Plasmablastic Lymphoma in a Previously Undiagnosed Human Immunodeficiency Virus-Positive Patient: A Case Report

Plasmablastic lymphoma (PBL) is a rare and aggressive non-Hodgkin lymphoma subtype associated with human immunodeficiency virus (HIV) infection. PBL is extremely aggressive and has a poor response to treatment. Clinically PBL resembles a periodontal disease, Kaposi sarcoma, or melanoma. Delayed diagnosis adversely affects the treatment and life expectancy. A 52-year-old male presented with a firm intraoral mass causing a slight elevation noticeable extraorally. Radiologically, loss of lamina dura around the first premolar and loss of both vertical and horizontal bone height around the dental implant replacing the second premolar were present. The biopsy confirmed a diagnosis of PBL. Further evaluation revealed that the patient was positive for HIV. The chemotherapy regimen included etoposide, vincristine, hydroxydaunorubicin, cyclophosphamide, and prednisolone, followed by an autologous hematopoietic stem cell bone marrow transplant. This article attempts to describe the clinical presentation and histopathological evaluation of PBL, and emphasize the paramount role of biopsy, early clinical suspicion, and correct diagnosis

CD30 (+), EBV (+) Atipik B hücrelerinin eşlik ettiği sitotoksik fenotipli periferik T hücreli lenfoma: İnterfoliküler yayılım paternli Hodgkin lenfoma benzeri prezentasyonl

Giriş: Reed-Sternberg benzeri hücreler T hücreli lenfomalarda sıklıkla görülebilmekte olup, bazı durumlarda Hodgkin lenfoma ile ayırıcı tanı zorluğuna neden olabilir. Olgu: Boyunda şişlik ve kilo kaybı şikayeti ile başvuran, ateş ve gece terlemesi tarifleyen 22 yaşında erkek hastaya yapılan PET-BT incelemesinde supra ve infradiafragmatik tüm istasyonlarda, yaygın konglomere lenfadenopati, splenomegali ve artmış FDG tutulumları saptandı. 1,5 cm çapındaki sol aksiller lenf nodu eksizyonel biyopsi materyalinde lenf gangliyonu çatısı büyük ölçüde korunmakta olup, sinüsler açıktı. İnterfoliküler alanda yer yer genişleme, eozinofiller ve histoyositler içeren zeminde mono-multilobüle nüveli, nükleolleri belirgin iri-atipik hücreler görüldü. Antijenik incelemede hedef hücrelerde CD30 (+), CD15 (-), EBV-LMP (+), CD3 (-), CD20 seyrek zayıf(+), Pax5 zayıf(+) bulundu. Bulgular ön planda Hodgkin lenfoma, klasik tip, interfoliküler yayılım paterni ile uyumlu olarak yorumlandı. Üç kür ABVD tedavisi alan hastada yanıt alınamaması nedeniyle PET incelemede daha yoğun FDG tutan 2,3 cm çapındaki inguinal lenf gangliyonu eksizyonu yapıldı. Kesitlerinde çatıyı silen, yer yer nekrozun da eşlik ettiği iki ayrı komponentten oluşan diffüz infiltrasyon görüldü. Komponentlerden biri ilk eksizyonda da görülen EBV ve CD30 (+) B hücre fenotipli iri atipik hücreler olup, ilk örnekten farklı olarak CD20 ve CD79alfa ile yaygın pozitiflik göstermekteydi. İkinci komponent zemindeki yüksek proliferatif kapasiteye sahip (%70) orta büyüklükteki atipik lenfositlerden oluşmakta olup, immunhistokimyasal olarak CD3 (+), CD5 (+), CD8 (+), TİA, Perforin ve GranzimB kısmen (+) saptandı. Bulgular CD30 ve EBV (+) B hücrelerinin eşlik ettiği sitotoksik fenotipli periferik T hücreli lenfoma olarak değerlendirildi.Sonuç: Reed-Sternberg benzeri hücreler anjioimmünoblastik T hücreli lenfoma başta olmak üzere T hücreli lenfomalara eşlik edebilmektedir. Sıklıkla CD30 ve EBV pozitif olan bu hücreler, olgumuzdaki gibi asıl lezyonun örneklenmediği ya da fokal tutulum gösteren ve T hücreli komponentin belirgin izlenmediği durumlarda Hodgkin lenfoma yanılgısına neden olabilir. Hastalık tutulumunun doğru olarak değerlendirilebilmesi için örneklemenin yapılacağı lenf gangliyonunun seçimi ve klinik tablo özellikleri büyük önem taşımaktadı

