sites, 3) the incidence of extranodal lymphomas seemed to be increasing annually, whereas that of nodal lymphomas was not, 4) B-cell lymphomas were dominant (69.8%), in a percentage similar to that of a previous nationwide investigation, 5) major categories among the B-cell lymphomas were diffuse large B-cell lymphoma, follicular lymphoma and extranodal B-cell lymphoma of MALT, 6) the percentage of T-cell lymphomas was less than that of the nationwide investigation, 7) angioimmunoblastic T-cell lymphoma was a major subtype of T-cell lymphoma, and 8) the incidence rate of Hodgkin lymphoma was 5.7% of total malignant lymphomas.
IL-11 is a cytokine considered to have potential for the treatment of thrombocytopenia patients undergoing chemotherapy. The administered dose of IL-11 must not facilitate growth of malignant cells in addition to its thrombopoietic effect. In this study we focused on malignant lymphoma (ML), in which thrombocytopenia is a common adverse effect of chemotherapy. Cells obtained from biopsied lymph nodes of 7 patients were cultured with and without recombinant human IL-11 (rhIL-11). Cells growth was analyzed by the MTT assay. rhIL-11 did not enhance the proliferation of the lymphoma cells at any concentration. We believe that rhIL-11 is an expected agent for ML patients by the potential to reduce chemotherapy-induced thrombocytopenia.
Mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) arises from Helicobacter pylori (H. pylori)-associated chronic gastritis, and eradication of H. pylori is an effective treatment in most cases. Using Wotherspoon and Isaacson's scoring system for the evaluation of gastric MALT lymphoma, in which grades up to 3 are considered reactive and grades 4 and 5 neoplastic, we assessed the histological findings of gastric biopsied specimens after eradication of H. pylori, and examined the relationship between the grade and the PCR-based monoclonality or the MIB-1 index. Expression of Ki-67 (MIB-1) antigen was examined immunohistochemically in 17 biopsied specimens from 3 patients, and 59 samples taken from these specimens were analyzed by PCR for immunoglobulin heavy chain gene rearrangement. Monoclonality was observed in 88%, 67%, and 17% of grade 5, 4 and 3 samples, respectively. No monoclonal band was detected in the samples of grades 1 and 2. The MIB-1 indices (mean±SD) in the interfollicular areas of grade 1 to 5 were 0.9±0.7, 0.9±0.2, 1.1±0.6, 1, 5±0.5, and 2, 9±1.6%, respectively. It is concluded that there is a good correlation between histological scoring and PCR-based monoclonality as well as MIB-1 indices.
Endemic and sporadic Burkitt's lymphoma differ in site and age of presentation, and Epstein-Barr virus (EBV) association. This study aimed to describe the clinical presentation, EBV association and p53 expression of Burkitt's lymphoma in 59 Malaysian patients. Expression of Bcl-2, retinoblastoma and Ki67 proteins was also investigated. EBV was detected by EBER in situ hybridization. Expression of p53, Bcl-2, pRb and Ki67 proteins was detected by immunohistochemical staining. Polymerase chain reaction was employed for EBV subtyping and detection of translocation t (14; 18). The male to female ratio was 3.9: 1. The most common age group was children younger than 15 years (72.9%), with a mean of 15.8y. The disease is more common in ethnic Chinese. EBV association is 33.3% and all were infected with type-A virus. Expressions of p53, Bcl-2, pRb and Ki67 proteins were detected in 42/49 (85.7%), 9/54 (16.7%), 47/51 (92.2%) and 35/39 (89.7%) of the biopsies, respectively. Translocation t (14; 18) was not detected in cases expressing the Bcl-2 protein. Clinical presentation and EBV association of Burkitt's lymphoma in Malaysian patients corresponds with that of sporadic Burkitt's lymphoma. This study also reveals that a substantial proportion of cases express high levels of p53 and retinoblastoma proteins, in contrast to the Bcl-2 protein.
We describe a rare case of a 68-year-old man with B-cell chronic lymphocytic leukemia (B-CLL) who developed autoimmune hemolytic anemia (AIHA) and anti-phospholipid syndrome (APS). On admission, he was diagnosed as having B-CLL and AIHA on the basis of CD5-positive B-lymphocytes infiltrated into his bone marrow and a positive Coombs test, respectively. Although the symptoms of B-CLL and AIHA were improved by chemotherapy, he developed deep-vein thrombosis, which was probably caused by a lupus anticoagulant. It was interesting that the thrombosis due to APS occurred following a decrease of hemolysis from AIHA after intensive chemotherapy.