This study characterizes the clinicopathological spectrum of lymphoproliferations involving the breast nipple and/or areola. Morphologic, immunohistochemical, molecular-genetic, and clinical features of 58 specimens from 56 patients were analyzed. They were re-diagnosed as cutaneous lymphoid hyperplasia (CLH, n = 44); other benign lymphoid infiltrates (OBLI, n = 8); peripheral T-cell lymphoma, not otherwise specified (n = 1); cases with overlapping features of CLH and B-cell lymphoma (n = 3), one of them composed of spindle cells. Cutaneous lymphoid hyperplasia infiltrates were dense, composed mainly of B cells forming follicles with germinal centers (GC). Cutaneous lymphoid hyperplasia frequently showed features suggesting a malignancy as coalescing follicles with non-polarized germinal centers lacking mantle zones, and smudged infiltrates of lymphoid cells spreading into collagen (often as "Indian files"), smooth muscle, vessel walls, and nerve sheaths. Only two cutaneous lymphoid hyperplasias recurred; otherwise all patients are without disease (mean follow-up 62 months). Monoclonal rearrangement of immunoglobulin heavy chain gene was detected in five, and of T-cell receptor gamma gene in two cutaneous lymphoid hyperplasias using polymerase chain reaction (PCR), but the patients fared well too. In 47% of cases Borrelia burgdorferi was detected by polymerase chain reaction and/or serology, of which one was monoclonal. We conclude that cutaneous lymphoid hyperplasia is the most common lymphoproliferation of the breast nipple, rarely recognized clinically, and often overdiagnosed histologically as lymphoma.
- MeSH
- Borrelia burgdorferi MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- financování organizované MeSH
- geny TcR gama MeSH
- hyperplazie genetika mikrobiologie patologie MeSH
- imunohistochemie MeSH
- kožní nemoci genetika mikrobiologie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymeská nemoc komplikace MeSH
- lymfom patologie MeSH
- lymfoproliferativní nemoci genetika mikrobiologie patologie MeSH
- mladiství MeSH
- polymerázová řetězová reakce MeSH
- přestavba genů pro těžké řetězce B-lymfocytů MeSH
- prsní bradavky mikrobiologie patologie MeSH
- pseudolymfom genetika mikrobiologie patologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- MeSH
- analýza moči MeSH
- diagnostické techniky radioisotopové využití MeSH
- diagnostické zobrazování metody využití MeSH
- dítě MeSH
- histologické techniky využití MeSH
- lidé MeSH
- neuroblastom diagnóza MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- kongresy MeSH
Myelosarkóm je zriedkavý extramedulárny alebo kostný zhubný nádor, ktorý vzniká tumoriformnounádorovou proliferáciou myeloidných buniek na úrovni rôzneho štádia ich diferenciácie. Vyskytuje saobyčajne v súvislosti s iným klonálnym myeloproliferatívnym ochorením kostnej drene, a to najčastejšies procesom zo spektra akútnej myeloblastovej leukémie. Extramedulárna manifestácia procesumôže byť pritom primárna („de novo“), alebo sekundárna. Jeho diagnózu určuje komplex morfologických,imunohistochemických, cytogenetických a klinických parametrov. Tieto parametre však vykazujúznačnú individuálnu heterogenitu, čo negatívne spolu s nedokonalými princípmi jeho gradinguovplyvňuje jeho správnu diagnostiku a voľbu adekvátnej terapie. V práci sa predkladá integráciasúčasných poznatkov o myelosarkóme, vrátane jeho definície, typizácie, gradingu, biologickej manifestáciea odhadu prognózy ochorenia.
Myeloid sarcoma (myelosarcoma) represents a rare malignant tumour arising by extramedullary orbone tumour mass forming neoplastic proliferation of myeloid cells at different stages of their differentiation.It is usually associated with some clonal myeloproliferative disease – most often with someof acute myeloblastic leukemia types – and the extramedullary manifestation might be primary („denovo“) or secondary. The diagnosis of myelosarcoma is defined by a complex of morphologic, immunohistochemical,cytogenetical, and clinical parameters. However, all these parameters are individuallyheterogenous what might negatively influence the correct diagnosis and appropriate treatment selection.The paper includes an integration of recent information about the definition, typing, grading,biologic manifestation and prognosis of myeloid sarcoma.