Effect of asymptomatic COVID-19 infection on the placenta in the third trimester of pregnancy: A prospective case-control study Term gebeliklerde asemptomatik COVID-19’un plasentaya etkisi: Prospektif olgu-kontrol çalışması

© 2022 by Turkish Society of Obstetrics and Gynecology.Objective: To clarify the effect of asymptomatic coronaviruse disease-2019 (COVID-19) positivity on the placenta in the third trimester of pregnancy. Materials and Methods: This prospective, case-control study included 30 pregnant women diagnosed with asymptomatic COVID-19 between April 30, 2021 and July 20, 2021 who delivered after the 34th gestational week, and a control group of 30 pregnant women without COVID-19, who delivered between April 2021 and July 2021, matched to the study group regarding age, gestational age and body mass index. Outcomes were compared in terms of demographic characteristics, serum blood outcomes, neonatal results, complications and placental histopathological findings. Results: The mean age of the study population was 28.8 years and the mean gestational week was 38.2 weeks. The C-reactive protein levels (38.2 mg/L vs 5.8 mg/L, p=0.001) and ferritin levels (266.4 μg/L and 40.5 μg/L, p=0.001) were significantly higher in the COVID-19-positive pregnant women. The lymphocyte level was significantly higher in the non-COVID-19 pregnant women (p=0.040). Mural hypertrophy was determined at a significantly higher rate in COVID-positive pregnant women (83.3% vs 30.0%, p=0.001). Multivariate regression analysis showed that only COVID-19 positivity increased the presence of mural hypertrophy in pregnant women with asymptomatic COVID-19 (4.716-fold, 95% confidence interval=1.012-22.251). Conclusion: The results of this study demonstrated that asymptomatic COVID-19 had no significant effect on pregnancy and neonatal complications. However, mural hypertrophy in the placenta was found at a significantly higher rate in pregnant women with asymptomatic COVID-19

Protein kinase c delta expression in primary central nervous system lymphomas

Primary central nervous system lymphoma (PCNSL) is a highly aggressive non-Hodgkin lymphoma confined to the central nervous system. Diffuse large B cell lymphoma (DLBCL) is the most common subtype, and it follows a much more aggressive course than its systemic counterpart. Differential diagnosis of PCNSL and systemic DLBCL depends on clinical staging, which is expensive and time consuming. Protein kinase C delta (PKCD) is a protein with proapopitotic properties and has a major role in negative selection of B cells in germinal centers, a regulatory function in B cell receptor (BCR) pathway and MHC II expression. Mutations identified in its gene are reported to be unique for PCNSL and not encountered in systemic DLBCL. Our aim is to evaluate immunohistochemical (IHC) expression and the mutation status of PKCD in PCNSLs and systemic DLBCLs in order to find out whether PKCD could be a novel marker that could be used in differential diagnosis of both entities. A total of 43 cases diagnosed with PCNSL, and 43 cases diagnosed with systemic DLBCL were included in the study. Immunohistochemistry for PKCD antibody and Sanger sequencing targeting exon 16 and exon 18 of PKCD gene were performed. Although immunoreactivity for PKCD was observed in all PCNSL and 95.3% of systemic DLBCL cases, strong and diffuse staining was found to be more frequent in PCNSL than systemic diffuse large B cell lymphomas (p < 0.001). However, mutations defined in literature were not encountered in our cohort. While clinical staging is still the primary way for differential diagnosis of PCNSL and systemic DLBCL, the diffuse and strong PKCD expression can be used as a supportive feature for PCNSL diagnosis

Metastases to the Stomach: Clinicopathologic Features of Metastases Mimicking Gastric Primaries

Objective: Metastatic involvement of the stomach is a rare event. Our aim in this study was to document the clinicopathological findings in patients with gastric metastases and find out if there are any potentially significant features to be used in the differential diagnosis

Retrospective Analysis of Peripheral T-Cell Lymphoma Patients: Single Center 'Real-Life' Experience

Objective: Peripheral T-cell lymhomas (PTCLs) represent a heterogeous group of diseases, with poor long-term outcomes excluding ALK+ anaplastic large cell lymphoma (ALCL)